We loved him in Apollo 13, Twister and True Lies, feared him in Weird Science, and cried for him in the Hatfields and McCoy’s. Sadly, the Emmy winner has passed away at age 61.
According to TMZ, the actor was undergoing an aortic valve replacement and aneurysm repair on February 14th. 11 days later he suffered a stroke and died on Feb. 25 at Cedars-Sinai Medical Center.
His immediate causes of death listed on the death certificate included stroke, aortic aneurysm and bicuspid aortic valve.
In a podcast earlier this month, Bill Paxton revealed he suffered from rheumatic fever when he was 13, a condition which begins with a sore throat and progresses to affect the joints and heart valves. He stated, “I’d had a sore throat at Christmas. It had kind of gotten into my wrist, but it usually damages your heart valves.”
However a bicuspid aortic valve is usually congenital, meaning one is born with it. The aortic valve usually has three flaps and its responsible for allowing blood flow from the left ventricle (holding freshly oxygenated blood from the lungs) to the aorta, the main artery that supplies the body. If the valve is bicuspid, it only has two flaps and thus blood may not fully pass and leak back into to the ventricle. The ventricle may enlarge and many of these patients elicit a murmur.
Image from URMC
Now those with bicuspid aortic valves are also at risk for ascending aortic aneurysms. Either the stress from the faulty valve or the weakness in connective tissue causes the aorta to balloon out. This could lead to what Alan Thicke suffered from, an aortic dissection. The blood flow dissects the lumen of the aorta, the main artery coming off the heart, and this side pooling within the vessel prevents adequate blood flow from getting to vital tissues. In many cases, the heart stops.
Those with Marfan’s syndrome suffer from a genetic connective tissue disorder that could give rise to both the bicuspid aortic valve and ascending aortic aneurysm.
image from heartosaurus.com
Aortic valve replacements carry a small risk of postoperative stroke, as can aneurysm repairs.
What is a stroke?
A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke. Ischemic and Hemorrhagic.
Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain. 80% of all strokes fall under ischemic. It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients. Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.
Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels. The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells. The bleeds could occur from high blood pressure or aneurysms that rupture.
What are the signs of a stroke?
Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side. We can also see central effects. The symptoms of stroke include the following:
Weakness of one side of the body
Loss of balance
Numbness on one side of the body
How are strokes treated?
If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot. Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA). These clots can also be surgically removed and arteries widened to bring blood flow to the brain.
With a hemorrhagic stroke, we need to stop the bleed and improve flow to the brain. Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utlized.
Time is of the essence, so its crucial to identify the warning signs and call 911 immediately. The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911). The sooner a stroke victim receives medical attention the better the prognosis.
COURTESY OF THE AMERICAN STROKE ASSOCIATION
What are the risk factors for stroke?
The following put us at risk of having a stroke.
High blood pressure
Family history of stroke
Cardiovascular disease (artery clogging, such as the heart and carotid arteries)
Abnormal heart rhythms, such as atrial fibrillation
Being older (greater than 55)
African Americans appear to be more at risk than Caucasians and Hispanics
Men seem to be more affected than women
How do we prevent strokes?
Avoid the following:
Control blood pressure, sugar and cholesterol
Get evaluated by a medical provider if at risk for heart disease or stroke.