Coroner's Finding: KEIPERT Mathew James

44y · Male·Ischaemic heart disease due to coronary atherosclerosis

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.