Muhammad Ali: Boxing legend died from ‘extreme’ septic shock – condition explained

Frank Bruno and Piers Morgan discuss Muhammad Ali in 2016

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A few years after retiring from boxing in 1981, Ali publicly announced that he had Parkinson’s disease – a neurodegenerative disorder that affects predominantly dopamine-producing neurons in a specific area of the brain called substantia nigra. With some speculating that the onset of the condition was caused by his boxing-related injuries, Ali remained an active public figure before his condition worsened. Having “bounced back” from so many injuries and illnesses over the years, when Ali was hospitalised just days before his death with a respiratory illness, no one could have expected him to develop septic shock.

Shortly after his death, Ali’s family spokesman Bob Gunnell revealed that the boxer’s death was septic shock “due to unspecified natural causes”.

“Muhammad has battled back many times,” Gunnell continued. “We expected it to happen this time.

“[But] things became more serious, [and then] it became clear that his condition wasn’t going to improve.”

Sepsis Alliance explains that septic shock is the “final and most severe form of sepsis,” that is also extremely difficult to treat. Patients with septic shock are among the most ill in hospitals, with sepsis claiming the lives of 52,000 every year in the UK.

Up to 87 percent of sepsis cases start from infections that can be caught anywhere, from work, school or home. But if the condition is not recognised and treated quick enough, it can suddenly turn into septic shock.

The body’s “extreme” response to infection usually stems from one that has started in the lung, urinary tract, skin or gastrointestinal tract, according to the Centres for Disease Control and Prevention (CDC).

Initially, symptoms will appear as weakness, chills and a rapid heart and breathing rate, but over time toxins produced by bacteria can damage small blood vessels, causing them to leak fluid into the surrounding tissues.

This can then affect the heart’s ability to pump blood to your organs, which lowers your blood pressure and means blood doesn’t reach vital organs, such as the brain and liver.

One of the main factors that causes sepsis to develop into septic shock is if treatment is given or not. Sepsis Alliance states that the chance of sepsis progressing to severe sepsis and septic shock, causing death, rises by four percent to nine percent every hour treatment is delayed.

The medical definition of “shock” is a drop or fall in blood pressure. The average blood pressure for a healthy adult is less than or around 120/80 mmHg, so when this level drops to below 90/60, an individual is classed as having low blood pressure, also known as hypertension.

Having low blood pressure means that blood doesn’t have enough force behind it to circulate around the body, leaving vital tissues starved of nutrients that they need to work. It is when one of these vital organs stops working effectively that an individual is diagnosed with septic shock.

In addition to low blood pressure, symptoms of septic shock can also include:

  • A change in your mental state, such as confusion or disorientation
  • Diarrhoea
  • Nausea and vomiting
  • Cold, clammy and pale skin.

Due to the seriousness of the condition, septic shock involves a number of complications including respiratory failure, heart failure, kidney failure and abnormal blood clotting. The individual’s chance of survival is based upon the number of organs that have failed.

However, there are treatment options for medical professionals to try on patients with septic shock. This mainly involves oxygen therapy and increasing blood flow in order to raise blood pressure.

To increase the blood flow to your vital organs, such as the brain, liver, kidneys and heart, individuals may be prescribed inotropic medicines or vasopressors.

The former, inotropic medicines (inotropes), stimulate the heart. They increase the strength of your heartbeat, which helps get oxygen-rich blood to your tissues and organs, where it is needed most.

The latter, vasopressors include:

  • Dopamine
  • Adrenaline
  • Noradrenaline.

These medicines will cause your blood vessels to narrow, increasing your blood pressure and the flow of blood around your body, allowing vital organs to start functioning properly.

In severe cases of sepsis or septic shock, the large decrease in blood pressure and blood flow can kill organ tissue. If this occurs, surgery may be required to remove the dead tissue.

Sepsis Alliance warns that recovering from septic shock can take longer than you may expect. Survivors may appear to be better, but many live with long-lasting effects from having been so ill. In fact, up to 50 percent of sepsis survivors live with post-sepsis syndrome (PSS), which can be mild or severe. Symptoms of PSS can include:

  • Insomnia
  • Chronic pain
  • Chronic fatigue
  • Hair loss
  • Memory issues
  • Frequent infections.

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