Beloved sports journalist Grant Wahl, who’s credited with igniting Americans’ passion for soccer, died at age 49 on Friday, Dec. 9 while covering the World Cup in Qatar. Wahl’s death was sudden, which prompted some to speculate that it may’ve been tied to his rejection of Qatar’s anti-LGBTQ policies.

Wahl’s wife, Dr. Céline Gounder, confirmed in a statement on Dec. 14 that this wasn’t the case. She explained that he died from “the rupture of a slowly growing, undetected ascending aortic aneurysm with hemoperdicardium.”

Gounder reiterated that there was nothing suspicious about Wahl’s death. “No amount of CPR or shocks would have saved him,” Gounder wrote. “His death was unrelated to COVID. His death was unrelated to vaccination status. There was nothing nefarious about his death.”

Days before he died, Wahl wrote about feeling sick, which he attributed to his long work hours at the World Cup and not getting much sleep.

“My body finally broke down on me,” he wrote. “What had been a cold over the last 10 days turned into something more severe on the night of the USA-Netherlands game, and I could feel my upper chest take on a new level of pressure and discomfort.”

Doctors assumed it was bronchitis and prescribed him antibiotics, which he said made him feel better. When Gounder shared Wahl’s cause of death, she noted that that chest discomfort “may have represented the initial symptoms.”

Here’s what to know about ascending aortic aneurysm with hemoperdicardium, the condition that killed Wahl.

An aortic aneurysm occurs when the aorta — the main blood vessel that carries blood from the heart to the rest of the body — develops a weak spot, called an aneurysm. This weak spot may grow over time, start to bulge and eventually tear or rupture, leading to life-threatening internal bleeding, according to the Cleveland Clinic.

The most common place for an aortic aneurysm is in the ascending aorta, which is the first part of the blood vessel that comes up through the heart, Dr. Eric Roselli, chief of adult cardiac surgery at Cleveland Clinic, tells Aortic aneurysms that rupture are one of the top 15 causes of death in the U.S. he adds.

The hemoperdicardium aspect of Wahl’s death refers to when the peridcardium — a sac containing the heart and first part of the aorta — accumulates too much blood, in Wahl’s case due to the rupture. This can put pressure on the heart chambers and result in cardiac arrest or death, Dr. Matthew Henn, a thoracic surgeon at The Ohio State University Wexner Medical Center, tells via email.

Age and lifestyle factors don’t play a role in aortic aneurysms as much as they do for other heart conditions. The average age of patients being operated on for an aortic aneurysm is 59 years old, Roselli says, adding that he’s treated patients ranging from 12 to 95 years old with the condition.

While aortic aneurysm is strongly associated with hypertension, aka high blood pressure, most cases have a genetic component, Roselli explains. “With these aorta conditions, it’s a lot less about lifestyle.”

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Henn adds: “Patients who are affected at a young age are often associated with an inherited condition, but occasionally no direct cause can be identified.”

Other conditions that can cause an aortic aneurysm include: plaque buildup inside the arteries, injuries that can result in tears in artery walls and genetic conditions like Loeys–Dietz syndrome and Turner syndrome.

An aneurysm will often go undetected, like Wahl’s did, because it doesn’t usually cause any symptoms “until it’s killing you,” Roselli explains. “It’ll expand in you, and you won’t even know it until the aorta reaches that limit where it starts to tear and comes apart.”

Wahl’s wife, a physician, speculated that his chest pain may have been a sign of his aneurysm, and Roselli agrees that it’s “so hard to say” whether it was “directly related to the aneurysm or not.”

“If he had some high blood pressure that wasn’t being controlled, maybe that caused him some symptoms or some other stress he was feeling through everything, but he must’ve had this aneurysm that was preexisting,” Roselli adds.

Henn echoes that aneurysms typically don’t cause symptoms “until a potentially catastrophic complication has occurred.” Those that are uncovered earlier are usually found through scans for another health condition, he adds.

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