Why did George Michael’s heart fail?

There is still a huge amount of speculation about the exact reason George Michael died at the early age of 53, and this can only be resolved by a postmortem examination (and even then this is no guarantee of finding a cause). However, I raised an eyebrow when I heard that the current line is that he died from heart failure — a general term and one not often used in middle-aged people.

As medical terms go, the words ‘heart failure’ aren’t greatly reassuring — it’s as if your doctor were to say you’d better rush home and brush up on your will – and it is a serious medical condition, but ultimately means that the heart of someone suffering from it does not pump blood around their body as well as it should. This in turn means that the blood can’t deliver enough oxygen to the body to allow it to work normally, and that waste products can’t be removed efficiently, causing fluid to build up in the lungs, legs and abdomen.

Heart failure usually develops as a complication of an underlying heart condition such as narrowing of the arteries, a heart attack, high blood pressure, abnormal heart rhythms or problems with the heart valves. As a result it is also extremely common and becomes more common the older we get — around one per cent of people under 65 years of age have it but this increases to seven per cent in 75-84 year olds, and 15 per cent in people older than 85. It is a little-known fact that heart failure is the most common cause of hospitalisation in patients over 65 years of age, and that a staggering 14 million people in Europe suffer from it — a figure that continues to increase all the time.

The two main symptoms I tend to see are increasing breathlessness on exertion or exercise, or difficulty in lying flat because of a feeling of shortness of breath. There is also usually swelling of the ankles due to fluid retention, usually worse at the end of the day and better after a night’s sleep. There may also be a general feeling of tiredness or weariness, and some people may develop chest pain or palpitations. Appetite may reduce, and low mood or even depression may occur because of its impact on quality of life.

Before medication is started there are a number of lifestyle changes that can dramatically improve the situation. Losing weight if you are overweight takes the strain off the heart, as does cutting down on the amount of salt in the diet since salt makes fluid retention worse. It is vital not to smoke because this worsens disease in the heart arteries, and excess amounts of alcohol (occasional drinking at recommended levels is acceptable here) may also further damage heart muscle. A tricky piece of advice is to try not to drink too much fluid — often difficult because heart failure can cause thirstiness — but two litres or less a day should suffice. Protection against flu and pneumococcal chest infections by annual immunisations every year is recommended, as is exercise. The fitter the heart, the better it will pump.

If medication should be required there are now a number of treatment options available to doctors, and the optimal treatment is usually with several different medications taken each day to produce a combination effect and benefit. These include diuretics (‘water tablets’), drugs known as an ACE inhibitor which have a protective effect on the heart and slow down the progression of heart failure in many people, beta blockers, angiotensin 2 receptor blockers, digitalis, vasodilators and aldosterone receptor antagonists to name but a few. Heart failure caused by abnormal heart rhythms can be treated with devices such as pacemakers and implantable defibrillators, and in extreme cases surgery may be considered, typically in the form of coronary artery bypass grafting, valve surgery or even heart transplantation in a tiny number of cases.

So why – if it is indeed the case – should Michael die from this condition? One major clue may be his longstanding and self-declared addiction to cannabis, smoking up to 25 joints a day plus ordinary cigarettes on top. Marijuana has been linked to lung infections and in 2011 he was hospitalised in a critical condition with pneumonia from which he made a slow recovery. Tobacco smoke of any kind is a common causeof bronchitis and chronic obstructive pulmonary disease (COPD) and chronic lung disease is a well-known factor in triggering a type of heart failure, with recent studies suggesting that heavy marijuana usage alone may lead to airflow obstruction in the lungs. The sudden death of the singer may indicate that a heart attack linked to heart failure was the ultimate cause and recent photographs showed him looking overweight and tired.

Whatever the cause of his death, it is another light in the entertainment world that has been snuffed out too soon this year. Let us hope that 2017 is quieter on this front.

  • hedgemagnet

    And there was me thinking he’d just done too many lines. (Charlie has negative effects on the heart.and vascular system too, doesn’t it?)

  • Mandy Austin

    Such a pity, wish he could have been helped if he was struggling emotionally. People think being rich and famous must make you happy but it does bring so many other problems. Just hope he is at peace.

  • Danik Shah

    But how comes that his cardio specialist doctor did not prescribe him treatment, regular check-ups or, or even some invasive surgery e.g. by-pass?He almost died from pneumonia 5 years ago, has he not been under constant surveillance since that time by internal specialist?This is an everyday praxis and everybody in Czech republic gets it.Is the situation different in the UK or in US? Especially if a person was a drug user, does not a doctor make a complex screening of veins, heart and lungs once a patient gets into the middle age?Same story with Whitney Houston or Prince or MJ.I don’t know any Czech celebrity or even anybody from family or friends who would die suddenly from heart failure in the age around 50 in last 25 years because of heart attack or failure….Can anyone explain to me pls?Every year I go for blood tests re cholesterol and sugar, blood pressure,every year my physician makes an EKG routine test( basic cardiology checking).If something is weird he would send me to specialist for further tests immediatelly or even for direct treatment.this is just normal everyday praxis in Czech healthcare system.the check-ups are called regular annual prevention check-ups.

    • post_x_it

      What does the Czech system have to do with any of this?

      • Danik Shah

        Yeah, sorry, I forgot to mention it. Well, the reason is, that I am from the Czech Republic, which is definitely not one of the richiest european economics, according to the average wages rather the opposite…. so I was commenting on this tragic event from my point of view, because for me it is absolutely impossible to believe that M.G. died on heart failure without having been under constant medical surveillance for several years. Not mentioning that he was a rich and famous man, not just ordinary man or even homeless, whose health condition would probably be neglected. Or, are the Britons so irresponsible towards their own health in general? I really do not mean it offensive, I visited England 20 years ago for the last time, and in that time I was young and fit and I did not care about those things at all, so I can not compare based on personal experience.

        • MrSpoons

          You sound very earnest and sensible regarding your health, many aren’t. Perhaps you need to realise that not everyone is the same as you, and that this has no bearing on their country’s system for providing health care.

          • Danik Shah

            haha, no, not at all, i am pretty messy re my own health. I am rather scared to visit my GP or even specialist. I was just wandering, how comes that almost same destiny hit Michael Jackson, Whitney Houston, Prince and George Michael too. I dont believe that all of those music geniouses were messy like me….

  • plainsdrifter

    I’m going to have heart failure if there’s any more breast beating over the death of a celeb.

  • Resurgent Right

    He took too many drugs, that’s why.

  • SonOfaGun

    Cocaine is a stimulant and makes the heart beat involuntarily fast, causing muscular enlargement of the main pumping ventricle, and leads to heart attacks from 45yrs onwards. Likewise, if a showbiz celebrity dies of liver failure, the first culprit has to be drink.

    It’s about time we stopped glamorizing drug use and started punishing it sufficiently..

    • Filip Kowalski

      That’s true! I totally agree and the reason why he looked so frail was use of drugs I believe. I remember him being such a handsome guy back in 80s then I couldn’t believe he developed such drastic changes in apperance. What a pity this happened to him

  • Jenki

    Probably got a nasty disease from one of the public toilets he liked to hand around in!

  • outlawState

    Why did George Michael’s heart fail?

    He was a known risk taker, and he took on one risk too many.

  • MacGuffin


  • Bristol_Boy

    How much more do we have to endure about this person? superstar? who in hell gave him that status? drug taking public toilet lurker, what a bloody great role model, is it any wonder Britain is in decline.

    • Lesley

      He also stood up against going into Iraq without a UN mandate and took the full wrath of the press in doing so. His predictions on the impact of doing so were prescient. He was a quiet philanthropist and by all accounts a highly intelligent, kind and gentle man who entertained millions, and loved life. A brave, kind and loving man who lit up the lives of those around him.

      • Polidorisghostfriend

        ‘Without a UN mandate’? What on Earth are you talking about? Iraq was in violation of 14 — yes you read that right: FOURTEEN — UN resolutions, and the Allies only went into Iraq with UN approval (even though the UN is dominated by theocratic thugs, autocrats, and tyrants: for some reason you think it has massive moral authority). I’m afraid your singer had as much knowledge of justice as he had about personal hygiene and health.

  • beenzrgud

    Sounds like he died painlessly in his sleep, which can happen with people who have a dodgy ticker. of all the ways to go it’s certainly not the worse.

  • the panda

    Because AIDS. The disease of the gays.

  • Louis Byron

    Cannabis? You have got to be kidding me. No independent (non government funded) study has ever definitively linked heavy cannabis use with any serious disease or health condition. Folks think heat & smoke and just assume “oh, there must be some lung damage”. With cigarettes, it is not the heat and smoke per se but rather the tars and other carcinogens in the tobacco that causes oxidative and mutagenic damage to the cells and ultimately, the organs. Cannabis on the other hand is filled with cannabinoids that appear to have strong antioxidant, antiviral, and anticancer effects. Folks are anecdotally reporting full cures from Stage IV Advanced Cancer and even advanced HIV & Hepatitis using high dose cannabinoid extracts like Rick Simpson Oil. Cannabis did not kill George Michael. My guess….cocaine and other hard drug abuse (anyone who smokes 25 joints a day and uses the white powders is not using those powders on a recreational basis I can assure you). Combined with terrible eating habits, obesity, and probably untreated or uncontrolled Type 2 Diabetes. It’s not completely clear if he had AIDS or advanced HIV but it’s unlikely that killed him outright anyway. Death from HIV these days happens to those who don’t take care of themselves or get “over treated” by traditional Western medicine with the rather toxic antiretroviral drug cocktail that is now the standard treatment for HIV. Rest In Peace George. God Bless.

    • Weeser1

      A guess may be that he knew or avoided the treatment. Not sure how much truth the media shares.

    • Tom Fox

      This post is a croc of nonsense from top to bottom. You are a lunatic advocate of cannabis. Mad as a hatter.

  • yklktk

    And there was I thinking it was his enduring cocaine habit.