(AP) - He was only 33, and fit enough to be a key member of the St. Louis Cardinals' pitching rotation, with a 5-4 record and 3.72 ERA.
So the news that Darryl Kile apparently died of heart disease came as a shock.
But heart disease is not limited to the middle-aged and elderly. About 10 percent of men between the ages of 25 and 34 show some signs of heart disease, though many don't experience symptoms, the American Heart Association said.
And while the average age of a first heart attack in men is 65, nearly 17,000 men in the United States under the age of 45 died of cardiovascular disease in 1999.
Kile apparently was among the many who had heart disease and don't know it. For about 50 percent of the men who die suddenly of heart disease, there have been no previous symptoms.
"This happens all the time," said Dr. Marc Ovadia, a cardiologist at Advocate Christ Medical Center and Mount Sinai Hospital.
Cardiovascular disease tends to run in families, and Kile's father died at age 44 of an apparent stroke.
"Some people just have bad genes, and this predisposes them to have bad disease at a very young age," said Dr. Jeff Teuteberg of the University of Chicago Hospitals. "If you have a strong history of family disease, you need to be watched pretty closely. You can't outrun your genes."
An autopsy found that two of Kile's coronary arteries were between 80 percent and 90 percent blocked. Had doctors known of this condition, they might have been able to prolong Kile's life by performing an angioplasty to unclog the arteries, or a heart bypass surgery.
Kile had an electrocardiogram during spring training. But as is often the case with EKGs, the test did not find anything wrong.
"It's not a perfect screenintg tool," Teuteberg said.
A stress test, in which the heart is monitored while the patient exercises, might have detected blockages in the arteries, depending on which arteries were blocked. But stress tests generally aren't ordered on patients who do not show symptoms, Teuteberg said.
Another test that might have detected a problem is an X-ray heart scan, such as the $395 test offered by Heart Check America. The scan takes a rapid series of X-ray pictures that detect calcium in arteries. A high calcium score might indicate a patient is at higher risk for problems such as chest pain or heart attack.
Skeptics say that while the test may save the lives of a small percentage of patients scanned, the cost per life saved may prove to be much higher than the lifesaving costs of other routine screening tests. Critics also say that ads for the test might attract people who don't need it.