William Dressler

William (Wilhelm) Dressler (1890-1969) was a Jewish-American cardiologist.

Dr W Dressler published numerous articles and textbooks on cardiology and electrocardiography. Dressler’s Clinical Cardiology (1942) became a classic book of cardiological diagnosis.

As Director of Cardiology at Maimonides Medical Centre, Dressler identified a post-myocardial infarction syndrome eponymously ascribed with his name – Dressler Syndrome (1956).

He is also eponymous with Dressler beat (1952), which he described as a ‘ventricular fusion beat‘ in the presence of paroxysmal ventricular tachycardia.


Biography
  • Born August 9, 1890, Vienna, Austria
  • 1915 – Achieved MD qualification, University of Vienna, Austria
  • 1934 – Cardiologist in Vienna
  • 1938 – Emigrated to the USA as a refugee
  • 1938-67 – Director of the cardiology clinic and electrocardiographic laboratory at Maimonides Medical Center, New York, USA
  • Died on October 10, 1969, New York, USA

Medical Eponyms
Dressler beat (1952)

A ‘ventricular fusion beat’ in the presence of paroxysmal ventricular tachycardia.

In 1952, Dressler stated that “reports in the literature on the occurrence of ventricular fusion beats in paroxysmal ventricular tachycardia are scant.” He reported six cases of paroxysmal ventricular tachycardia, which demonstrated variations of the ventricular complexes “transitional in shape to sinoauricular beats” and termed them ‘ventricular fusion beats.


Dressler syndrome (1956)

Fibrinous or fibrinohaemorrhagic secondary pericarditis that occurs as a result of injury to the heart or pericardium, either from myocardial infarction (MI) or cardiac surgery. Also known as post myocardial infarction syndrome

Initially described by Dressler as a condition developing as early as 2-3 days after a transmural infarct, due to underlying myocardial inflammation

Exact cause is unknown but appears to be an immune-mediated response to injury to pericardial cells with subsequent immune complex deposition in the pericardium causing an inflammatory response


De Winter T waves (1947)

Twenty-seven instances of myocardial infarction were studied, in which the first electrocardiogram was taken as early as one and one-quarter hours, and not later than twelve hours, after the onset of symptoms.

In twenty-five cases the earliest electrocardiographic signs of infarction were high ‘T‘ waves, the majority of which became inverted in the healing stage of infarction. In most of the cases the high T waves were no longer present twenty-four hours after the attack.

In five instances where the T waves persisted for several days, early mortality was as high as 60%, as compared with 14% in the cases where the high T waves underwent regression within twenty-four hours.

In five cases (18%), high T waves were not associated with abnormal elevation of S-T, nor with significant changes in QRS. Thus, they represented the leading diagnostic sign in the early stage of myocardial infarction.

Dressler, Roesler 1947
Dressler 1947 de Winter wave description

Fig. 3; case 4. Signs diagnostic of anteroseptal infarction. Dressler, Roesler 1947
A: 3 hours after the onset of the attack, shows high T waves in the chest leads associated with abnormal depression of S-T; especially Leads CR3-CR6.
B: 18 hours post symptom onset. Significant changes in QRS appeared when the high T waves had decreased in amplitude and become semi-inverted.
C: 3 days post onset; and D: 7 days post onset, show progressive inversion of the previously high T waves.

Controversies

Note: Dressler syndrome (1854) – intermittent haemoglobinuria associated with haemolytic disorders was described by Lucas A Dressler. (Dressler LA. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin. 1854;6:264-266)

Despite later publishing research on the success of cardiac pacemakers, Dr W Dressler was initially reluctant to his Maimonides Medical Centre colleague’s (Dr A Kantrowitz) idea of implanting a self-made pacemaker into his patient with Adams-Stokes syndrome. Dressler was said to have approached the hospital director to dismiss the pacemaker insertion, stating “that man [Kantrowitz] is too much. He wants to put a battery in my patient!”


Major Publications

References

Biography

Eponymous terms


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

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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