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The Trouble with the "Apparent" Heart Attack

The American Heart Association says that heart attacks kill about 1,200 people in the United States every day. In many of those people's obituaries or death notices, the cause of death will be given as "an apparent heart attack."

Except, as many a journalism professor has noted, "apparent heart attacks" can't kill; only real heart attacks can kill.

This advice is often taught, but more often ignored: A quick Nexis search shows that in the last three months, "apparent heart attack" outpolled "apparently of a heart attack" (or similar constructions), about 350 to 50.

"Apparent" is an adjective meaning "readily seen; visible" or somewhat contradictorily, "appearing (but not necessarily) real or true." Most people use the adjective to mean "it looks like to me …," as in: "He has no apparent interest in learning the difference between disinterested and uninterested." So, what just is "wrong" with saying "an apparent heart attack"? Let's take two sides: the why can't you? and the why not?

Why you shouldn't

For some, "apparent" is a wishy-washy word. If you don't know it was a heart attack, don't mislead the reader. Just say "the cause is suspected to be a heart attack," or something like that.

Garner's Modern American Usage says "an apparent heart attack" is illogical, because it attaches "apparent" to the wrong word — it should be attached to a verb, not a noun, and thus be an adverb, "apparently." (Not to give the next section away, but if you do use an adverb, be sure to put it in the right place: "she died, apparently of a heart attack, not "she "apparently died of a heart attack."

"Apparent heart attack" is at Stage 3 of Garner's five-stage Language-Change Index, meaning it is commonly used but should still be avoided "in careful usage." That, and the admonition in many stylebooks to avoid it, might be enough to discourage you from using it.

Why not?

As Jan Freeman wrote in 2008, the arguments against using "apparent heart attack" "have holes you could drive an ambulance through." To begin with, if you make "apparent" into the adverb "apparently," many people will look for the verb it's modifying, and the only one they're likely to find in "she died of a heart attack" is "died." But "died" is pretty final and doesn't brook much modification. Instead, "apparently" is modifying the preposition phrase "of a heart attack." But, as we see above, that placement can cause palpitations of its own. Why replace one problem with another?

As the editors of The Associated Press Stylebook say in the online "Ask the Editor" archive, "apparent" is "an accepted method of indicating that while the hallmarks seem clear, the news report is preliminary pending an official conclusion." In other words, use it only when you must, but when you must, it's OK.

Almost no one will misunderstand "an apparent heart attack," except perhaps the occasional conspiracy theorist, convinced the "apparent heart attack" was actually an undetectable poison administered by a secretive multinational cartel. And we use adjectives and adverbs loosely all the time—"literally" when we don't mean it literally, for example.

So what to do? Make up your own mind, based on your style guide and audience. But if you see an editor clutching his chest as he reads "apparent heart attack," you'll know which way to go.


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Merrill Perlman is adjunct assistant professor at the Columbia Graduate School of Journalism and president of Merrill Perlman Consulting, offering consulting and freelance editing services and training in journalism, grammar and usage. Among her clients are The New York Times, ProPublica and the Poynter Institute. She writes the "Language Corner" column and blog for Columbia Journalism Review. Merrill retired in June 2008 after 25 years at The New York Times, most recently as director of copy desks with responsibility for managing 150 copy editors. Click here to read more articles by Merrill Perlman.

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Comments from our users:

Wednesday December 19th 2012, 6:33 AM
Comment by: Michael D.
It brings to mind the literature of obituaries- once reported as a public service- now a costly adjunct to funeral services as a whole. I say go with the one that uses the fewest words
Wednesday December 19th 2012, 2:50 PM
Comment by: Susan C.
Is it time to talk about the flattening of the adverb? Especially those ending in "ly"? "Literally" lives on, especially thanks to Rob Lowe, but more and more I hear things like "do it real quick" and "he sings beautiful" and "she was hurt bad."

To paraphrase someone else, "People are dropping the 'ly' from adverbs like it was arugula in a right-winger's refrigerator."

So "apparently a heart attack" becomes "apparent heart attack" in a jiff, even if the syntax is different.

Or did I mean jiffy? :) My brain was trained on the longer versions and the flat adverbs just sound WRONG. We may not misunderstand the speaker's meaning but we don't have to like it.
Wednesday December 19th 2012, 7:53 PM
Comment by: Joann Z. (Rockford, IL)
When someone dies a sudden death, I'm loathe to speculate the etiology. Was it a pulmonary embolus? a dysrhythmia? a brainstem infarct? a massive subarachnoid hemorrhage? Better to state, "sudden death".
Thursday January 17th 2013, 7:17 AM
Comment by: Rudolf M. (Almonte Canada)
can you use apparent for something appearing out of the blue? Then an apparent heart attack is unexpected, sudden ... , which it is most of the time.

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