Autopsy confirms Lewis had serious heart defects Specific ailment still unknown

August 05, 1993|By Judy Foreman | Judy Foreman,Boston Globe

BOSTON -- The Massachusetts state medical examiner's office confirmed yesterday that Reggie Lewis, who died last week of cardiac arrest, had extensive scar tissue in his heart, a finding other specialists said is consistent with the potentially serious heart defect diag- nosed by two of the three medical teams that Lewis had consulted.

The Boston Celtics captain collapsed while shooting baskets at a Brandeis University gym July 27 and was pronounced dead 2 1/2 hours later at Waltham/Weston Hospital.

The scar tissue, the Boston Globe has learned, was concentrated at the top of Lewis' heart -- where some of his doctors thought they had spotted a potentially serious defect -- but also showed up throughout his heart tissue.

From its appearance -- and because it usually takes at least a month to form -- the scar tissue is probably not new and may have been in Lewis' heart for a few weeks to several months, the specialists said.

Given that Lewis began having near-fainting episodes in the spring, it is possible that the biological process that ultimately led to the scarring was going on at that time or earlier.

Precisely what caused the extensive scar tissue to form in Lewis' heart has not been determined, the medical examiner's statement said. Yesterday, the Boston Globe reported that, according to the autopsy report, Lewis died of myocarditis, an inflammation of heart muscle tissue. Myocarditis can cause scar tissue, which in turn, can trigger fatal arrhythmias.

In general, scar tissue formation and myocarditis can have many causes, including viral infections, medications, poisons, alcohol and illegal drugs. Often, a cause is never found.

The autopsy turned up no evidence of drugs; it also found that the coronary arteries that supply blood to the heart were normal, suggesting he had never had a heart attack.

Lewis' heart, however, was both "abnormal" and "enlarged," said the statement from the medical examiner's office, which added that Lewis' family has been told of the findings.

The autopsy was done by associate chief medical examiner Dr. Stanton Kessler under the supervision of deputy chief Dr. Joann M. Richmond. The preliminary findings were reviewed by Chief Medical Examiner Dr. Richard Evans and Dr. Jeffrey Isner, chief of cardiovascular research at St. Elizabeth's Hospital in Brighton.

The preliminary findings will now be reviewed by two other cardiovascular pathologists, whom state officials declined to name.

Though it is often not possible to pinpoint the cause of cardiac scar tissue, a number of things can cause it, said Dr. Bill Dec, director of the cardiac transplantation program at Massachusetts General Hospital.

One possibility is a heart attack. If cardiac arteries become clogged or narrowed, blood flow to the heart is shut off, which can lead to tissue damage and scarring. Since Lewis' arteries were fine, it is unlikely his scar tissue was caused by a heart attack, said Dec, who was not part of the autopsy team.

Certain drugs, such as those used for cancer chemotherapy, can also cause cardiac scarring, as can blunt trauma to the chest and heart, such as slamming into the steering wheel in a car accident.

"The most likely cause [of Lewis' heart scarring] was myocarditis," said Dec, and "the most likely cause [of that] would be a viral infection."

AUTOPSY TEXT

The text of a statement about an autopsy on the body of Boston Celtics captain Reggie Lewis. The autopsy was done by associate chief medical examiner Dr. Stanton Kessler under the supervision of deputy chief Dr. Joann M. Richmond. The preliminary findings were reviewed by Chief Medical Examiner Dr. Richard Evans and Dr. Jeffrey Isner, chief of cardiovascular research at St. Elizabeth's Hospital:

"These findings are preliminary and will be reviewed by two other cardiovascular pathologists. The Lewis family has been notified of the preliminary findings.

"The preliminary findings show that the heart was abnormal, enlarged and was extensively scarred. The cause of the scarring has not been determined.

"Preliminary findings also show that the coronary arteries were normal. Preliminary drug screens showed no evidence of drug abuse.

"The chief medical examiner is the source and will remain the source of any and all information regarding this matter. Information will be forthcoming from the Executive Office of Public Safety when findings are complete.

"Under Massachusetts law, a certificate of death stating the cause of Mr. Lewis' death will be filed with the city clerk of Waltham immediately upon the completion of the chief medical examiner's investigation. All other information relative to the autopsy and investigation is required to be held in confidence. The law and the family's right of privacy will be rigorously observed."

MEMORIAL SERVICE

A memorial service for Reggie Lewis is scheduled for Saturday at 1 p.m. at the Dunbar High School auditorium, said Bob Wade, Lewis' coach at Dunbar. Wade said yesterday that no other details of the memorial program had been set.

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