ST. LOUIS (AP) Mike Martz is out indefinitely as coach of the St. Louis Rams with a bacterial infection of the heart.
Martz was told by a specialist Monday that his condition, which kept him out of two practices last week, had worsened. The 54-year-old has been ill for more than a month and was tested for endocarditis, a bacterial infection of the lining of the heart or a heart valve.
After the Rams' 37-31 loss Sunday to the Seattle Seahawks, Martz said he shouldn't have been on the sideline. St. Louis dropped to 2-3.
Rams president John Shaw said Monday that Martz will be hospitalized four to 12 days but would not speculate on the length of his absence. Shaw said he wasn't told the specific name of the illness, but was led to believe that Martz's heart valve had weakened since last week.
''I think he was concerned he was letting down a lot of people, but also had concern about the gravity of the situation,'' Shaw said.
The antibiotics that Martz began taking on Friday didn't seem to help, Shaw said, but he didn't know if any additional procedures would be necessary. Severe cases of endocarditis can require open-heart surgery.
Assistant head coach Joe Vitt will take over as coach. Martz told his players during a brief but emotional team meeting that he would step aside, Vitt said.
Martz spoke with a raspy voice after Sunday's game but sounded optimistic about his health. Still, he said that in retrospect, he should have allowed offensive coordinator Steve Fairchild to run the show.
''I wasn't myself this week, the game plan wasn't clear for me,'' Martz said. ''It's over with now but I just feel what happened to me has affected this team, and that breaks my heart.''
Martz was first hospitalized Sept. 30 with what was thought to be a sinus infection. He coached two days later during a 44-24 loss to the New York Giants.
Seahawks coach Mike Holmgren, a friend of Martz's, advised the Rams coach to be careful with his health.
''Really, what I told Mike was and I put myself in the same category you get so caught up in this that it, at times, appears to become more than life and death,'' Holmgren said. ''And it's not. It really isn't.
''So, with the health problem like he seems to have, he's got to take care of it. He's got to take care of himself, his family. He's got to think of way more things than football, of winning a football game. But it's hard for us. It's hard for all of us to back away on something like that.''
Endocarditis affects 10,000 to 20,000 Americans each year and in some cases can cause require open-heart surgery, according to Dr. Arthur Labovitz, director of cardiology at the Saint Louis University School of Medicine. Martz did the right thing by stepping down, Labovitz said.
''It's a very serious condition,'' Labovitz said. ''There can be some serious complications that are probably influenced by how you take care of yourself once a diagnosis is made.''
Vitt, 51, was hired as assistant head coach and linebackers coach prior to the 2004 season after four years in Kansas City. Martz and Vitt worked together on the Los Angeles Rams' staff from 1992-94, when Vitt was defensive backs coach and assistant head coach under Chuck Knox.
Now in his sixth season with the Rams, Martz is 56-36 including the postseason. The Rams have missed the playoffs just once in his tenure (2002) and reached the Super Bowl after the 2001 season, losing 20-17 to New England.
Martz joined the Rams as offensive coordinator in 1999, and his high-powered offense led St. Louis to its first Super Bowl title that season. He became head coach following Dick Vermeil's retirement after that championship run.
NFL coaches are notorious for their long hours, and Martz is no exception, sometimes sleeping at the office. And heart problems have affected relatively young coaches before in the high-stress atmosphere of the NFL.
Dan Reeves had a heart procedure while coaching Denver in his mid-40s. During the 1998 season, he underwent quadruple bypass season at age 54 but returned to the sidelines less than four weeks later to coach the Atlanta Falcons to the Super Bowl.
Dallas' Bill Parcells has had several heart procedures and cited health problems when he quit the New York Giants after winning his second Super Bowl with them at age 49 in 1991. He has since coached New England and the New York Jets as well as the Cowboys.
In 1988, Chicago coach Mike Ditka suffered a heart attack at the age of 49 and missed just one game. Two weeks later, in Washington, he was supposed to be just an observer, but ended up coaching the game.
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