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Dr. Sanjay Gupta discusses Ritter, Cash deaths
(CNN) -- Country music legend Johnny Cash died early Friday from diabetes complications and actor-comedian John Ritter died Thursday night from an aortic dissection. CNN's Dr. Sanjay Gupta joined anchor Bill Hemmer to shed some light on the conditions these men suffered. HEMMER: A dissection of the aorta, what does that mean to you? GUPTA: Well ... the aorta is the largest blood vessel that's leaving the heart. And while this is not a very common condition, certainly a lot less common than a heart attack -- this is actually a little bit different from that. One of the major blood vessels now leaving the heart, [the aorta] can actually dissect. Think about this as a big tube and there can become a little hole in the tube so blood actually starts to dissect within that hole. The aorta goes through the chest and then down into the abdomen. It sounds like, from what we're hearing now, he had sudden pain and symptoms that sometimes look like a heart attack and can actually be that, where it goes through the chest, the aorta actually dissecting open. It's like a tube and blood actually gets in between the layers of that tube and you can get massive bleeding into that. You can actually bleed out all of your blood into this specific layer, and essentially it's significant bleeding that occurs within the body but ... can cause death. Now, the heart -- when the heart is not pumping enough blood, obviously the heart fails, as well. So, in fact, [Ritter] probably ultimately died because his heart failed, but because of this bleeding into the aorta. HEMMER: Why do they say it's unrecognized? Can you detect it or not? GUPTA: Well, it's sort of interesting. A good portion of these are congenital, meaning that he may have had this his entire life. A good percentage of them are also worsened by hypertension It's a very significant bleed when it does occur. Fifty percent of the people who have a rupture like this do die before they even make it to the hospital. Of the people who survive, about half of those have significant complications afterward with their kidneys, sometimes paralysis, all sorts of things. So it can be a devastating bleed. But, yes, it's something that you could have your entire life, even, and not really know about it. HEMMER: Clarify something. [Some reports say] he died of a heart attack, but in your first answer you say it's not necessarily the case that it was a heart attack. GUPTA: That's right. That's right. You know, when you really look at why a lot of deaths occur, ultimately it's because the heart fails. You know, when the doctor actually determines death, it's because they no longer detect a heartbeat, which is probably what happened with [Ritter], as well. But why did the heart stop ... ? Because he had massive bleeding into his aorta, which is a major blood vessel leaving the heart. HEMMER: I want to talk about what happened with Johnny Cash here in Nashville, Tennessee. He was in the hospital at least on September 10 of this week, died a day and a half later, complications with diabetes, we are told, and a long-term history of a number of illnesses. GUPTA: Yes, you know, he's been sick for a long time. We've certainly been following that along. You know, it's interesting, he was admitted for stomach ailments. Oftentimes that's related to an ulcer in the stomach that may be bleeding or something like that. When someone has diabetes, there's a whole host of problems that they sort of open themselves up to. One of the major ones is infection, as well as problems with the heart, again, as well. We're being told that he died of respiratory failure or lung failure. What happens in that situation, Bill, oftentimes there can be a massive infection of the lung and you just really can't get enough oxygen into the rest of your body. And that can be a pretty quick and sudden death. HEMMER: And we all know how much he suffered when his wife passed away in May of this past year. GUPTA: Yes, June Carter passed, right.
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