The Los Angeles county coroner’s office recently ruled that singer Whitney Houston drowned in her hotel bathtub but that other factors contributed to her demise. Did the 48-year-old have preexisting cardiovascular disease? Did cocaine abuse trigger a deadly cardiac event? Drs Payal Kohli and Christopher Cannon put the autopsy results and the pop star’s final moments in context.
What killed pop star Whitney Houston? A self-identified substance abuser, Houston had publically admitted to using marijuana, alcohol, pills of many varieties, and cocaine during her rise to fame and troubled life in the spotlight. The Los Angeles county coroner recently ruled that Houston’s death was an accidental drowning with the “effects of atherosclerotic heart disease and cocaine use” as contributing factors.
Streaking found in Houston’s aorta suggests that in addition to her high-profile fight against multiple addictions, she may have also been the victim of an invisible war gathering strength in her cardiovascular system.
Did the 48-year-old Houston have preexisting vascular disease? Did the singer’s cocaine abuse trigger a deadly cardiac event? What specific hazards does abuse of cocaine and other drugs-both illicit and legal-pose to cardiac function?
Here to put this issue into perspective are Drs Christopher Cannon and Payal Kohli. Dr Cannon, a senior investigator with the TIMI Study Group, is editor in chief of Cardiosource Science and Quality. He is also Professor of Medicine at Harvard Medical School and Associate Physician in the Cardiovascular Division of Brigham and Woman’s Hospital in Boston. Dr Kohli graduated from Harvard Medical School and completed her internal medicine training in Boston and is scheduled to start her fellowship in cardiovascular medicine at the University of California San Francisco in June 2012.
Podcast: Did Heart Disease Kill Whitney Houston?
• The evidence of atherosclerotic disease in the 48-year-old singer’s major vessels is a reminder that women, and young women, are at risk for heart disease and should be targeted for primary prevention.
• Houston’s autopsy found no evidence of compromise in left ventricular function; however, cocaine-induced cardiac fibrosis may have created a nidus for a ventricular arrhythmia, a situation made more likely given the toxicologic evidence of other pro-arrhythmic drugs in her body, including over-the-counter agents.