Brittany Murphy and various Causes of Sudden Death

Brittany Murphy (1977-2009)

Since actress Brittany Murphy was declared dead two days ago at Cedars-Sinai Medical Center in Los Angeles, there has been a lot of speculation in the media about her possible current medical conditions, medical history, state of mind and whether or how any of these factors might have contributed to her sudden death from cardiac arrest. Here we describe, in general, some of the causes of sudden death in young adults that have some similarities, but also important differences, with causes of sudden death in other age groups such as infants and the elderly.

But first let’s consider why so little medical information about Ms. Murphy is available and what this has to do with you. There has been a U.S. law since 1996 that makes it illegal to share or distribute a patient’s private medical information without their (or their family’s) permission. This law is referred to as “HIPAA” which stands for the Health Insurance Portability and Accountability Act. When does the average person encounter the HIPAA law? Actually quite often - every time you are seen by a new doctor or health case organization, part of the paperwork you have to fill out includes a HIPAA waiver that allows your private health information to be shared with insurance companies that may pay for the medical services you receive.

Returning to the general issues surrounding sudden death, there can be many causes or explanations but the majority involve various types of heart disease which may not have been previously diagnosed and will only become apparent during or after an autopsy. These diseases can involve

* the arteries supplying blood to the heart (such as in coronary heart disease)
* the heart muscle itself or
* the heart’s valves

These diseases can be acquired during life or be present from birth (congenital). Cardiac arrest can also be caused by abnormalities or disturbances in the normal electrical activity (arrhythmia) that makes our hearts beat in a regular, controlled fashion.

Cardiac arrest can also result from viral or bacterial infections of the heart muscle or valves. These conditions are known by the medical terms myocarditis or endocarditis and can occur during or after what appears to be a common viral illness (Ms.Murphy was reported to have suffered flu-like symptoms and abdominal pain in the days leading up to her death).

Abnormal and dangerous electrical activity of the heart can result from congenital diseases and also from acquired conditions such as the effects or side effects of prescription or non-prescription drugs or metabolic conditions (abnormal blood chemistries). Such metabolic conditions can be the result of diseases of the stomach and intestines (abnormal diet or digestion, eating disorders) or the endocrine system (diabetes, thyroid conditions).

Sudden death doesn’t necessarily have to involve the heart. Various disease of the blood vessels and lungs (such as pulmonary embolism) and the nervous system (such as spontaneous bleeding into the brain from a ruptured aneurysm or congenital abnormal blood vessels). Certain infections of the lungs and airways and brain can also lead to sudden death.

The final, declared cause of death will be made based on features of the medical history in conjunction with the autopsy findings. Autopsy results include both visual and microscopic evaluation of the anatomy and tissues (anatomic pathology) as well as analysis of the chemical condition of the blood and other body fluids (laboratory medicine or clinical pathology) and the presence or absence of drugs (toxicology).

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