Now let's talk about Justin. Did he have a heart condition? No, his heart was healthy on autopsy. There were no signs of congenital diseases, like Hypertrophic Obstructive Cardiomyopathy (the condition that kills young healthy athletes). There were no signs of stenosis, dilatation, obstruction, plaques, or ischemia. In other words Justin's heart was a healthy heart. The official diagnosis will be Sudden Cardiac Arrest (SCA) of unknown etiology. All of us have irregular heartbeats from time to time. Some call them palpitations, some call them skipped beats. Patients come into the Emergency Room all the time with palpitation and skipped beats. Thankfully most of the time our hearts recognize these abnormal beats and correct for them. We might not even realize it has occurred. Unfortunately, in some individuals their heart does not recognize this abnormal beat and does not correct it, which causes the heart to go into ventricular fibrillation (VF), leading to a quick, painless brain death followed by full body death. When SCA occurs, often the person has underlying heart disease or a heart condition and this is the cause of the SCA. When SCA occurs in a healthy individual like Justin without a heart condition we are often left without any answers as to why the heart did not recognize the abnormal beat and fix it or "re-start" the regular rhythm.

Justin died long before Stephanie heard his "snoring" and tried to awake him. The "snoring" sound was most likely agonal breathing or "death rattle" indicating Justin had been brain dead for several minutes, if not longer. There was no saving Justin. He was truly taken from this earth and went peacefully in his sleep without any knowledge of what was happening. He kissed Stephanie goodnight and that was his last memory.

I was able to speak with the coroner before, during, and after the autopsy, and, thanks to Staci, we have many of the medical records including the paramedic and ER run sheets, and spoke briefly with the doctors who treated Justin. I have tried to write this explanation is in a straight forward manner but as you can imagine there is nothing straight forward about losing my healthy 35 year old brother and best friend.