Q: My father died unexpectedly this year at the age of 54. He had a bicuspid valve, which was unknown to him or to us, and he had minimally high blood pressure. The narrowing of the valve caused the valve to rupture and fill his lungs with fluid. He never saw it coming, and it came as a shock to us. He had an EECP machine that was used to treat patients, and he, himself, used the machine. Could the treatments with the EECP have accelerated the narrowing of the valve?

A:Narrowed valves do not rupture. The aorta distal to the valve may be dilated in some people with bicuspid valve predisposing to rupture. There may have been an infection on the valve causing back leak, leading to fluid in the lungs. I am unaware of EECP (Enhanced External Counter Pulsation) predisposing to rupture and I don’t think it contributed to your father’s demise. The commonest causes of sudden death are silent heart attacks and very fast rates due to electric problems of the heart (especially in people with heart failure for which your father might have been using the EECP).