Beating a Sudden Killer; August 2005; Scientific American Magazine; by John A. Elefteriades; 8 Page(s)
It was the first beautiful Saturday in spring, and I was in charge of my children. We were out browsing the stores around our local green when the page came in. Lawrence Cohen, a preeminent cardiologist and my colleague at Yale University, was distraught. Normally a man of few words, Cohen was speaking quickly, almost feverishly. "I need you, John. In the ER. Right away. She's dying, John. She's dying right in front of me."
The situation was particularly distressing because Cohen had been following the woman's condition for three years, ever since her husband had come to teach at Yale. So Carmela Kolman was like a member of the family. She was 32 years old and had Marfan's syndrome, a connective tissue disorder that tends to produce thoracic aortic aneurysms: dangerous swellings in the upper part of the large artery that carries blood from the heart, down through the chest and into the abdomen. Left untreated, these aneurysms can grow until they rupture, an event that is often fatal. The only intervention is a preemptive operation to replace the damaged regions with artificial components. But the surgery has its own risks, so physicians hold off on making that call until it seems absolutely necessary. Because Carmela's aorta had been only modestly enlarged, Cohen had not recommended surgery.