Kile Death Raises Screening Questions

June 25 -- The sudden death of St. Louis Cardinal's pitcher Darryl Kile underscores the need, some experts believe, for aggressive cardiac screening among patients who, like Kile, have a family history of premature heart disease.

But there is disagreement among experts on exactly which tests should be performed.

Kile was no stranger to heart trouble. His father died at age 44 from a heart attack. And a preliminary autopsy shows the younger Kile had undetected hardening of the arteries — and 85 to 90 percent blockage of two of three branches of his coronary artery, which most likely contributed to his death.

While it's not yet clear if Kile had intensive medical screening, one of the country's leading heart specialists believes his death may have been preventable had the right screening been undertaken.

"All patients who have a compelling history like Mr. Kile should have intensive screening and this should not have been missed," says Dr. Eric Topol, chief of cardiology at the Cleveland Clinic. Topol has spoken out before on the importance of agressive screening, for instance, calling for a much more agressive approach to tests for Vice President Dick Cheney, who now has a defibrillator implant.

Among Topol's recommendations for patients with such early history (i.e. death before age 45), include:

Cholesterol tests

Special blood markers which may add even more to understanding of risk than cholesterol tests

Exercise stress testing

Agressive preventive care, "often with the use of statins," the name for the widely used class of cholesterol-lowering drugs.

Predicting Risk for Heart Disease

Kile leaves behind a wife and three young children, and one cardiologist says the children should be given cholesterol tests to see if they are at risk. Dr. Richard Smalling, director of cardiovascular medicine at the University of Texas Houston, says people with early family history need to be tested. "We now have very effective medicines with few side effects that can virtually stop this disease in its tracks. The time to act is literally yesterday."