[Fill in name] has died of a heart attack this morning.

Often I read online news articles or hear on television news that a well known figure has died of a heart attack less than a day ago. Surely that’s not enough time for both an autopsy to be performed and the results from it to go public. Is the medical examiner determining that it was a heart attack in some other way besides autopsy? Is it supposition from journalists? Something else?

Below is a recent example of an article declaring a death was from a heart attack in less than a day after the death took place.

http://instinctmagazine.com/blogs/blog/30-year-old-popular-porn-star-erik-rhodes-has-died?directory=100011

I was going to suggest that if a person has a heart attack, and on-site physicians identify it as a heart attack, and the physicians can’t help him, and he dies, then no autopsy is needed, as the cause of death is so obvious.

But in the article you linked to, he died in his sleep, so it is only after the fact that they identified it as a heart attack, so I agree that your question is a good one.

Yeah, I should have mentioned that I’m talking about reports where it’s obvious the person wasn’t in a hospital or being attended to by medical personnel at the time of death.

It’s whatever they told the journalist.

There are symptoms of death by heart attack. That’s what people are basing their diagnosis on. It is not necessarily the correct one, but for the purpose of a newspaper article on deadline, that’s close enough. If it’s discovered to be wrong, it will likely just not be corrected in the paper. (And, if you notice, usually in these cases, the paper says, “He was found dead of an apparent heart attack,” leaving room for error.)

I’ve always suspected that a certain fraction of these “heart attack” deaths are actually drug overdoses or suicides. Partly because it seems to happen suspiciously often to celebrities, especially those with party boy/girl reputations, and partly because of what the OP says – they can’t have completed any sort of proper medical examination that fast.

Well, heart attacks are more common in substance abusers, so it’s not all that surprising that they would occur frequently among celebrities.

Anyway, strictly speaking more or less everyone dies of heart failure*.

*There are of course exceptions: decapitation, and so on.

This, also identifiable by the wordage “sources say” and “according to reports.”

I said “well known figures.” Are you sure celebrities are more likely to be substance abusers than the general population?

“Heart failure” has a specific definition:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001211/

Anyway, “heart attack” is not synonymous with “heart failure.”

I guess you’re defining heart failure as the inability of the heart to pump blood? Even with that definition, I’m not so sure “more or less everyone dies of heart failure.”

Well, barring violent trauma to the brain itself (for example, getting blown up), everyone dies for want of oxygen supply to the brain. That pretty much requires some sort of failure to pump blood (a heart problem), a failure to oxygenate blood (a lung problem), or a failure of blood to reach the brain (due to anything from a blood clot to the head no longer being attached to the torso).

I think it was a Patricia Cornwell novel where I read a medical examiner complaining about the cause of death recorded on a certificate: “‘Cardiac arrest’ is a symptom, not a cause! Everyone’s heart stops beating when they die!”

That may be true (I don’t know), but that’s not the same as death being caused by heart failure (you even go on to say "a failure to oxygenate blood (a lung problem), or a failure of blood to reach the brain "). I’d bet we have the technology to keep patients’ hearts pumping and a large percentage of those close to death would still die.

Unless, of course, the true cause of death is something more newsworthy.

“Heart attack” (as well as “heart failure”) is also commonly used to describe sudden cardiac arrest, which may or may not be related to an actual heart attack (myocardial infarction); this is often the case when you hear that somebody suddenly dies with no prior warning, especially when they are relatively young and fit (and it happens very often - around 300,000 deaths a year).

Assuming they weren’t hooked up to an ecg at time of death, there’s a hormone in the blood (troponin) that shows up in high levels after heart muscle dies (heart attack). IANAD, but from what I’ve been told, positive troponin + no obvious trauma ----> pretty good sign of a heart attack.