Preliminary Autopsy Results Available in Boyzone Death

Preliminary autopsy results on 33-yr-old Boyzone singer Stephen Gately, revealed that the pop star died of “fluid on the lungs,” medically known as pulmonary edema. The cause of the pulmonary edema was not given, pending the final autopsy report.

The function of the respiratory system (otherwise known as the pulmonary system) is to bring oxygen from the air into the blood stream and to release carbon dioxide (a product of the body’s metabolism) back into the air. Air drawn into the lungs is drawn into smaller and smaller airway tubes to the smallest units called alveoli. These tiny bubble-shaped sacs are very thin and are surrouded by the smallest blood vessels, called capillaries. This intimate relationship allows oxygen (O2) and carbon dioxide(CO2) gasses to pass freely back and forth from the airways to the blood system. Pulmonary edema is fluid accumulation in the lungs. The extra fluid and “drown” the patient by impairing this healthy gas exchange with the circulating blood and can cause respiratory failure. Symptoms include extreme shortness of breath, a feeling of suffocating or drowning, frothy, possibly blood-tinged sputum, paleness, and excessive sweating.
Causes of pulmonary edema most commonly are caused by issues with the heart. In these cases, the heart has become weakened, and is unable to pump effectively. This causes blood to “backup” into the lungs, forcing fluid in the blood to pass through the capillary walls into the air sacs. These cardiac causes include:

  • Coronary artery disease-narrowing of the blood vessels which supply the heart muscle with blood
  • Cardiomyopathy– the heart muscle weakens as a result of infection or other factors
  • Heart valve disease– leaky valves cause a backup of blood into the lungs
  • High blood pressure– thickens left heart muscle and worsens coronary artery disease

There are also non-cardiac (heart) causes of pulmonary edema. In these cases, the lung capillaries become leaky without back pressure from the heart. These causes include:

  • Lung infections–  such as pneumonia
  • Inhaled toxins- such as chloride or ammonia, or even inhaled stomach contents (from vomiting)
  • Kidney disease- the kidneys can’t remove waste effectively, and excess fluid builds up
  • Smoke inhalation -Smoke from a fire contains chemicals that damage the membrane between the air sacs and the capillaries
  • Adverse drug reaction -Many drugs, ranging from illegal drugs such as heroin and cocaine to aspirin and chemotherapy drugs
  • Acute respiratory distress syndrome (ARDS)- This serious disorder occurs when your lungs suddenly fill with fluid and inflammatory white blood cells. Many conditions can cause ARDS,including severe injuries (trauma), systemic infection (sepsis),pneumonia and shock.
  • High altitudes. Mountain climbers and people who live in or travel to high-altitude locations run the risk of developing high-altitude pulmonary edema (HAPE), which typically occurs at elevations above 8,000 feet (about 2,400 meters)
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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