A ruptured ascending aortic aneurysm — the reported cause of death of American football writer Grant Wall — is a rare but fatal condition.
Wall, 49, a prominent journalist in the American football community, collapsed on December 9 while covering the Qatar World Cup and could not be revived. On Wednesday, his wife, Dr. Celine Gounder, announced that Wall’s unexpected death was caused by the rupture of an undiscovered ascending aortic aneurysm with hemopericardium following an autopsy performed by the New York City Medical Examiner’s Office.
“Grant died of a ruptured, slow-growing, undetectable ascending aortic aneurysm with hemopericardium,” Gounder wrote in a post on Substack. “No amount of CPR or shock could save him.”
When someone who is young and apparently healthy suddenly dies, “we worry about possible underlying health problems,” says Dr. Eric Isselbacher, co-director of the Thoracic Aorta Center at Massachusetts General Hospital, told ABC News.
“There’s no good way in a case like this to know exactly what happened before the autopsy.” But we see things like this happening in young people, and it’s reminiscent of an aortic aneurysm, especially when people don’t know about it because it can lead to rupture and death,” he said.
What is an aortic aneurysm?
Aorta is the main artery that carries blood from the heart throughout the body and brain. An aortic aneurysm is a balloon-like bulge in the aorta. An aneurysm weakens this part of the artery, allowing blood to sever or split its wall and cause it to rupture. Ascending aortic aneurysm is an aneurysm in which a portion of the aorta bulges and weakens before it bends into the aortic arch.
Hemopericardium means blood is found in the tissues around the heart, which is most likely related to an aortic aneurysm. When enough blood gets to these tissues around the heart, it can stop the heart from pumping properly.
Doctors say that aortic aneurysms that develop slowly over time, like Wahl’s, may not have associated symptoms until they grow large, fester, or rupture. If an aneurysm dissects or ruptures, a person may experience severe chest pain, difficulty breathing, confusion, or fainting.
Wahl reportedly had some flu symptoms recently and was being treated for bronchitis.
“The chest pressure he felt before his death was probably the first symptom,” Gounder also wrote.
Doctors say some of the symptoms of a growing aortic aneurysm can mimic those of a respiratory infection, such as coughing or chest discomfort, but it’s not known if this was what happened in Wahl’s case.
There’s also no way an automated external defibrillator would have saved Wahl’s life during a medical emergency; Only surgery can repair a ruptured aortic aneurysm.
Who is at risk?
This condition is rare. Routine screening tests for ascending aortic aneurysm are not recommended. Although it is not clear how many people have the condition, a recent study estimated that the prevalence of thoracic aortic aneurysm, including the ascending type, is approximately 0.16% of the population.
Nearly 10,000 people died from aortic aneurysms or aortic surgery in 2019, the US Centers for Disease Control and Prevention reported.
Abdominal aortic aneurysms, which are located at the bottom of the aorta, have “very clear risk factors” — they tend to occur in people in their late 60s and 70s, in smokers and in people with high blood pressure or high cholesterol, Isselbacher said. However, aneurysms located in the chest, such as ascending aortic aneurysms, are usually not due to these typical risk factors and are mostly caused by birth defects of the aorta or hereditary disease, he said.
Aortic Aneurysm Symptoms and Treatment
Symptoms of an aortic aneurysm include:
- Sudden stabbing pain in the back or chest
- lack of air
- Difficulty breathing or swallowing
- hoarseness
- Cough
Not everyone will experience symptoms, even with large aneurysms. Actor John Ritter died suddenly of an aortic aneurysm while rehearsing on set in 2003.
If an aneurysm is detected early, it can be treated with medication or surgery.
Aortic aneurysms have become more common over the last decade, increasing by about 75 percent, according to the American Heart Association. However, this occurrence is rare, occurring in about two in 100,000 people.
Because of its association with tobacco use, the US Preventive Services Task Force recommends that all men between the ages of 65 and 75 who have ever smoked have an ultrasound scan for an abdominal aortic aneurysm, even if they have no symptoms. Abdominal aortic aneurysm is a bulge in this artery that can rupture in the abdomen.
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