An Indiana mother who mysteriously died on her flight home from the Dominican Republic suffered a carotid artery attack, her family has revealed.
Stefanie Smith, 41, was killed in “truly a tragic medical event,” her brother Chris Volz said, adding that autopsy results did not indicate foul play.
The damage occurs when an artery in the side of the neck tears, preventing blood from reaching the brain – causing neurons to stop working and die.
The condition is rare, affecting only one in 50,000 people, and can be caused by something as innocuous as heavy coughing, nose blowing, neck strain, poor posture and in-flight turbulence.
But most are caused by a traumatic injury such as a high-speed car or sports accident, which physically tears the arteries.
Stefanie Smith, 41, was just minutes into the American Airlines flight home from the Dominican Republic when she became fatally ill from an unknown cause on February 28
Smith is pictured with her two children. The late mother’s cause of death has now been revealed by her brother
The tear allows blood to enter between the layers of the artery wall and separate them. This causes the artery wall to bulge, which can slow or stop blood flow to the brain. This can lead to a transient ischemic attack (TIA) or stroke
In many cases, carotid dissection can happen suddenly without a known cause, called spontaneous carotid dissection.
The tear allows blood to enter between the layers of the artery wall and separate them. This causes the artery wall to bulge, which can slow or stop blood flow.
It can also cause problems by pressing on nearby structures such as nerves.
The tear can trigger the body’s clotting system. A blood clot can block blood flow at the site of the tear, or pieces of the clot can break off and block flow in smaller branches of the artery.
Blocked or reduced blood flow can cause a stroke by starving the brain of blood and oxygen. A blood vessel supplying the brain bursting and bleeding can also lead to a stroke.
Carotid dissections can occur at any age, but are more common in people in their 40s and 50s and are a common cause of stroke in people under 50, possibly because younger people do more activities that can lead to a dissection.
It is slightly more common in men than in women.
Her brother Chris Volz, pictured with Stefanie Smith, has revealed she died from a carotid artery dissection in her neck
Smith and her boyfriend had joined close friends Maria Yannotti, 36, and Clay Sharpe, 43, for a five-night stay at the all-inclusive Iberostar Grand Bavaro in Punta Cana, Dominican Republic.
But the romantic couple’s getaway turned to tragedy minutes into her return journey when she began convulsing and was pronounced dead after the American Airlines flight was diverted to the Turks and Caicos Islands.
A stroke, which can be caused by carotid dissections, prevents brain tissue from getting oxygen and nutrients, causing brain cells to die within minutes and eventually death.
Seizures, where the body convulses, can occur after a stroke due to the electrical disturbance in the brain.
Research has suggested that prolonged, incorrect posture on a flight, such as leaning your head forward, can increase the chance of carotid dissection in people who are already at higher risk.
Turbulence in aircraft can also increase the likelihood.
Certain health conditions increase the risk of carotid dissections, including fibromuscular dysplasia, Marfan syndrome, Loeys-Dietz syndrome, and Ehlers Danlos Vascular type IV.
But Smith’s brother Volz previously told DailyMail.com that he was unaware his sister had any pre-existing health conditions.
Yannotti also claimed that Smith was the picture of health throughout their vacation, using the hotel’s gym and jogging along the beach.
There have been reports linking carotid dissection with weight lifting or intense exercise, but the specific relationship is not well understood.
One prospective study of 750 Canadian patients found that about 30 percent of the observed population who weight-lifted more than 50 pounds experienced spontaneous carotid artery dissection.
Patients with carotid artery dissection are advised to avoid push-ups and sit-ups for eight to 12 weeks after the dissection, the American College of Cardiology said.
Cocaine use can also increase the likelihood of a carotid artery dissection.
Some people who have carotid dissection have no symptoms. In others, symptoms may appear suddenly or appear over several days.
Symptoms may include headache, scalp pain, eye pain, neck pain, weakness on one side of the body, and facial flushing.
Sufferers may also experience problems with speech, difficulty swallowing or an abnormal or lost sense of taste.
When carotid artery dissection is diagnosed early, the prognosis is usually good,
But it can be difficult to diagnose because symptoms vary considerably between patients.
Research suggested that with spontaneous dissection, less than five percent will die and close to 75 percent of patients recover.
With dissections caused by trauma, an estimated 37 percent – 58 percent of patients have permanent neurologic problems with higher mortality compared to patients with spontaneous dissection.