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Biomedical subjects

E J Epstein

Publications and source records attributed to E J Epstein.

At least 19 recordsLinked to original sources
PubMed1993

Traumatic mitral valve rupture during the Hillsborough football disaster: case report.

Ninety-five spectators died from crush injuries and asphyxiation at the Hillsborough football ground in Sheffield, England on April 15, 1989. Survivors suffered a spectrum of compression injuries to the chest, including documented cardiac injuries although these were not permanent. We report the case of one survivor who developed an isolated traumatic mitral valve rupture during the crush, and may require mitral valve replacement at a later date.

Echocardiography↗
PubMed1986

Constrictive pericarditis after myocardial infarction.

Constrictive pericarditis developed in a 55 year old man two years after transmural myocardial infarction complicated by severe acute pericarditis. Pericardiectomy was successful. Although this very rare late complication of myocardial infarction has been reported as a sequela of frank anticoagulant induced haemopericardium, in this case there was no clinical evidence of such an association.

Electrocardiography↗
PubMed1986

Preoperative clinical predictors of long term survival in mitral stenosis: analysis of 200 cases followed for up to 27 years after closed mitral valvotomy.

Two hundred patients aged 17-40 years undergoing closed mitral valvotomy during 1955-60 were studied by actuarial survival analysis. The period of follow up was 22-27 years. The following preoperative features were found to be independent predictors of long term survival: sinus rhythm (p less than 0.05); pulmonary arterial pressure below systemic pressure (p less than 0.01); absence of congestive cardiac failure (p less than 0.01) and pure mitral stenosis (p less than 0.01). A better long term survival was found for mitral valvotomy with a Tubb's dilator than finger splitting or Brock's method. The presence of calcification at the time of valvotomy adversely affected survival (p less than 0.01). Anticoagulation improved survival (p less than 0.01). It is concluded that closed mitral valvotomy gives good results if performed before the onset of established atrial fibrillation and congestive cardiac failure and that all patients should have anticoagulation. These results have important implications for selection of patients in countries with limited facilities for open heart surgery.

Adolescent↗
PubMed1983

Diagnosis of coronary embolism: a review.

Coronary embolism is an uncommon but distinct clinical entity. It can be diagnosed clinically, and should be suspected when acute myocardial infarction occurs in association with an underlying condition which predisposes to embolism. The most common are valvular heart disease, a prosthetic heart valve, infective endocarditis, cardiomyopathy with mural thrombus and arrhythmia. The diagnosis may be obscured by atypical symptoms and transient ECG changes. The diagnosis is supported by the demonstration of normal coronary arteries by selective coronary arteriography. Treatment with long-term anticoagulants may prevent further emboli. Additional antiplatelet drugs are also necessary in patients with prosthetic heart valves.

Adult↗
PubMed1982

Coronary embolism in valvular heart disease.

Coronary embolism is considered to be rare but recent evidence suggests that it may be underdiagnosed, and implicated in acute myocardial infarction associated with angiographically normal coronary arteries. Twenty-six patients were studied. In six, coronary embolism was a primary cause of death confirmed at autopsy. In 20 patients, 23 episodes of coronary embolism were diagnosed clinically. The left coronary system was occluded in 65 per cent, transient electrocardiographic changes occurred in 30 per cent, and either no history or an atypical history of acute myocardial infarction occurred in 29 per cent. Other systemic emboli occurred in 25 per cent. Aortic valve lesions were present in 70 per cent and combined mitral and aortic valve disease in 55 per cent of the patients. The incidence of coronary risk factors was low. Sequelae included increased dyspnoea (35 per cent), ventricular aneurysm (25 per cent) and cardiac failure (12 per cent). Angina rarely followed acute myocardial infarction.

Adult↗
PubMed1981

Myocardial ultrastructure and the development of atrioventricular block in Kearns-Sayre syndrome.

A right ventricular endomyocardial biopsy specimen from a 30-year-old male with chromic progressive external ophthalmoplegia, retinal pigmentation and complete atrioventricular block (Kearns-Sayre syndrome) was examined in the electron microscope. There was a proliferation of mitochondria between the myofibrils and beneath the sarcolemma. Many of the mitochondria showed morphologic abnormalities not previously described in this condition. There were associated accumulations of glycogen. A similarly affected female with left anterior hemiblock developed complete atrioventricular block at age 26 years, Despite the ultrastructural changes, clinically detectable myocardial disease is not a feature of Kearns-Sayre syndrome. However, intraventricular conduction defects show an unusually rapid progression to potentially fatal complete atrioventricular block and are an indication for prophylactic cardiac pacing.

Adult↗
PubMed1978

Cephalothin induced neutropenia during the treatment of bacterial endocarditis.

The occurrence of cephalothin induced neutropenia in 3 patients with infective endocarditis is described. In each patient, withdrawal of cephalothin was followed by rapid haematological recovery. It is apparent that granulocytopenia may frequently occur in patients receiving prolonged, high dose, intravenous cephalothin for the treatment of bacterial endocarditis.

Adult↗
PubMed1977

Polyradiculoneuritis and Mycoplasma pneumoniae infection.

A patient with severe Mycoplasma pneumonia developed polyradiculoneuritis and respiratory failure. The acute phase of the illness was complicated by a myocarditis, and recovery of neurological function was slow. Residual left hemidiaphragmatic paralysis was present 1 year after onset of the illness.

Acute Disease↗
PubMed1977

Severe mycoplasma pneumonia.

A patient who developed who developed a protracted illness following severe mycoplasma pneumonia is described. The acute phase of the infection was complicated by myocarditis and haemolytic anaemia. The respiratory symptoms abated and lung function tests improved with the administration of systemic and inhaled corticosteroids.

Anemia, Hemolytic↗