Medical Professionals - Can I have your insight?

Question

There is a man with a history of heart problems (two previous mild heart attacks). He goes to bed in a room with the window open because it makes him feel more comfortable (perhaps because it helps him breath better). During the middle of the night the window is closed by another person. The man then has a heart attack, the same night.

Do you think the person who closed that window is the direct cause of the heart attack? Or would have it happened anyway with the window closed or open?

Answer 1

Coincidence, unless there was inadequate oxygen in the room (kerosene heater and no ventilation?) or something toxic (like CO).

I've been in a number of cardiac ICUs - no open windows.  Ever.

Just because one event follows another in time, it does NOT mean that the first event caused the second.  That's one of the problems with the whole "vaccines caused my kid's autism" issue.  (Which, btw, it does not).

Answer 2

My old physical diagnosis textbook antedates the era when most middle class people slept in air conditioning. One of the questions we were instructed to ask was if the patient slept with the windows open. A positive answer suggested the possibility of congestive heart failure and should prompt further questions such as shortness of breath on exertion, swelling of the extremities, number of pillows you sleep on, etc. Opening the windows was possibly more psychologic than physiologic, but perhaps some homes were overheated and smokey with what my grandmother would call "stale air."

So my conclusion is that the person had pre-existing heart disease and was more prone to a heart attack. Closing the window was coincidental.

Answer 3

If the patient has a history of cardiac problems, then I would conclude the heart attack can happen whether or not the window was closed. This is the problem with cardiac cases, you can never predict when an attack is coming. One minute the patient is doing fine, the next he may be down and out.

Answer 4

No, it's hard to imagine how it could be related, and certainly wouldn't be a proximate cause. To "connect the dots" you'd have to have something toxic in the house (carbon monoxide?) that needed airing out as an intermediate step.