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Richard Gorlin (June 30, 1926 – October 16, 1997) was an American cardiologist known for his contributions to the fields of
valvular heart disease Valvular heart disease is any cardiovascular disease process involving one or more of the four valves of the heart (the aortic and mitral valves on the left side of heart and the pulmonic and tricuspid valves on the right side of heart). These ...
,
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
and
cardiac catheterization Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes. A common example of cardiac catheterization is coronary catheterization that ...
,
digitalis ''Digitalis'' ( or ) is a genus of about 20 species of herbaceous perennial plants, shrubs, and biennials, commonly called foxgloves. ''Digitalis'' is native to Europe, western Asia, and northwestern Africa. The flowers are tubular in sha ...
and
vasodilators Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, ...
in
congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...
, and
thrombolysis Thrombolysis, also called fibrinolytic therapy, is the breakdown (lysis) of blood clots formed in blood vessels, using medication. It is used in ST elevation myocardial infarction, stroke, and in cases of severe venous thromboembolism (massive p ...
in
myocardial infarctions A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may tra ...
. Along with his father, developed the Gorlin formula used to calculate valve areas in
aortic valve stenosis Aortic stenosis (AS or AoS) is the stenosis, narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets ...
and
mitral valve stenosis Mitral stenosis is a valvular heart disease characterized by the narrowing of the opening of the mitral valve of the heart. It is almost always caused by rheumatic valvular heart disease. Normally, the mitral valve is about 5 cm2 during d ...
.


Early life and education

Gorlin was born in Jersey City, New Jersey on June 30, 1926, to Sol and Henrietta Gorlin. His father was a mechanical engineer who at the turn of the century is variously reported to have designed hydraulic systems for gasoline engines and worked on building, structural, and real estate projects. Gorlin’s early education was in the Jersey City public school system. Gorlin then entered Harvard College in January 1943 as part of the accelerated wartime program. He spent five semesters at
Harvard College Harvard College is the undergraduate college of Harvard University, an Ivy League research university in Cambridge, Massachusetts. Founded in 1636, Harvard College is the original school of Harvard University, the oldest institution of higher lea ...
and then entered Harvard Medical School in October 1944. He graduated with his Bachelor's degree from Harvard College and his MD degree from Harvard Medical School in 1948 at the age of 21. He served a one-year internship and then completed a two-year cardiology fellowship at the
Peter Bent Brigham Hospital Brigham and Women's Hospital (BWH) is the second largest teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two fo ...
. While at the Brigham, he studied
cardiology Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart d ...
under the direction of Dr. Lewis Dexter.


Career

During the 1952–1953 academic year, Gorlin traveled to England as the Mosley Traveling Fellow from Harvard Medical School. There he joined the laboratory of Professor E. P. Sharpey-Schafer at St Thomas’ Hospital, London, and joined the weekly rounds of Dr. Paul Wood at the
National Heart Hospital University College Hospital at Westmoreland Street, named The Heart Hospital until refurbished and renamed in 2015, was a specialist cardiac hospital located in London, United Kingdom until 2015. It is part of the University College London Hospi ...
in London. Returning to Boston, he served as Chief Resident Physician in Medicine at the Brigham from 1953–1954. Gorlin then enlisted in the U. S. Navy and was assigned to the United States Naval Hospital at
Portsmouth Portsmouth ( ) is a port and city in the ceremonial county of Hampshire in southern England. The city of Portsmouth has been a unitary authority since 1 April 1997 and is administered by Portsmouth City Council. Portsmouth is the most dens ...
,
Virginia Virginia, officially the Commonwealth of Virginia, is a state in the Mid-Atlantic and Southeastern regions of the United States, between the Atlantic Coast and the Appalachian Mountains. The geography and climate of the Commonwealth ar ...
from 1954–1956. He was appointed the Officer in Charge of the Cardiopulmonary Laboratory where he worked closely with Dr. John Knowles. With Dr. Knowles, they researched pulmonary function and right heart catheterization and established the
Valsalva maneuver The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air out as if blowing up a balloon. Variations of the maneuver can ...
as a test in patients with congestive heart failure and pulmonary congestion. They reported some of the earliest studies of the hemodynamics of aortic valve stenosis. In 1956, Gorlin returned to the Brigham and faculty at Harvard Medical School where he established his own research laboratory and cardiology fellowship training program. He was the director of the Cardiovascular Unit (1967–74) and chief of the Cardiovascular Division (1969–1974) at the Brigham. He stayed until 1974 having developed an international reputation as a researcher, teacher, and clinician. In 1974, he left Harvard and joined the
Mount Sinai School of Medicine The Icahn School of Medicine at Mount Sinai (ISMMS or Mount Sinai), formerly the Mount Sinai School of Medicine, is a private medical school in New York City. It is the academic teaching arm of the Mount Sinai Health System, which manages eigh ...
in New York City. He was the Murray M. Rosenberg Professor of Medicine and served as the Chairman of the Samuel Bronfman Department of Medicine. While at Mount Sinai, Gorlin added seventeen subspecialty divisions and helped plan the Guggenheim Pavilion (new patient care facility). In 1987, he began serving as the President of the Medical Board and Dean for Clinical Affairs. He was co-director of the cardiology fellowship program at Mount Sinai. Gorlin retired from the Chairmanship of Medicine at Mount Sinai on June 30, 1992, and assumed the position of Senior Vice President of Ambulatory Care Programs and the George Baehr Professor of Clinical Medicine.


Contributions to medicine

Working with his engineer father, they developed the Gorlin formula, an indirect method for calculating the orifice area of cardiac valves or congenital heart chamber defects. This formula is used to study the severity of aortic valve stenosis and mitral valve stenosis. Gorlin was a very early pioneer in the use of coronary angiography to evaluate coronary artery disease. He completed studies integrating the clinical findings in coronary artery disease with the anatomy, physiology, and metabolism of the disorder. His findings preceded by ten years the concept of
hibernating myocardium In cardiology, hibernating myocardium is a state when some segments of the myocardium exhibit abnormalities of contractile function. These abnormalities can be visualised with echocardiography, cardiac magnetic resonance imaging (CMR), nuclear me ...
. Gorlin was one of the first to describe the relationship between diminished heart pumping function ( left ventricle ejection fraction) and increased mortality. He was also one of the first to describe
angina pectoris Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of obstru ...
in patients without obstructive coronary artery disease, also now known as
microvascular angina Microvascular angina, previously known as cardiac syndrome X, is angina (chest pain) with signs associated with decreased blood flow to heart tissue but with normal coronary arteries. The use of the term CSX can lead to the lack of appreciation of ...
. In addition, he was one of the first to recognize that significant left main coronary artery disease was a dire prognostic factor. Gorlin played a dominant role in the DIG trial, the largest trial to evaluate digoxin in patients with chronic congestive heart failure. He authored more than 400 published papers and over 100 invited articles, delivered 75 honorary lectures, served on the editorial boards of multiple journals, and was Editor-in-Chief of the journal ''Primary Cardiology'' for 20 years.


Awards

Gorlin's major awards include: * Lewis Conner Lectureship of the American Heart Association 1985 * Council on Clinical Cardiology Distinguished Achievement Award of the American Heart Association 1987 * Jacobi Medal of the Mount Sinai Hospital 1991 * Henry Russek Lectureship of the American College of Cardiology 1991 * James B. Herrick Award of the American Heart Association’s Council on Clinical Cardiology 1995 * J. Lester Gabrilove Award, for Significant Contributions to Medicine 1992


Personal life and death

Gorlin's first marriage was to Marjorie Shore in 1960 and they had a daughter, Wendy, and sons Bill and Douglas. His second marriage was to Winifred Leifer in 1970. His third marriage in 1987 was to Florence Zuckerman and they remained married until his death. Gorlin died at Mount Sinai Hospital in Manhattan on October 16, 1997, at 71 years of age due to
pancreatic cancer Pancreatic cancer arises when cell (biology), cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a Neoplasm, mass. These cancerous cells have the malignant, ability to invade other parts of t ...
.


References

{{DEFAULTSORT:Gorlin, Richard 1926 births 1997 deaths American cardiologists Harvard Medical School alumni Icahn School of Medicine at Mount Sinai faculty