and so in close to the aorta is called proximal to the aorta and then the further out it goes, distributingod along the way to the heart muscle is called distal. >> when you have proximal narrowing how does that affect the heart? >> it can narrow the blood supply to more of the heart than if you have distal narrowing. >> another way of saying that would be it decreases the amount of blood the heart is getting. right? >> yes. >> and it also affects how things are removed from the heart? or carbon dioxide. >> well, that's different. that wouldn't happen from the blood vessels coming in, i don't think. so i wouldn't include carbon dioxide in that. >> okay. is there a standard within forensic pathology where pathologists would consider to be that there's enough of a narrowing to cause sudden death? >> so the way i would describe that is anything over more than 70 to 75% is in the view of a forensic pathologist something that in the absence of another cause of death could be used to explain death. >> okay. >> now, it's also true that people live with 100% occlusion, and go on and do fine. so you

. >> the way the coronary arteries supply blood to the heart, they come off of the aorta which is the main vessel that takes blood from the heart to the rest of the body and so in close to the aorta is proximal to the aorta and the further out it goes history beating blood along the way to the heart muscle is called distal. >> when you have proximal narrowing, how does that affect the heart? >> it can narrow the blood supply to more of the heart than if you have distal narrowing. >> another way of saying that would be decreasing the amount of blood the heart is getting. it affects how things are removed from the heart. carbon dioxide. >> that is different. that wouldn't happen from blood vessels coming in i don't think. so i wouldn't include carbon dioxide in that. >> is there a standard within forensic path policy where pathologists would consider to be that there is enough of a narrowing to cause sudden death? >> the way i would describe that is anything over more than 70-75% is in the view of a forensic pathologist something that in the absence of another cause of death could be us

want to make sure the arteries are in the right place and make sure they have normal connecting the aorta[inaudible] >> after we have done that, she typically carefully part the organ, cut through the muscle. [inaudible] hemorrhage in the heart suggesting a heart attack, if you will. there are many more that we are looking for we doac this, then apply in mr. floyd's case they are in the back of the lines as we do this. the last thing once we have cut through the muscles, we open the valves of the heart in the same direction as the blood flows. no infections, no calcification, so yes, we have now the outside of the heart, the muscle of the heart and valves. >> having done all of this ino respect to mr. floyd, did you find any previous damage to his heart also? >> no, no visible or microscopic previous damage to his heart. >> i apologize but there is one other photograph so pull out number 172, the heart valves. [background noises] will. >> would you tell us what we see in exhibit 192? >> exhibit 192 cross-sections of what i would describe as the worst or narrowest lesions i found in mr. fl

close together elf upper most one in the photograph -- odd -- that means that's pretty close to the aorta, oorigin of the artery, and in most adults the left anterior descending this largest of the three coronary art riffs so you can see mr. floyd's arrest anterior descending artery is quite narrowed. i would put that at 75% narrowing. the cut that you see right below that, the middle of the three, that's another section through mr. floyd's left anterior descending coronary and that is very tight narrowing is there. 75%. and then the third one you see in that series of three, the one close toast ruleres the first branch off of his left anterior descending coronary artery. that is called the first diagonal branch. that can be a big one in some people. it was good sized in mr. floyd's case but quite narrowed. and i should back up and explain that when i say norioed i mean the yellow plaque that you see lining those coronary arteries like a partially clogged plumbing pipe. that's the cholesterol, the fiberrous tissue, the scar that you don't want on your coronary arteries. that's why your do

when it occurs close to its origin, a aorta, that's proximal. further down the artery, it's distal. if you have narrowing close to the beginning of the artery, anything downstream from that narrowing is suggest to decreased supply of blood. if you have it further down and distal, then the first part and all the branchs that come off the first part are supplying part of the heart and receive enough supply. it's not restricted. once you get to beyond the narrowing, any tissue -- heart tissue, muscle downstream from that is going to be subject to a reduced supply. in this particular case, he had significant narrowing of all of his coronary arteries close to the origin, which is consistent with all of his heart, unfortunately, being subject to reduced supply, the entire heart. >> is there a certain amount of narrowing that forensic pathologists consider to be enough to cause sudden death? >> the typical conventional number that forensic pathologists use is between 70% and 75% narrowing is a risk factor for sudden cardiac death. >> can you survive with greater than 75% narrowing? >> abso

>> when it occurs close to its origin, close to the aorta where the blood supply comes from, we will call that proximal. if it occurs far down the artery towards the end of the artery or further down the artery, it's called distal. the implications are somewhat different. if you have narrowing close to the beginning of the artery, anything downstream from that narrowing is subject to decreased supply of blood. if you have it further down and distal, then the first part, and all the branches that come off the first part are supplying the heart, and that part of the heart will still receive enough supply. it's not restricted. but once you get to beyond the narrowing, any tissue, heart tissue, muscle, downstream from that is going to be subjected to a reduced supply. so in this particular case he had significant narrowing of all of his coronary arteries close to the origin which really is consistent with all of his heart, unfortunately, being subjected to reduced supply, not just a portion of his heart, but the entire heart. >> is there a certain amount of narrowing that forensic pathol

. >> the way that the coronary arteries that supply blood, it comes off of the aorta taking it from the heart to the rest of the body, so being close to the aorta is proximal and then the further out of those it distributes blood along the way to the heart muscle is called distal. >> when you have proximate narrowing, how does that impact our? >> it can narrow the blood supply to more of the higher than distal narrowing. >> so another way of that would be the decreased amount of blood the heart is getting? >> yes, that is correct. >> and that also affects how things are removed from the heart ouimette is that correct reign or carbon dioxide? >> well, that is different. that wouldn't happen from the blood vessels coming in, i don't think. and so i wouldn't include carbon dioxide in. >> is there a standard where path colleges would consider it to be that there's enough of a narrowing to cause sudden death? >> the way i would describe that is anything older, more than 70 to 75% is in the view of a path colleges, something that in the absence could be used to explain death. ando it's also c

that's close to the aorta. in most adults the left anterior descending is the largest. mr.is quite narrowed. i would put that at 75% narrowing. the cut that you see right below that, the middle of the three, that's another section. you can see that a tight narrowing is there. again, about 75%. then the third one you see in that series, the one closest to the ruler is the first branch off his left anterior descending coronary artery. it was a pretty good size in mr. floyd's case. that one is also quite narrowed. i should back up and explain when i say narrowed, i mean the yellow plaque you see lining the arteries, like a partially clogged pipe. that's the cholesterol, that's the fibrous tissue, that's the scar you don't want. that's why your doctor checks your cholesterol and asks you not to smoke. this is what they're trying to prevent, the plaque build up. they should be wide open. getting back to the description of the photograph. the fourth cross section, closer to the rule on the scale, that's mr. floyd's right coronary artery. in most adults that's the second largest o

any other thing that can occasionally happen is this thing called an aortic dissection where the aorta, the need to that leaves the heart can tear and i can cause death or i want to make absolutely clear these conditions can cause death on occasion in areas not involving the heart but most of the time if death is going to occur by them it is going to be caused because of their impact on the heart. >> and did mr. floyd have an aortic dissecting? >> no, he aptly did not based on the reader of the autopsy. >> did have a stroke? >> he again did not stroke. >> just to be clear to the jury with all the discussion of the narrowing of the arteries, death, et cetera, was there any damage at all observed to mr. floyd's heart muscle? >> based on my review of all the evidence, the ekgs, the autopsy report, i found absolutely no evidence at all of heart damage in mr. floyd's heart. >> thank you, dr. rich. >> any redirect? [inaudible] >> on redirect you asked a question about the various paraganglioma, the coronary heart disease, , high blood pressure, if any one of those can cause death independent

when it occurs close to the aorta where the blood supply comes from, we would call that proximal. if it occurs far down the artery towards the end of the artery or further down the artery it is called [inaudible] the implications are somewhat different. and if you have a narrowing close to the beginning of the artery, anything downstream from that narrowing is subject to decreased supply of blood. then they supply part of the heart that will still receive enough supply. it is not restricted. >> once you get the narrowing, any heart tissue, muscle downstream from that is going to be subject to a reduced supply. so, in this particular case, he had significant narrowing of all of his coronary arteries close to the origin which really is consistent with all of his heart, unfortunately, being subject to the supply, not just proportional but all of it. >> is there a certain amount of narrowing that forensic pathologists considered to be enough to cause a sudden death? >> so, the typical conventional number that forensic pathologists use is between 17 to 75% narrowing is a risk factor fo

that means that's close to the aorta.e left anterior descending is the largest of the three coronary arteries. in this picture you can see mr. floyd's left anterior descending artery is quite narrowed. i would put that at 75% narrowing. the cut that you see right below that, which is the middle of the three, that's another section through mr. floyd's left anterior descending coronary artery. you can see that area a very tight narrowing is still there. again, i would put that at about 75%. and then the third one you see in that series of three, the one closest to the ruler, is the first branch off of his left anterior descending coronary artery. that's called the first diagonal brampl. that can be a big one in some people. it was pretty good sized in mr. floyd's case but that one is also quite narrowed, as you can see in the photograph. i should probably back up and explain. when i say narrowed, i mean the yellow plaque you see lining those coronary arteries like a partially clogged plumbing pipe. that's the cholesterol, t

call the proximal left interior descending coronary artery so that means that's pretty close to the aorta that's close to the origin of the artery and in most adults the left interior descending is the largest of the 3 coronary arteries so in this picture you can see that mr floyd's left anterior descending or artery is is quite narrowed. i would put that at 75 percent narrowing the cut that you see right below that which is the middle of the 3 that's another section through mr floyd's left the interior descending coronary artery so you can see that that area very tight narrowing is still there again i would put that at about 75 percent. and then the 3rd one you see in that series of 3 the one closest to the ruler is the 1st branch off of his left hand here descending coronary artery that's called the 1st diagonal branch that can be a big one in some people it was pretty good sized in mr floyd's case but that one is also quite narrowed as you can see in the photograph and i should probably back up and explain that when i mean when i say narrowed i mean the yellow plaque that you see eccen

and the other thing that can occasionally happen is this thing called an aortic dissection where the aorta the main 2 that leads the heart can tear that can cause death so i want to make absolutely clear that these conditions can cause death on occasion in areas not involving the heart but most of the time if death is going to occur by them it's going to be caused because of their impact on the car and it was deployed have an aortic dissection no yep saluted not based on the review of the autopsy didn't happen he also did not have a stroke so again just to be clear for the jury with all the discussion about the marriage arteries that. was there in damage at all observed to this of floyd's heart muscle based on my review of all of the evidence the e.k.g.'s the autopsy report i found absolutely no evidence at all of heart damage mr floyd's heart. thank you doctor. and he rose. or if you're just joining us on al-jazeera we've been watching proceedings on day 11 and are there excelled in trial where a cardiologist is on the witness stand don so. jonathan rich who's been testifying. that george

in close to the aorta is called proximal. and further away is called distal. >> when you have proximal narrowing, how does that affect the heart? >> it can narrow the blood supply to more of the heart than if you have distal narrowing. >> another way would be to say it decreases the amount of blood the heart is getting? >> yes. >> it also affects how things are removed from the heart, like carbon dioxide? >> well, that's different. that wouldn't happen from the blood vessels coming in i don't think. so i wouldn't include carbon dioxide in that. >> is there a standard within forensic pathology where pathologists would consider there is enough of a narrowing to cause sudden death? >> so the way i would describe that is anything over more than 70 to 75% is in the view of a forensic pathologist something that in the absence of anything else, could be used to explain death. it's also true that people live with 100% occlusion and go on and live fine. this is my perspective as a forensic pathologist and everyone i see is dead so tha

or banana split aorta. that sounds good. finally, let's compare two vocations. making ice cream and law enforcement. to protect and serve versus to protect soft serve. in one arena, you make everything everyone loves but it's bad for your health. in the other, something that so many elites hate but keeps them safe from hard. don't you think people with the easy job of making people fat might want to understand the professions that are morris i can than theirs? if your biggest names are brain freeze and muffin top, how about those that got shot at for a living and not with cool whip? let us welcome tonight's guests. she's more southern than a chicken fried pickup trump. anchor dagen mcdowell. he's too smart to have hair that gorgeous. robby suave. and imagine what he wears when he's not on tv. he saved thousands of people sometimes with his jokes. writer, median, michael loftus. finally, she's like botox. toxic, in your face and has a lot of fans over 50. kat timpf. dagen, welcome to the program. always a pleasure to see you. >> i'm nervous. >> greg: don't be ner

or banana split aorta. that sounds good. finally, let's compare two vocations. making ice cream and law enforcement. to protect and serve versus to protect soft serve. in one arena, you make everything everyone loves but it's bad for your health. in the other, something that so many elites hate but keeps them safe from hard. don't you think people with the easy job of making people fat might want to understand the professions that are morris i can than theirs? if your biggest names are brain freeze and muffin top, how about those that got shot at for a living and not with cool whip? let us welcome tonight's guests. she's more southern than a chicken fried pickup trump. anchor dagen mcdowell. he's too smart to have hair that gorgeous. robby suave. and imagine what he wears when he's not on tv. he saved thousands of people sometimes with his jokes. writer, median, michael loftus. finally, she's like botox. toxic, in your face and has a lot of fans over 50. kat timpf. dagen, welcome to the program. always a pleasure to see you. >> i'm nervous. >> greg: don't be ner