A new study reported in the Journal of the American Heart Association (JAHA) reveals that firefighters who died from cardiac arrest were much more likely than those who died of other causes to show signs of heart disease.
The report released Wednesday relied on a study of autopsy results in cases involving a line-of-duty death. The evidence showed a commonality of coronary artery disease—or narrowing of the arteries—and structural abnormalities that include an enlarged heart and increased wall thickness in the left ventricle.
Among firefighter cardiac fatalities in this study, coronary artery disease, an enlarged heart, increased wall thickness and prior heart attack were strong, independent predictors of death. Firefighters who had a prior heart attack were six times more likely to suffer a duty-related death.
“Firefighters face many dangers, but the greatest risk is from underlying cardiovascular disease in combination with the physiological strain that the work places on the firefighter,” said Dr. Denise L. Smith, the study's lead author and director of the First Responder Health and Safety Laboratory at Skidmore College in Saratoga Springs, NY. “Medical screening is necessary to establish that a firefighter is healthy enough to do this strenuous work.”
The study included autopsy records for American male firefighters who died on duty between 1999 and 2014. Among the 627 total deaths studied, 276 resulted from cardiac arrest and 351 from trauma. At the time of death, the firefighters were between the ages of 18 and 65.
“Historically, screening has focused more on risk factors for coronary artery disease,” Smith said. “While this screening remains essential, it is important that clinicians also consider testing to identify an enlarged heart and increased wall thickness.”
According to the JAHA, approximately one in seven people in the United States will die of sudden cardiac arrest. Symptoms include unresponsiveness and gasping for air or not breathing. Cardiac arrest occurs when the heart’s electrical system stops working properly and differs from a heart attack, which occurs when a blockage prevents blood flow to the heart.
Read the full JAHA report here.