The medical blogosphere’s response to the death of Anna Nicole Smith is beginning to read like a virtual CPC. So far myocarditis, serotonin syndrome, cardiomyopathy, congenital heart disease, heritable disorders of connective tissue, pulmonary embolism, WPW, ischemic heart disease, Brugada syndrome and drug overdose and/or interaction have been posited.
Methadone garnered more attention in the last few days following reports that it was found in her refrigerator. As I posted here methadone could have caused an arrhythmic death. It causes prolongation of the QT interval and torsade de pointes, effects which would not be mitigated by narcotic tolerance or the use of Narcan. These electrophysiologic effects are under appreciated and may be responsible for many of the deaths recently reported in association with abuse of methadone.
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As a patient with a connective tissue disorder, Ehlers-Danlos Syndrome, it did look to me like she and Daniel both may have shared some similar traits. I read today that she told a friend she had lupus back in 1998. I was misdiagnosed with lupus myself before the EDS dignosis was confirmed. Both disorders can cause heart issues, endocrine system disfunction, joint pain, fevers..but methadone is not usually prescribed for lupus. Many EDSers I know do take methadone for joint pain however. Both of these disorders should be considered, as her daughter might aldso carry one if she did have an inherited condition.
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