Why did Michael Jackson have a heart attack, and CPR by Dr. Conrad Murray

Michael Jackson suffered a cardiac arrest. And still, that’s really all we know for sure.

Medical websites continue to speculate on the possible causes. Over at theheart.org, doctors who were interviewed continue to speculate on Jackson’s narcotic use, including Demerol, which I wrote about a few days ago. Indeed, a spokesperson for the American College of Cardiology, cardiologist Douglas Zipes, suggested that a lack of oxygen from respiratory depression can certainly be a cause of life-threatening ventricular fibrillation.

In addition, Dr. Zipes mentioned how chronic narcotic use can “also lead to Jackson’s apparent debilitation and malnutrition,” and, “it is possible Jackson was dehydrated as well, and a shot of Demerol in this state could have produced hypotension, which would also lead to cardiac arrest.”

Contrary to my speculation that Jackson presumably underwent cardiac stress testing, The New York Times apparently reported that wasn’t the case. I find that to be surprising, considering he underwent such a thorough physical for insurance purposes a few months ago. Even without stress testing, coronary artery disease remains a unlikely possibility, as a “myocardial infarction leading to cardiac arrest is not impossible, but it would be unusual.”

conrad-murray Much has also been made about Jackson’s personal cardiologist, Dr. Conrad Murray, and his CPR resuscitation attempts while Jackson was still in bed. Apparently, Dr. Murray “raced one hand behind Jackson’s back and used the other to perform chest compressions.”

MedPage Today interviewed a few other cardiologists, who all universally condemned that technique. It’s standard practice to move the patient to a hard surface, which will result in more effective compressions that can better circulate blood to the brain. Indeed, Dr. Zipes commented that, “To think that you could have sufficient compression with one arm behind the individual and another trying to do CPR just makes no sense.”

Questions also were further raised on Dr. Murray’s credentials, who is not board certified in cardiology or a member of the American College of Cardiology.

I continue to believe that a combination of Mr. Jackson’s weight, with a body mass index of 17.9, in combination with possible dehydration and probably narcotic use, all were plausible factors leading to respiratory arrest, and subsequently causing his fatal cardiac arrest.