# John Ritter's death and revising annual physicals? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [September 13, 2003, 5:16pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407 "2003-09-13T17:16:16Z")\ **Posts on this page:** 14\ **Page:** 1
**Author:** ![AmericanMaid](https://avatars.discourse-cdn.com/v4/letter/a/e480ec/32.png) [@AmericanMaid](https://boards.straightdope.com/u/AmericanMaid)\ **Post date:** [September 13, 2003, 5:16pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/1 "2003-09-13T17:16:16Z")
John Ritter is the second person I know whose life was impacted by a heart defect. When I heard his death was due to a heart defect, a chill went through me. I know doctors don’t go looking around people’s hearts unless there is an apparent problem. Regardless, our hearts should be scanned during our routine physicals. The first person I know whose life was changed by a heart defect is me. I had an undiagnosed patent foramen ovale (hole between the intake and outtake chambers in my heart). For 24 years, I was a ticking timebomb ready to go off walking around completely clueless. At age 24, I developed a clot in my leg which travel to my heart, through my patent foramen ovale to my brain. The timebomb went off taking my right parietal lobe and part of my right frontal and temporal lobes. I survived, John Ritter didn’t. I got to have my heart defect repaired, John Ritter didn’t. My stroke and John Ritter’s death were completely preventable. This is why complete heart scans should be part of a physical. ---
**Author:** ![Skywatcher](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skywatcher/32/254_2.png) [@Skywatcher](https://boards.straightdope.com/u/Skywatcher)\ **Post date:** [September 13, 2003, 6:11pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/2 "2003-09-13T18:11:06Z")
I doubt an _annual_ physical would have done anything to prevent John Ritter’s death. IANADoctor but those who are have been saying the defect that killed him was the sort of thing which would require at least _monthly_ MRI scans. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 13, 2003, 6:34pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/3 "2003-09-13T18:34:01Z")
Such sceening is **not** feasable. Not only would it tie up all the equipment and technicians to do screening tests, but the results would be so rife with false negatives (test looks abnormal, but really isn’t) which would need further, _invasive_ testing that the complications of the follow-up tests would cause more illness and death than catching an abnormality early would save. QtM, MD ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 13, 2003, 6:37pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/4 "2003-09-13T18:37:13Z")
Here’s a little screed I posted in an earlier thread about screening tests: > [@](#): > > Anecdotally, screening is a wonderful idea, but it often fails in practice. Consider ovarian cancer, which generally is too far advanced to cure by the time it causes symptoms. One great test which does pick up ovarian cancer before it causes symptoms and it’s too late to cure is pelvic ultrasound. > > So one immediately thinks: “Let’s screen all women for ovarian cancer with pelvic ultrasound”. A fine idea, as the test picks up nearly all cases of early ovarian cancer. But it also picks up a lot of “false positives” or things that look like ovarian cancer on the ultrasound, but aren’t. > > And what must be done with an ultrasound which shows something that may be ovarian cancer? Surgery! Laparoscopic surgery, specifically. Which while safe overall, has its complications. > > In fact, for every case of ovarian cancer that an ultrasound will pick up early enough to cure, there will be over 20,000 normal ultrasounds performed which otherwise would not have been done, and 1500 unnecessary surgical procedures without complications done on women with abnormal ultrasounds without the disease. There will also be 150 complications from the laparoscopic surgery on women who had an abnormal ultrasound, but no disease. The complications for the most part will be minor, but some will be major, and some women will die from it. > > So in the case of ovarian cancer, the proposed screening protocol would be vastly expensive, tie up lots of resources, and cause more harm than benefit. > > Thus far, few screening tests have stood up to the gold standard for implementation: Does it accurately test for the disease, while accurately excluding people who don’t have the disease? Does it find the disease early enough to make a difference in outcome? And can we as a society afford to do this sort of screening? from [http://boards.straightdope.com/sdmb/showthread.php?s=&threadid=207530](http://boards.straightdope.com/sdmb/showthread.php?s=&threadid=207530) ---
**Author:** ![AmericanMaid](https://avatars.discourse-cdn.com/v4/letter/a/e480ec/32.png) [@AmericanMaid](https://boards.straightdope.com/u/AmericanMaid)\ **Post date:** [September 13, 2003, 8:43pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/5 "2003-09-13T20:43:50Z")
> [@](#): > > Such sceening is not feasable. Not only would it tie up all the equipment and technicians to do screening tests, but the results would be so rife with false negatives (test looks abnormal, but really isn’t) which would need further, invasive testing that the complications of the follow-up tests would cause more illness and death than catching an abnormality early would save. The simple test that could have saved my right parietal, frontal, and temporal lobe can be found in any doctor’s office and can be used to a GP. I don’t know it’s name but I get tested at my annual physical to make sure my heart implant is still in place and not mucking around. > [@](#): > > I doubt an annual physical would have done anything to prevent John Ritter’s death. IANADoctor but those who are have been saying the defect that killed him was the sort of thing which would require at least monthly MRI scans. The articles I read said that John Ritter had an aortic dissection, which is an undetected flaw in the heart. What killed him was an aortic aneurysm in his stomach. Which is basically his aorta blowing out in his stomach and slowly bleeding to death. The dissection is a birth defect. Yes, detecting whether the aorta would blow would require frequent MRI scans but he could have had an operation to correct the dissection. ---
**Author:** ![AmericanMaid](https://avatars.discourse-cdn.com/v4/letter/a/e480ec/32.png) [@AmericanMaid](https://boards.straightdope.com/u/AmericanMaid)\ **Post date:** [September 13, 2003, 8:49pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/6 "2003-09-13T20:49:33Z")
Crap, I mis-typed. The test I was talking about can be performed _by_ a GP. And the defect is not a birth defect. It can occur with age. But still, who knows how long he had it? Years? Months? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 13, 2003, 9:00pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/7 "2003-09-13T21:00:13Z")
If you could tell us what test it was you had, that would help us to address your point. ---
**Author:** ![sultana\_of\_slash](https://avatars.discourse-cdn.com/v4/letter/s/bbe5ce/32.png) [@sultana\_of\_slash](https://boards.straightdope.com/u/sultana_of_slash)\ **Post date:** [September 14, 2003, 6:27pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/8 "2003-09-14T18:27:07Z")
> [@](#): > > \*Originally posted by AmericanMaid \* > \*\*The articles I read said that John Ritter had an aortic dissection, which is an undetected flaw in the heart. What killed him was an aortic aneurysm in his stomach. Which is basically his aorta blowing out in his stomach and slowly bleeding to death. The dissection is a birth defect. Yes, detecting whether the aorta would blow would require frequent MRI scans but he could have had an operation to correct the dissection. \*\* Hey, sorry to hear about your miserable experience. You had about the worst luck I’ve ever heard of a person surviving. There can be a couple of reasons to have an aortic dissection. It’s in the aorta, by the way, not the heart; can rupture back into the heart, but only secondarily; sounds like his ruptured into the abdomen. The defect _can_ be congenital (cystic medial necrosis, Marfan’s syndrome, some of the Ehlers-Danlos syndromes). But those are the tiniest part of the problem. The great majority of aortic dissections are due to stress on a normal aorta after years of high blood pressure. The usual inciting incident is a surge of high blood pressure. The majority of triple-A’s (abdominal aortic aneurysms) are due to the double whammy of years of longstanding atherosclerosis and high blood pressure. If Ritter had high blood pressure, and didn’t know it, his doctors are at fault. If he had high blood pressure, and didn’t treat it, he’s at fault. If he had high blood pressure, knew it, treated it, but often did cocaine, he’s at fault. Not saying he did cocaine; I know nothing about him, except that he’s a Hollywood actor. I am an MD. My grandfather died of aortic dissection. Best to you and yours. ---
**Author:** ![kniz](https://avatars.discourse-cdn.com/v4/letter/k/c37758/32.png) [@kniz](https://boards.straightdope.com/u/kniz)\ **Post date:** [September 15, 2003, 6:05am UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/9 "2003-09-15T06:05:16Z")
Mine showed up on an MRI that I had to see what was wrong with my back. Shortly after my operation, Conway Twitty died and now Ritter. Boy was I lucky! :eek: ---
**Author:** ![CrankyAsAnOldMan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crankyasanoldman/32/11670_2.png) [@CrankyAsAnOldMan](https://boards.straightdope.com/u/CrankyAsAnOldMan)\ **Post date:** [September 15, 2003, 1:58pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/10 "2003-09-15T13:58:17Z")
I’d like to know an estimate of what proportion of the public has utterly normal, well-functioning hearts, compared to those who have hidden life-threatening defects which would be revealed on an annual scan–and what a “complete heart scan” costs. I suspect (but wouldn’t know until I had such estimates) that you’d end up spending a staggering amount of money testing healthy people to find problems in the relatively few. Take John Ritter’s problem: the figure I heard was that aortic dissection occurs in 5,000 people annually (not that this condition, as someone else pointed out, would be reliably caught in a yearly scan). We cannot sensibly propose that the medical community do everything possible to reduce any chance of premature death. There are costs involved, costs that we all will bear. Of course a loved one’s life is priceless–but we’re talking about spending that money on millions of adults, every year, the majority of whom will not benefit from it. ---
**Author:** ![Spiff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spiff/32/9852_2.png) [@Spiff](https://boards.straightdope.com/u/Spiff)\ **Post date:** [September 15, 2003, 4:22pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/11 "2003-09-15T16:22:49Z")
> [@](#): > > \*Originally posted by CrankyAsAnOldMan \* > **We cannot sensibly propose that the medical community do everything possible to reduce any chance of premature death. There are costs involved, costs that we all will bear.** So how 'bout we only screen celebrities for these hidden medical dangers? After all, they’re more important and valuable to society than the rest of us, eh? \ ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [September 15, 2003, 5:17pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/12 "2003-09-15T17:17:31Z")
> [@](#): > > \*Originally posted by Spiff \* > \*\*So how 'bout we only screen celebrities for these hidden medical dangers? > > After all, they’re more important and valuable to society than the rest of us, eh? > > \ \*\* Why don’t you go back and read what Cranky wrote as well as the excellent information by QtM on the dangers of mass screenings and false positives, compare that information with the (useless) snippy comment that you made based on something that no one even implied much less said, and then report back on the perils of making logical non sequitors in front of an educated audience. ---
**Author:** ![lurkernomore](https://avatars.discourse-cdn.com/v4/letter/l/d6d6ee/32.png) [@lurkernomore](https://boards.straightdope.com/u/lurkernomore)\ **Post date:** [September 15, 2003, 7:03pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/13 "2003-09-15T19:03:58Z")
Isn’t this the thing the guy who wrote Rent died from? And he had been to 2 NYC hospitals in the week before he died. There was a suit over the images some said showed an aneurysm. IIRC he died when they were in dress reharsals, right before the Broadway opening. Think his name was Larson, Larsen, something like that? ---
**Author:** ![GuanoLad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guanolad/32/42_2.png) [@GuanoLad](https://boards.straightdope.com/u/GuanoLad)\ **Post date:** [September 15, 2003, 10:40pm UTC](https://boards.straightdope.com/t/john-ritters-death-and-revising-annual-physicals/201407/14 "2003-09-15T22:40:38Z")
Everybody dies sometime, some sooner than others. It sucks, but there ya go. We can’t expect to all live a full length\* of life. \*as predicted by statistical averages. About 75 years.