Martin Duke

Bed rest in acute myocardial infarction: A study of physician practices

Abstract Physician practices in prescribing bed rest for hospitalized patients with an acute myocardial infarction were studied. The mean duration of bed rest for the patients of each of eleven physicians varied widely and significantly from 7.4 to 15.2 days. No differences in patient population or in the ages or types of practices of the physicians were found to account for this. Each physician appeared to have a relatively fixed program of bed rest for his patients. In view of well-established experiences advocating early mobilization in patients with an acute myocardial infarction, it was apparent that some physicians are still traditionally bound to prescribing prolonged bed rest. The medical as well as the socioeconomic implications of this are discussed.

Isolated U Wave-Inversion in Acute Myocardial Infarction

Three patients are presented in whom an isolated inversion of the U wave preceded by several hours typical electrocardiographic changes of an acute myocardial infarction. The association of transient hypertension and an acute U-wave inversion during this period of myocardial ischemia is discussed. It is suggested that within the appropriate clinical context an isolated U-wave inversion may portend an acute myocardial infarction.

Hemophilus influenzae pericarditis with cardiac tamponade

Abstract The unusual occurrence in an adult of purulent pericarditis caused by Hemophilus influenzae, type b and complicated by cardiac tamponade is described. Medical and surgical treatment was required. The clinical course and the pathologic report of tissue removed at pericardiectomy within 3 weeks after onset of the infection indicated the development of “acute” constrictive pericarditis. The patient fully recovered and was asymptomatic 3 years later without evidence of chronic constrictive pericarditis.

Aortic Stenosis and Transmural Myocardial Infarction Without Coronary Artery Disease: A Case Report and Discussion

A 59-year-old man was hospitalized with exertional chest pain, dyspnea and paroxysmal nocturnal dyspnea observed for 5 months. Nitroglycerin and rest usually relieved the chest symptoms in 3 to 4 min. Past history was significant for a heart murmur first described during an insurance examination 15 years previously. There was no history of rheumatic fever. On physical examination principal findings consisted of a blood pressure of 98/80, weak peripheral pulses, n grade 1 apical systolic murmur, a grade 2 to 3 aortic systolic murmur extending towards the neck, and decreased intensity of the second sound in the aortic area. Chest x-ray revealed enlargement of the left ventricle and extensive aortic valve calcification. Electrocardiogram showed a left bundle branch block pattern. The diagnosis of aortic valve stenosis was made

Victor Eisenmenger (1864–1932): The man behind the syndrome

Although much has been written about the cardiovascular abnormalities present in Eisenmenger’s syndrome, little has been recorded previously in the medical literature about Victor Eisenmenger, the Austrian doctor whose name is attached eponymously to this disorder. Archival material together with information provided by his descendants and relatives has been gathered to make available further details of his life, family, schooling, medical training and accomplishments. An examination of Eisenmenger’s book about his observations and experiences while serving from 1895 to 1914 as personal physician to Archduke Francis Ferdinand, the heir presumptive to the Austro-Hungarian throne, also sheds light on Eisenmenger’s personality, abilities and interests.

Major General Henry Douglas VC RAMC: his military and non-military accomplishments

Major General Henry Edward Manning Douglas had a distinguished military career in the Royal Army Medical Corps (RAMC). In addition, during an eventful leave of absence from his army duties in 1908–1909, he played an important role, and made several noteworthy contributions, as a member of a

Leonard Craske (1878–1950): from medical student to sculptor

Summary Leonard Craske (1878–1950), born and raised in London, England, spent two years as a medical student at St Thomas’ Hospital Medical School. Following this, he worked as an actor and studied drawing and sculpting. After emigrating to the USA and settling in Boston, he became an accomplished sculptor, creating the well-known Fishermens Memorial in Gloucester, Massachusetts, the work for which he is best remembered.

An historical review of rupture of the heart.

In 1649 William Harvey noted the autopsy findings of a patient with spontaneous rupture of the heart. Additional reports by Nicholls, Morgagni, Hodgson, Quain, Vulpian, and others describing the dramatic clinical and pathological features of cardiac rupture appeared during the following 250 years. These reports are cited in order to document and trace an increasing awareness that acute myocardial infarction caused by obstructive coronary artery disease was the most frequent cause of this catastrophic event. Frequently these older reports speak for themselves without elaboration. At other times, they will be cautiously interpreted in the context of present-day understanding of this disease.In 1649 William Harvey noted the autopsy findings of a patient with spontaneous rupture of the heart. Additional reports by Nicholls, Morgagni, Hodgson, Quain, Vulpian, and others describing the dramatic clinical and pathological features of cardiac rupture appeared during the following 250 years. These reports are cited in order to document and trace an increasing awareness that acute myocardial infarction caused by obstructive coronary artery disease was the most frequent cause of this catastrophic event. Frequently these older reports speak for themselves without elaboration. At other times, they will be cautiously interpreted in the context of present-day understanding of this disease.

Experiences with Congenital Heart Disease in a Community Hospital: Discussion of the Role of a Cardiac Clinic

*Director of Medical Education and Associate in Cardiology Manchester Memorial Hospital, Manchester, Conn. 06040. Supported in part by a grant from the Gertrude H. Rogers Fund and Manchester Area Heart Amciation. BECAUSE of differences in physician experience, patient ~r~~~rn~~ ~.nd availability of diagnostic, and therapeutic resources, the management of congenital heart disease (CHD) within a sub~rb~.n’ community may be expected to differ from that in an area serviced by a large medical center.. It is therefore pertinent tc~ ask whether physician, skills and diagnostic and therapeutic facilities in a suburban community hospital are able to provide the. same standard of present day medical care -.