Michael villani obituary nyt

Abstract

Sudden cardiac death (SCD) in competitive athletes, though relatively uncommon, invariably leads to controversy. Specific limitations of an extensive screening process include lack of robust evidence to support prevention of SCD, poor cost-effectiveness and uncertain downstream implications of a positive screening test. An emerging body of evidence points to enhanced neurologically intact survival to hospital discharge when automated external defibrillators (AEDs) are used in a timely manner following sudden cardiac arrest (SCA). A viable alternative to an expansive screening process could be a robust secondary prevention system comprising of improvements in AED availability, stringent enforcement of CPR training in athletes and trainers to provide timely and effective resuscitation to reduce death following SCA. This strategy could widen the window to diagnose and treat the underlying etiology and prevent recurrence of SCA while also offering financial feasibility. Restricting athletes from competitive sports is a difficult decision for physicians owing to a lack of well-defined cutoffs for acceptable and prohibitive risk from pathology predisposing to SCD, especially in the absence of a protective medico-legal framework. In this review, we highlight a few cases that generated intense scrutiny by the public, media and medical professionals about the efficacy, feasibility and pitfalls of the existing screening process to diagnose cardiovascular pathology predisposing to SCD. Furthermore, contrasting approaches to screening, diagnosis and downstream workup protocols between the European Society of Cardiology and the American Heart Association are analyzed.

Keywords: Atrial fibrillation, Sudden cardiac death, Sudden cardiac arrest

Introduction

Athletes have traditionally been known to exhibit an exorbitant level of physical fitness and excellent cardiac health. Contrary to the general belief that they are relatively well protected from cardiac pathol

Over the weekend, the New York Times reported that the car that exploded near the Rainbow Bridge in Niagara Falls, New York—killing both occupants of the car, injuring a border control officer, and snarling traffic at the international crossing on one of the busiest travel days of the year—was an ultra-high-end Bentley with a 542-horsepower engine that could go from 0 to 60 in 3.9 seconds. Indeed, when you watch the video released by U.S. Customs and Border Protection of the car hitting a median as nearby vehicles crawl into tollbooths, you can’t help but admire how fast the Bentley Flying Spur is going when it launches upward as if shot from a cannon.

It does make you wonder, though: Why on earth would someone want to own a car—one meant to be driven on regular old roads in, for example, upstate New York, where its driver operated a small local chain of hardware stores—that can go a reported 175 miles per hour? That’s 110 miles per hour faster than the highest posted speed limit in the state of New York. It’s about 107 miles per hour faster than the highest posted speed limit in Ontario, where the driver hoped to attend a KISS concert. Heck, that’s 90 miles per hour faster than the highest posted speed limit in all of America (on state Highway 130 outside Austin, Texas). Unfortunately, we can’t ask Kurt P. Villani, 53, of Grand Island, New York, or his wife, Monica Villani, also 53, why they bought a car that can go that fast, because they both died horribly when the car exploded.

Why would an automaker manufacture a car with so much engine power that it requires an eight-speed transmission? The obvious answer is: because people pay a lot of money for it. A 2022 Bentley Flying Spur like the Villanis’ sells for upward of $200,000, according to Car and Driver, and that’s the price for a used model. Car and Driver does not reveal the MSRP for a new Bentley but describes it as both “eye-watering” and “eye-popping.” (Once you dry out your eyeb