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From: (Steven B. Harris )
Subject: Re: Ask for help-medical terms about deaths registry
Date: 06 Oct 1995

In <>

> My name is Pat Lau. Last month my father died suddenly. I really want to
> know the reason of his death. From the Deaths Registry I read the cause
> of death but I can't read it clearly. It is some words like "Coronary
> acclrsic by atheroma". I may spell the words wrong. I really need your
> help to tell me the meanings of these death cause!
> My father was about sixty, he was quite heathy in the past but always
> smoking and sometimes drinking. But one night of last month , after
> having the dinner he felt very sick and tired (want to vomit and
> defease). And he felt like somethings pressing on his chest. After
> sometimes he fainted and then a few minutes later he had no breath and
> puls. He was approved died before arrived to the hospital. I would like
> to know what cause this happened and why it suddenly happened. Moreover,
> I would like to know by what ways I can get the detail death report.
>	Please help me!!
>	Remark:Please reply to my e-mail

   Coronary occlusion by atherosclerosis.  He had a heart attack.  A
buildup of fatty placque (something like a tumor) in the wall of one of
the arteries feeding his heart muscle got so large that it eventually
nearly choked off the blood supply.  Then, all at once, it clotted off
completely.  The part of his heart "downstream" quit working and began
to die.  Then, due to the damage, the electrical function of his heart
went on the blink, and it went into a disorganized discharge,
preventing it from pumping.  With no blood pressure, he fainted and

   This happens to at least 25% of men with atherosclerosis.  They
don't know they have a problem until they have a heart attack and die
(often immediately, but formally within 24 hours).   Major risk factors
for the disease are genetics, age, sex, smoking, high saturated fat
diets, high blood pressure, high blood cholesterol, low vitamin
intakes.  Get yourself checked out-- this is a disease which is mostly

                                                Steve Harris, M.D.

From: B. Harris)
Subject: Re: heart disease and osteoporosis
Date: Wed, 24 Sep 1997

In <> Joan
Livingston <> writes:

>Let's talk about the alternatives, Steve. What would we rather die of?
>Quite frankly I hope I do get a heart attack. All this nonsense trying to
>scare us that we should take "hormones" so we don't die of a heart
>attack. This out of context is meaningless as we all die from something.

   Indeed we do, and I think I'd like pneumonia, please.  Aka the old
man's friend.  Systemic sepsis in general is not a bad way to go, and
(fortunately) is a fairly common way in any kind of debilitation or
cancer.  Especially if your Living Will specifies no antibiotics.

   The only reason you want the heart attack is you've seen so many
people die of nice ones on TV.   Less than a quarter kill you quickly--
the rest take heart muscle and leave you less than you were.   In
reality people who die of coronary disease more often than not have
years of very nasty chronic disablity first.  Consider that it takes a
lot to make somebody go through a bypass operation.  And perhaps a
second one and a third one (which always impresses me, since for
numbers 2 and 3 you know exactly what you're in for).  _How We Die_ is
a pretty good book, but _Heartsounds_ is just as realistic.  And I
don't mean the movie of it, which pulled more than a few punches.

                                    Steve Harris, M.D.

From: B. Harris)
Subject: Re: Women, Men and Heart Attacks
Date: 2 Nov 1998 06:19:15 GMT

In <363D0309.CB64A6D4@bit.bucket> "Ted W." <spamme@bit.bucket> writes:

>The American Medical Association Science News Update from which dozens
>of popular press articles are derived is here:
>It is titled
>in the last paragraph of this release, we find that
>   ...the gender difference is balanced by a higher death among men
>   with myocardial infarction before reaching the hospital.
>This is not a new result.

    It sure isn't.  It's long been known that men tend to tough out
their chest pain at home, and die there, and women tend to go to the
hospital, and die THERE.  This says a lot for the differences between
men and women, but it doesn't say a lot about the efficacy of hospital
therapy.  If you ASSUME that hospitals do good things for you when you
have a heart attack, it's rather a remarkable result that women get to
the hospital in greater numbers, yet still have the same total death
rate.  This does indeed suggest that the process is inherrently more
deadly in women, but the results are mitigated by early care-seeking.
The other possibility is that hospitals don't help at all.  I discount
this from other results, showing that women have higher mortality from
the same amount of heart disease, and with the same surgeon in the same
hospital, when undergoing cardiac bypass.  Women's hearts apparently
don't tolerate a given amount of damage and disease as well as those of

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