Friday, July 8, 2011

Bruno Sammartino has heart surgery

On June 28th, 2011 Sal Corrente issued the following statement:

"We want to address any rumors regarding Bruno Sammartino and his current health situation. If you have read Bruno's Auto Biography you are aware that he had Rheumatic Fever as a child that caused damage to the valves in his heart. He was very sick for three plus years and came very close to dying as a child.. It clearly didn't affect him for many years he grew strong and had great stamina in the ring. It was recently discovered that the valves had detriorated and had to be replaced immediately. He has had the surgery and began a rehabilitation process that should last around three months. I have been told that Bruno's doctor's expect a full recovery and he should have the heart of a forty year old man when the rehab is complete."


Bruno Sammartino

     Acute rheumatic fever is a delayed complication of a Group A Streptococcal infection involving the tonsils/pharynx.  Features of the initial bacterial infection include the sudden onset of sore throat, pus on the tonsils, tender lymph nodes in the neck, and fever.  Cough and significant nasal drainage are usually absent.  The infection is commonly referred to as "strep throat".  Prompt recognition of the infection and treatment with appropriate antibiotics are important.  Timely therapy has been shown to reduce the duration of the illness, prevent transmission to others, and decrease the likelihood of developing delayed complications including rheumatic fever.  (1, 2)  Some of the potential complications of Group A Streptococcal infection are listed in Table 1.


Table 1
  • Acute rheumatic fever
  • Scarlet fever
  • Streptococcal toxic shock syndrome
  • Acute glomerulonephritis
  • PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder associated with group A Streptococci)

     Acute rheumatic fever typically occurs 2 to 4 weeks after the Group A Streptococcal infection.  It most commonly develops in children ages 5 to 15 years old.  It is rare to see in younger children and adults.  A major manifestation of acute rheumatic fever is a severe inflammation of the heart.  This can involve all components of the heart including the muscle, valves, and sac that surrounds the heart (pericardium).  The major and minor manifestations of rheumatic fever are listed in Table 2.  (3)

Table 2

Major manifestations:
  • Migratory arthritis (predominantly involving the large joints)
  • Carditis and valvulitis (eg, pancarditis)
  • Central nervous system involvement (eg, Sydenham chorea)
  • Erythema marginatum
  • Subcutaneous nodules
Minor manifestations:
  • Arthralgia
  • Fever
  • Elevated acute phase reactants [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)]
  • Prolonged PR interval on the EKG

     Rheumatic heart disease is the most severe complication of acute rheumatic fever.  It usually occurs 10 to 20 years after the original illness. The mitral valve is more commonly involved than the aortic valve. Mitral stenosis, caused by severe calcification of the mitral valve, is the classic finding in rheumatic heart disease.  As the valve disease progresses a person can experience a wide variety of problems including shortness of breath, exercise intolerance, and even congestive heart failure.  Once the valve disease is moderate to severe surgery is usually required.

Specific details about Sammartino's health have not been released.  It is unknown how long he was having symptoms, and what valve was involved.



References.
  1. J Pediatr. 1985;106(6):870.
  2. J Pediatr. 1978;92(2):325.
  3. JAMA. 1992;268(15):2069.  

The medical resource www.uptodate.com was used in the preparation  of this blog.  Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

    Friday, July 1, 2011

    Wrestlers' sore eyes.

         Trachoma is an eye infection caused by Chlamydia trachomatis.  The organism can be transmitted by social contact through eye, nose, and throat secretions and remains the leading cause of infectious blindness worldwide.  It is estimated that over 80 million people worldwide have trachoma, and approximately 1 million are blind as a result. (1)

         The initial infection is often mild, causing a self-limited conjunctivitis (inflammation of the membrane surrounding the white of the eye).  Many cases do not produce any symptoms.  The duration and severity of the infection predict the likelihood of progression to blindness later in life. (2)  

         Trachoma used to be epidemic among early professional wrestlers.  It used to be referred to as "wrestlers sore eyes".  There are numerous references in the medical literature that attest to this.  For example, in the November 20, 1930 College of Physicians of Philadelphia Ophthalmology Society transactions there is a discussion about trachoma in wrestlers.  One physician shared his experience treating "a case of trachoma in one eye of a wrestler who at that time was champion of the world". (3)

         That trachoma was  common among professional wrestlers is also well illustrated in a presentation given on April 3, 1935 by A.F. MacCullan, President of the International Organization against Trachoma.  At the annual meeting of the Organization held in London, England he stated that "It is not generally know that nearly all professional wrestlers have trachoma". (4)  Phillips Thygeson in 1963 made similar observations in his work Epidemiologic observations on trachoma in the United States.  He concluded that the only clear cut occupation that was related to trachoma in the United States was wrestling, having personally treated several infected professional wrestlers. (5)

          Such a concern was the infection that it prompted the National Wrestling Association to state in the official 1939 rulebook that "No wrestler having trachoma (eye disease) shall be permitted, under any circumstances, to engage in any wrestling contest. The National Wrestling Association recommends that all wrestlers be given a rigid examination for evidence of trachoma before being allowed to enter the ring, and particular attention shall be given to the provisions of this rule". (6)

         The most famous professional wrestler to suffer from trachoma was Robert Freidrich, known worldwide as Ed "Strangler" Lewis (June 30, 1891-August 8, 1966).

    Ed "Strangler" Lewis


         Trachoma no longer is a common infection.  An increased awareness of the modes of transmission and antibiotics such as oral azithromycin and topical tetracycline have significantly reduced the prevalence in developed countries.  Modern era American professional wrestlers no longer have to worry about the dreaded "wrestlers' sore eyes".



     References

    1. Bull World Health Organ. 2004;82(11):844.
    2. Ophthalmic Epidemiol. 2001;8(2-3):137.
    3. archopht.ama-assn.org/cgi/reprint/5/4/666.pdf
    4. www.ncbi.nlm.nih.gov/pmc/articles/.../pdf/brjopthal00805-0013. 
    5. www.iovs.org/content/2/5/482.full.pdf 
    6. www.silverstatechronicles.com/.../pro-wrestling/official-national-wrestling-alliance

     The medical resource www.uptodate.com was used in the preparation of this blog.

     Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.