Arthur Hollman

Hypertrophic Cardiomyopathy: Lessons from History

The modern description of hypertrophic cardiomyopathy is credited to the London pathologist, Robert Donald Teare who likened the disease to “a tumour of the heart” and published his observations in the British Heart Journal 50 years ago. Teare recognised asymmetrical hypertrophy and myocyte disarray as a familial condition associated with premature and sudden death in young people. He rightly deserves the accolade for bringing a poorly understood, but well recognised phenomenon into the public domain. Thick and heavy hearts had been of interest and investigation to physicians and pathologists for many centuries. This article reviews the early history of hypertrophic cardiomyopathy and reflects on several centuries of progress in our understanding of the condition.

MITRAL VALVE DISEASE WITH VENTRICULAR SEPTAL DEFECT.

Although congenital mitral valve disease is well known as an essential feature of persistent common atrio-ventricular canal (Campbell and Missen, 1957), and in association with corrected transposition of the great arteries (Helmholz, Daugherty, and Edwards, 1956), it is much less common apart from these anomalies. Up to 1954 Ferencz, Johnson, and Wiglesworth could find only 34 reported cases, to which they added 9 of their own, and in a review of 357 cases studied pathologically at the Mayo Clinic by Fontana and Edwards (1962) there were only 3 with congenital mitral value disease. However, the practical importance of the subject was demonstrated by the pioneer surgical work of Bower et al. in 1953, and we now wish to report our own experience of the lesion in association with ventricular septal defect.

An early percutaneous catheter-mounted valve

The early surgical treatment of aortic insufficiency can be briefly stated. In 1952, Charles Hufnagel of Chicago invented a ball valve prosthesis that was placed in the descending thoracic aorta to partially correct regurgitation, and in 1955, Gordon Murray of Toronto placed a homograft valve in the same position. Aortic valve replacement was inaugurated in 1960 by Albert Starr of Seattle with a mechanical valve and in 1962 by …

Leaders of British Cardiology

Russell Brock was a notable pioneer of cardiac surgery, known worldwide for his achievements. He was born in London, educated at Christ’s Hospital School, and entered Guy’s Hospital Medical School at the age of 17. As a medical student, he showed the brilliance and force of character which were to mark his whole career, winning prizes and two gold medals. At the age of 25 he became a Hunterian professor, and a Rockefeller scholarship in 1929 enabled him to work under Evarts Graham in St Louis, which gave him his interest in thoracic surgery. Graham in 1922 had been the first surgeon to operate on mitral stenosis, though without success.

The Hammersmith Hospital and the Royal Postgraduate Medical School

In 1918, Sir William Osler, regius professor at Oxford, said, “The profession must get over its infantile fears of government finances, and must start to think about postgraduate education on an imperial scale.” Osler and others proposed that a hospital be used solely for the purpose of postgraduate education.[1]

Effectiveness of amiodarone in resistant arrhythmias

Amiodarone is used in the treatment of previously drug-resistant supraventricular and ventricular arrhythmias. We report our experience with amiodarone in 8 patients. Five patients had paroxysmal atrial flutter, one had paroxysmal atrial fibrillation, one had supraventricular tachycardia, and one ventricular tachycardia. Considerable improvement, both objectively and subjectively, was observed in all patients. Side effects were as follows: all patients had corneal microdeposits, one developed left bundle branch block which resolved on stopping amiodarone, and one reported constipation and abdominal pains. Six patients have been treated for 10–28 months; 3 developed tolerance at 4–14 months after the introduction of amiodarone therapy, but symptoms improved with increased dosage. It is important to watch for the development of tolerance to this drug.