Report: Heart Attack While Doing CPR

Physical exertion of doing chest compressions

Bill Carey
9 October 2021

CINCINNATI, Ohio – The NIOSH Fire Fighter Fatality Investigation and Prevention Program released the report on the death of a 49-year-old firefighter/paramedic while on a medical call in Illinois in 2015.

The incident occurred on 4 December 2015 in Matteson, Illinois and killed Matteson Fire Department Firefighter/Paramedic Mark Anthony Zielinski, Sr.

Firefighter/Paramedic Zielinski’s death is listed by the United States Fire Administration with a Nature of Death being Heart Attack cause by Stress/Overexertion.

In the afternoon the victim and his engine company responded to assist and ambulance crew with a cardiac arrest patient at a store. The victim and firefighters loaded the patient into the ambulance and was doing chest compressions for five to six minutes when he stated he was tired.

The victim complained of chest pain but wasn’t sure if it was due to doing the chest compressions. The victim’s officer called for a second ambulance.

Once inside the second ambulance the victim began to have seizure-like activity and became unresponsive.

The autopsy revealed a large intracoronary thrombus in the left anterior descending coronary artery as the cause of death due to underlying coronary atherosclerosis and noted obesity as a contributing condition [1].

Key Recommendation:

  • Phase in a mandatory comprehensive wellness and fitness program for firefighters.

This incident was investigated by the NIOSH Fire Fighter Fatality Investigation and Prevention Program, Cardiovascular Disease Component located in Cincinnati, Ohio. Denise L. Smith, Ph.D, led the investigation and coauthored the report. Dr. Smith is professor of Health and Exercise Sciences, and Director of the First Responder Health and Safety Laboratory at Skidmore College. She is a member of the NFPA Technical Committee on Occupational Safety and Health. Dr. Smith was working as a contractor with the NIOSH Fire Fighter Fatality Investigation and Prevention Program, Cardiovascular Disease Component during this investigation. Wendi Dick, MD, MSPH, provided medical consultation and contributed to the report. Dr. Dick is Medical Officer for the Cardiac/Medical Fatalities Component in Cincinnati.


  1. Firefighter Suffers Fatal Cardiac Event While Assisting with a Medical Call – Illinios, NIOSH,

Photograph courtesy of Unsplash.

Published by Data Not Drama

Data Not Drama is writings that provide a point of critical thought about firefighter fatality data and education, line of duty deaths, and risk. The main focus is to encourage less risk aversion and better knowledge on the subject of firefighter fatalities in firefighters, fire departments, and fire service organizations.

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