Yesterday, we heard the tragic news that George Michael passed away. This morning, the news is awash with the announcement from his manager that the singer died from heart failure. Even reputable news sources like the BBC and CNN carry this headline, but as further information emerges, we are likely to discover that this is highly unlikely to have been the case.
What is heart failure?
The term "heart failure" refers to a heart's inability to pump enough blood around the body. It therefore refers to the function of the left ventricle, although the right ventricle (which pumps to the lungs) will be involved to varying degrees also. Broadly speaking, heart failure can be split into two types:
- Poor systolic function (poor left ventricular contraction, often quantified by ejection fraction)
- Poor diastolic function (inability of the left ventricle to relax and fill properly), which can sometimes present with what appears to be normal systolic function or a "preserved" ejection fraction.
Can heart failure be a cause of death?
Yes, but it's not the kind of condition that strikes down a relatively young and active person, without any warning signs or symptoms. A person suffering from heart failure - a long-term chronic condition - is likely to suffer symptoms such as shortness of breath, coughing and wheezing, fatigue, and ankle and leg swelling (oedema). It seems unlikely that George Michael would have been suffering from these symptoms, untreated, for the months and years it would take for his heart condition to deteriorate sufficiently enough to kill.
In addition, as heart failure is frequently secondary to other conditions such as coronary artery disease and hypertension (high blood pressure), it again seems remarkable that he would not have been treated for these conditions, which would surely have been suspected in light of the above symptoms in a relatively young man.
Will we ever find out what killed George Michael?
Whether we will receive any further updates on the singer's cause of death is unknown (the family may prefer not to make any more statements). He may well have suffered from cardiac arrest, similar to Carrie Fisher only a few days ago, which could in the singer's case be due to underlying coronary artery disease or, of course, the use of certain drugs. What's important for those recently diagnosed and living with heart failure to know that this condition is unlikely to result in sudden cardiac death when being well managed, particularly in younger people. Even for patients whose condition eventually deteriorates, there are now options such as cardiac resynchronisation therapy (CRT) for congestive heart failure, and implantable cardiac defibrillators. If you have been diagnosed with heart failure, you will be sent for annual checkups and serial echocardiography, to keep a close eye on the progression of your condition.