Samuel Albert Levine

Samuel Albert Levine (1891 – 1966)

Samuel Albert Levine (1891 – 1966) Polish-American cardiologist

Innovator in the treatment of coronary thrombosis patients. He recommended arm-chair recuperation within the first few days following an attack, instead of traditional bed rest.

An early advocate for the use of the ‘mechanical-electro-cardiograph’ to study heart patients, but he impressed upon his students the value of simple bedside methods of examination. He believed a physician should use the cardiogram to supplement his stethoscope.

Biography

  • Born 1 January 1891 Łomża, Poland
  • 1894 – Relocated to Boston, USA, aged 3
  • 1914 – Graduated from Harvard Medical School. Undertook internship at the Peter Bent Brigham Hospital, and a fellowship at the Rockefeller Institute.
  • 1917 – Volunteered to join the British medical corps during World War 1. Levine was assigned to the British Heart Hospital, Colchester, where he worked under renowned cardiologists: Sir Clifford Allbutt, Sir William Osler, Sir James McKenzie, and Sir Thomas Lewis.
  • 1919 – Returned to the Peter Bent Brigham Hospital
  • 1921 – Advised the diagnosis of poliomyelitis for the paralytic illness of future President Franklin D. Roosevelt.
  • 1921 – Started a summer postgraduate cardiology course, which ran for 36 years at Harvard Medical School – the longest running course at the University.
  • 1940 – Appointed physician at Peter Bent Brigham Hospital
  • 1948 – Clinical Professor of Medicine at Harvard
  • Died 31 March 1966, in Massachusetts

Medical Eponyms

  • Lown–Ganong–Levine syndrome (1952) Pre-excitation syndrome with short PR interval (A-V conduction time), normal QRS duration and paroxysms of tachycardia:  Lown BGanong WF – Levine SA
  • Levine Scale (Levine Grading Scale) (1933) a six-point grading system that is used to define the volume or intensity of a heart murmur with an acoustic stethoscope
  • Levine sign – placing clenched fist against the sternum to describe ischaemic chest pain
  • Cossio-Levine Sign (1934) placing the extended palm against the sternum to describe ischaemic chest pain
  • Samuel A. Levine Professorship (Harvard, 1954) founded with a gift from the late Charles E. Merrill of New York

Key Medical Attributions

  • Published over 250 articles
  • Wrote one of the first cases of coronary thrombosis
  • Contributed to the pathophysiology understanding of pernicious anaemia (the lack of gastric hydrochloric acid)
  • Reported one of the first successful cases of mitral valvulotomy in a 12-year-old girl
  • Long-standing medical educator, with students such as Dr W Proctor Harvey, and Dr Bernard Lown
  • Several textbooks in cardiology, and clinical skills

Controversies

Levine sign.

Dr SA Levine taught that a ‘clenching the fist over the chest whilst describing pain’ increased the potential that the pain was ischaemic in nature (84% sensitive but 9% specific for ischaemic heart disease; Table 3). No specific published work by Levine SA, but referenced in major cardiology textbooks to acknowledge the bedside teachings of Levine. Original source of term still being sought.

Earlier (1934), the Argentinian cardiologist Pedro Cossio (1900-1986) described the ‘Palm sign’ – extended palm placed against the sternum – to define ischaemic chest pain (67% sensitive; 38% specific). This is referred to as the Cossio-Levine Sign

Of note, Levine RI wrote to the NEJM to have a different ‘Levine sign’ popularised – that is, the use of carotid massage to slow the pulse in patients presenting with chest pain, with an easing of the pain ‘confirming’ the an ischaemic in origin…

The ‘other’ Levine sign (1964)
Levine Sign 1964 The other Levine sign

Major Publications


References

  • Samuel Albert Levine (1891-1966). Br Heart J. 1966;28(6):853-4. [PMC490104]
  • Levine HJ. Samuel A. Levine (1891-1966). Clin Cardiol. 1992 Jun;15(6):473-6. [PMID: 1617831]
  • Edmondstone WM. Cardiac chest pain: does body language help the diagnosis? 1995; BMJ. 311 (7021): 1660–1 [PMC2539106]
  • Levine RI. Levine Sign. New England Journal of Medicine, 1964; 271(27): 1425–1425.
  • Silverman ME, Wooley CF. Samuel A. Levine and the history of grading systolic murmurs. Am J Cardiol. 2008 Oct 15;102(8):1107-10. [PMID 18946930]

eponymictionary CTA

eponym

the person behind the name

Doctor in Australia. Keen interest in internal medicine, medical education, and medical history.

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