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Coroner's Finding: KEIPERT Mathew James

Deceased

Mathew James Keipert

Demographics

44y, male

Date of death

2018-11-21

Finding date

2020-07-16

Cause of death

Ischaemic heart disease due to coronary atherosclerosis

AI-generated summary

Mathew James Keipert, age 44, died of ischaemic heart disease due to coronary atherosclerosis while on home detention bail. He had significant cardiovascular risk factors including hypertension, heavy smoking (40 cigarettes daily for 30 years), and substance abuse history. In August 2018, he presented with bilateral lower limb oedema and dyspnoea on exertion, concerning for possible cardiac pathology. Despite investigation including chest X-ray, abdominal ultrasound, and echocardiogram (all reportedly normal), the underlying coronary artery disease was not identified. He self-ceased prescribed diuretics after two weeks. No formal cardiology assessment or stress testing was documented. The case highlights the importance of comprehensive cardiac evaluation in middle-aged patients with multiple risk factors presenting with oedema and dyspnoea, particularly when imaging findings are discordant with clinical presentation.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.

Specialties

cardiologygeneral practiceemergency medicineaddiction medicine

Error types

diagnosticdelay

Drugs involved

buprenorphinenorbuprenorphinenaloxonepregabalinfurosemidebuprenorphine/naloxoneserepax

Clinical conditions

coronary atherosclerosisischaemic heart diseasehypertensionlower limb oedemadyspnoea on exertionpulmonary oedemaleft ventricular dilatationhepatitis Copioid dependenceasthmaneuropathic back pain

Contributing factors

  • Moderate to focally severe coronary artery atherosclerosis
  • Heavy smoking history (40 cigarettes per day for 30 years)
  • Hypertension
  • Substance abuse history
  • Hepatitis C
  • Bilateral lower limb oedema in August 2018 not fully investigated
  • Dyspnoea on exertion for 4-5 years not adequately assessed for cardiac causes
  • Patient self-ceased diuretics after two weeks
  • Normal echocardiogram despite clinical presentation suggestive of cardiac disease
Full text

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