I am very confused about something and anyone that has ANY information on this I would very much appreciate.

My cousin, 41 years old, male passed away 2 weeks ago. He began having problems with his bowels. He complained of not diarrhea, but almost like diarrhea. He passed it off as a virus. It lasted all week. He then began hurting in his back later in the week, but no one thought too much of that because he was out of work with his back and was taking Vicoden, and by Friday, he felt that he had indigestion, and began taking antacids like they were going out of style. A few hours later he began having a popping in his ears, I suggested blood pressure, and then he jumped up, said he was going to throw up and fell to the floor. He never had chest pains or numbness, and we did not know that Vicoden could mask a heart attack or even cause one until after his death.
911 was called, and I heard the call and went straight to the house. His brother had begun CPR, and I joined him in the effort until the ambulance arrived. He never had a chance and I knew that then, I thought that he had a heart attack, BUT, there is one thing that I do not understand and this is where I am asking for help....
When his brother went to begin CPR, he had to clean his mouth out first because there was blood in his mouth. A great deal of blood, and as we were doing it together, it was virtually impossible to get an airway.

The family did not request an autopsy, and I never thought about it until it was too late...but could it be a heart attack because I have never heard or seen blood in someones mouth after suffering a heart attack. If it wasnt, then what could it have been.

I guess I am just trying to understand the unexplainable, but working as a health professional, I seek medical reasons so that I may understand what could have happened. Anyone with any information, please let me know as I am befuddled.

If this helps someone and could prevent this to happening to anyone, then I will feel better. Please dont ever dismiss indigestion, or something happening to your body because your body has ways of telling you that something isnt right. Wouldnt you rather go and find out that you have IBS or acid reflux but at least you took it seriously, rather than this happening to you or someone that you love.
He was a father to three sons, and a very active member of his community. Dont let this happem to you.

Thanks so much.

I don't have any anwsers for you but I just wanted to say I am very sorry for your loss.

It could have been a number of things, that unfortunatly, only an autopsy would have revealed.
Some things that come to mind, in regards to the blood in the mouth upon cardiac arrest, a possible bleeding ulcer due to the symptoms and his use of Vicoden, which is known to cause gastro problems in some; or perhaps a pulmonary embolism which would also cause a frothy bleeding.
hope this helps, and sorry for your loss.

Or possible rupture of the abdominal aorta.

Thank you for the information that you are giving me and also thank you for your sympathy. Maybe through some of the information that you are giving I can do more research and maybe it will help our grieving process by helping us to understand. At least I have a few things that I can search on. Thank you guys so much to be willing to help out a stranger and I welcome any more information that anyone is willing to give. Gives me something to do with idle hands and a racing mind.

My best to you all..thanks so much :)

I don't have much to offer but my sympathies. Hope you find what you are looking for.

I agree with what is mentioned above. Vicoden can cause sudden gastric bleeding especially in those that are aspirin sensitive. And yes, and aortic anuerysm could do the same. I'm so sorry for your loss of your cousin, especially so suddenly as you have described. PLease know that you & your family are in my thoughts & prayers at this time....Goody

In the state where I live if a 41 year old dies without obvious cause (known illness, gunshot etc.) they always do an autopsy. Why was one not done. Did the family request one not be performed. The blood in the mouth could have very well been from a GI bleed or ruptured aneurysm. I am very sorry for your loss. We had a young child (13) die in our family. She went to take a nap and she never woke up. They performed an autopsy and never did figure out why she died. They said it probably was something with her heart rhythm that doesn't show up on autopsy.

Almost always an autopsy is mandated when the cause of death is not apparent and the deceased is not under a doc's care.
Certainly true if there is a life insurance underwriting on the deceased life.

Well, at the time, it was thought to be a heart attack. It seemed all of the right things of a heart attack. I did not know at first that he had blood in his mouth when CPR was started. So, no one really requested an autopsy. In the state where we lived, an autopsy is done if someone dies alone, but his mother and brother were there when it happened. I went as soon as I heard the call on my pager. The family never thought of anything other than a heart attack, his brother said that sometimes when someone has a "massive" heart attack that the heart can actually explode, causing the blood in the mouth. The more that I started thinking about it though, the stranger it seemed to me.
He did have a life insurance policy. Actually, a very large one, so that if anything ever happened to him, his kids would be well taken care of. The insurance company has not questioned his death either, because it was ruled a heart attack, and I did not know about the blood until a couple of days later, so it was too late then.
I guess it is something that we will question for the rest of our lives, I just wanted a better understanding of things. He was under a doctors care, a family physician and one for his back problem, and he has never had heart problems, or blood pressure, or anything.
Thanks for everything. I have been doing some research and a lot of the things that you all have suggested have been very helpful. The one thing that has stuck out in my mind the most after my research is the abdominal aortic aneurysm. That has the most symptoms of what his chief complaints were, and where he was on vicoden that didnt help. Also, it stated that most people dont even make it to the hospitol, which was his case. He was gone before he hit the floor, sadly.
Thank you all....

justinsmommy I am so very sorry for your loss. I cant give any answers either hun. Sorry I just wanted you to know some things may not ever be answered. My sister passed away last year at the age of 33. It was out of the blue too. We had an autopsy it said she died of affixiation. However they couldnt tell if she had had a seizure and somehow didit herself or if someone had hurt her. She did have a mark on the side of her face than ran down under her throat. So we still dont really know and the case is still open. Its really hard the not knowing and my heart goes out to you and your family......Stephanie

mommy,

I am pretty sure that an artery burst INTO his gastrointestinal tract, probably the UPPER part. The back pain points to abdominal aortic aneurism but the bleeding is INTO the abdomen in this case and could not find it's way to his mouth.

I'll go with a burst artery into his stomach probably from a gastric wound like an ulcer (or cancer, stomach artery aneurism, or duodenal artery burst [my father was found unconscious in a HUGE pool of blood that came from his mouth from a massive duodenal ulcer bleed...he survived])

I'm imagining a scenario where the bleeding was going on and on for a couple weeks and every time the artery tried to seal itself the Vicodin prevented it and reopened the wound...then finally, BOOM!

So sorry for your loss that might have been prevented.

It is indeed sad when one loses a family member. Sorry for your loss.

Regarding the autopsy...Someone has to sign a death certificate and apparently the doctor who signed has evidence of the cause of death. The doctor has made a legal declaration and is vulnerable for any adverse consequences for any carelessness or mistakes in judgement. If no one will sign the death certificate, a public officer (coroner) will inquire by an inquest into the cause of death when there may be a question to the cause of death.

If the heart is severly damaged by a heart attack, fluids can/will backup into the lungs and the pressure can burst veins, arteries, and capallaries. CPR will force repiration and expel the blood. This is another possiblity.

First I'm sorry for the loss of your loved one.

You said he complained of diarrhea. Probably not, but did he mention if his stools were black? (black stools is an indication of blood)

The reason I ask.... Several years ago I noticed I had very black stools. I went to my doctor ASP... after a simple test he said I had blood in my stools. He immediately sent me to the hospital for emergency admittance and called in a specialist. He asked if I had volunteers to give blood... my wife called friends. He did a esophagogastroduodenal endoscopy, that is he went down my throat with a camera that has a tool that he can perform different functions. He found a hole the size of a dime caused from a duodenal ulcer and it was bleeding bad. He was able to stop the blood and in time the ulcer healed. Previously I had never had any problem with my "cast iron stomach" nor did I have any pain from my bleeding ulcer.
I wonder if your cousin could have had the same problem I had, only with him it had been going on for several days?

lelu,

That's the scenario I envision most likely as well.

A medical examiner, coroner, funeral director, MD, whatever, will opine the cause of death on a death certificate. I don't believe the cause of death would be listed as "unknown" and go without scrutiny. What does the death certificate show?

Hello to all of you. The death certificae my aunt has and I never asked what it said I know that would tell me what the doc said but I never asked. I will find out tomorrow. I have been on several codes in my ems career, and sometimes I have seen fluids in the airway but never blood, that is what made me so curious. Only 2 people have we ever gotten back, but it never stops you from trying.
As far as his bowels, he had been having problems with them for about a week. The abdominal aortic aneurysm had the most syptoms of what he had, though I could pick out symptoms out of everything that you all have given me info wise. It is just something that we will never truly know.
Its like I told me aunt, if he had gone out and gotten into a car accident, then that would be a "reason" but this had no reason that none of us will ever know. With strong faith and the togetherness of our family, we will get through this, but we will never understand.
My heart goes out to all of you that have lost family, especially unexpectedly, and without reason. Those are the deaths that are the hardest. I have lost my father, and my uncle to cancer, my father in law due to a heart attack after a chemo treatment but at least they had "reasons" that were explainable. I guess I am talking in circles huh?? But then there is my 92 year old grandmother who will outlive us all...rofl.
Thank you all so much....my thoughts and prayers are will all of you that have lost someone...you never get over it, it seems that you just get through it.

{{HUGS}}
Rhonda

I also want to say how sorry I am for the loss of your cousin. My brother 46 passed away in July and they just said it was a massive heart attack. He was alone and they required no autopsy be done. He was under doctors care for congestive heart problems so it most likely would of been a massive heart attack. Just when its so sudden and a shock it leaves your mind wondering.
My thoughts are with you and your family. :angel: god bless, Baylee

so sorry for your loss. blu

I guess a moral we can pick up here is not to put off something pleasant for tomorrow...do it today!

Hi,

Sorry for your loss!!

Sounds like it very possibly could have been a bleeding aorta, if he was nursing it for as long as he did unaware, it may have ruptured.

Try some searches on the internet, you may find some other valuable information that fits with what you saw at the time.

Karen

A very long time ago, an acquaintance of mine passed away from a massive heart attack. Her daughter said she had blood coming out of her mouth, nose, and ears.

I'm surprised they didn't do an autopsy automatically. Usually in deaths at home, it's done whether you'd want it or not.

I believe the standard in most jurisdictions is whether the deceased passed under suspicious, unusual, or unexplained circumstances. That would include the knowledge of a person's age, health, medical history, and whether or not a person is under a doctor's care. When under a doctor's care in a hospital or at home the treating doctor will sign the death certificate with an explanation. Autopsies are costly and usually unnecessary.

I am not sure how one would reconcile a death at home vs. a death in the hospital and differentiate that to require an autopsy? Many people with hospice care pass on at home!

kenkeith, you are correct.

My mother in law died at home after several years with Parkingson... no autopsy.

The only requirement here is that a coroner must see the body before the funeral home picks it up.