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Posts Tagged ‘history of cardiology’

Great men dream , but they just do not sit idle. They do what they are passionate about .History just follows them or they create it.Here is a brief story of an ordinary man born in a small European country Lithuania in 1921  ,lived much of his  life in the east coast of USA ,transformed into a brilliant cardiologist  based in Brigham Hospital , Boston.

He is Dr Bernard Lown , best known as a founder of what is used in every coronary care unit and cardiac surgical theaters around the world . Yes, the DC cardioversion was invented by Lown in the year 1961.(Of course,  it was an Improvement  upon the  pioneering work of Zoll’s AC power line  for defibrillating   the heart  which was impractical and caused much injury )

 

drlown_history

Dr.Bernard Lown (Born 1921) ,With his Invention of DC Cardioversion machine Currently  working in  Harvard University

 

He was also the brain behind the  conversion of local anesthetic agent Lignocaine to cardiac anesthetic  which revolutionized the treatment of ventricular arrhythmia.(What a simple  but a path breaking  idea to use membrane stabilising action of local anesthesia to sedate the heart when it behaves erratically !)

We can also credit him for  rediscovering  Digoxin and found the secret that potassium supplementation can largely overcome  toxicity of this drug which was otherwise lifesaving in dilated , failing hearts  running amok with delirium tremors (Surname for Atrial fibillation in those days !)

While the Invention  of DC cardioversion had  a dramatic impact all over  world , he simultaneously popularized the concept of coronary care units along with Julian in London and Dr Day in Kansas city.

Its said great men’s mind  are perennially restless.Accordingly ,he was worried about the impending nuclear war with USSR and other global powers then. He collaborated with Russian cardiologist Dr. Eugene Chazov. It became a hugely popular peace organisation  International Physicians for the Prevention of Nuclear War (IPPN) for which he got ultimately the Noble prize for  in 1985.

 

bernard-lown-dc-cardioversion-lown-institute

During one of his Noble lectures (Linked to video)

 

 

It turned out to be “lovely Irony” for a man who probably should have got a Nobel prize for medicine for inventing DC cardioversion ,  ended up with Nobel peace prize for  his fight against a man made disease called  “Nuclear proliferation”.

Its heartening to note he has visited my country(India)  and was  awarded with Mahatma Gandhi peace prize  as well.He is now 95, active in Harvard   currently turned his vision towards eradicating Inappropriate medical treatment from the noble profession .I wonder , for a man who fought against a  nuclear war, what does this new Initiative mean ? Does he equate the medical profession in its current form and the direction in which travels to something that’s  grossly unacceptable ?

Whatever it is , I humbly endorse his views and has since dragged me to  his Institute.

lown-image

I just joined the institute and signed  a declaration . I wish every physician who take oath on Hippocrates should strengthen Dr Lown’s Doctrine .

Reference 

Link to Wikipedia

nobel-prize-in-medicine-cardiology-drsvenkatesan-venkatesan-madras-medical-college

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The field of cardiology has seen great men over the centuries. Few women have permanently stamped their presence  in that history .Jane Somerville can be termed mother of pediatric cardiology along with Maude Abbott She has a fascinating life history , having  worked  in Royal Brompton  , Imperial  and Guys London.She was mentored  by  pioneers like  Paul wood , Blalock and others .She is primarily interested in the pediatric cardiology especially congenital heart surgeries .The classification  of pulmonary atresia with VSD  goes with her name.

jane somerville

Dr. Jane Somerville : British cardiologist , (b-1933 )

She carries the credit  of  starting  the Pediatric cardiology world congress in 1990 ,is the founder of GUCH (Grown up children with congenital heart disease.) .

Here is a rare  interview  from he  to Dr Robert Califf  for Heart.org. For  those,who like to  have a glimpse of  cardiology in its vintage  times , don’t miss it.Dr Jane addresses the past treasures , explores specific issues of facing pediatric cardiology  and frank expression about the issues of women being a cardiologist  in a man’s world.

 

She has a foundation in her name that helps the children and adults with congenital heart disease.

somerville foundation

Reference

The landmark paper in BHJ 1970

pulmonary atresia

 

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William  I am Harvey first discovered human circulatory system in the year 1628 .Published his work in  De Motu Cordis” (otherwise known as “On the Motion of the Heart and Blood”) as a 72 page booklet in Frankfurt book fair. The world of medicine changed  forever , and new system of human circulation was born.

Read this now

Who first invented human circulation william harveyExcerpts  from   Chinese classic of Internal medicine , written  2000 years before William Harvey,

All the blood is under the jurisdiction of the heart .Twelve blood vessels are deeply hidden between the muscles and cannot be seen.Only on the outer ankles are visible because there is nothing to cover. All other blood vessels that are on the surface are  veins. The harmful effects of wind and rain enter the system first through the skin , being conveyed to the capillaries. When these are full , the blood goes in and turn empty into the big vessels .The blood current flows continuously in a circle and never stops

Post-amble

Of course , this in no way takes credit away from any body .William Harvey collected  every data on circulation available at that time , and  came with that classic De Moutu Cordis ,  the importance of which is undisputed. But ,history time and again tell us there are silent restless brains pondering over important  concepts all over the globe .Whoever has the access to scientific  facility , proves the same  point ,  publishes first and gets attention . After all thoughts are never rewarded in human domain ! (God , does it I guess  !)

Reference

1.Hume E.H Medicine in china ,old and new,American medical history 1930; 2;272-280

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In the early  20th century , Waller invented the ECG machine. Wilson  created  leads and  methods to record it. Eienthoven  formulated the concepts the electrical theory behind ECG.

Between 1940-197os one man ruled supreme in the world of electro cardiography .   He is Dr Sodi pallares from Mexico. His deep insights revolutionised  and helped  us  understand how the cardiac electricity is generated  and propagated  in various pathological states that is the beginning new age electrocardiography! It adds much to his  credit , as in those days scientists  from non American and European countries   were hard to come  in the  global limelight.

Some of his thought processes and Inventions

  • He laid the foundation  for deductive electrocardiography.
  • Applied  vectorocardiographic  principles to scalar  ECG and helped  understand mechanism of ventricular chamber enlargements
  • He was instrumental  to analyse  the genesis of current from the myocardium . He tried to reason out  the contribution  of  cell metabolism, hypoxia, electrolytes to the current genesis.
  • Polarising myocardium with GIK infusion STEMI was proposed by him
  • Finally he tried to incorporate the laws of thermodynamics into electrocardiography .

Please remember , Sodi pallare’s  conscience  is still largely unexplored .There are lots of hidden truths .We now know fever can influence qrs voltage and febrile illness can trigger  ventricular tachycardia as in  of Brugada syndromes.

Today’s youngsters can take a  few cues from this great man and enlighten the field of electro-cardiology

DOCTOR DEMETRIO SODI PALLARES

Demetrio Sodi Pallares (1913-2003 )

If  modern-day cardiologist is able to  interpret the  ECG by a cursory 3 second scan of  strip of waves  , we are greatly  indebted to the knowledge imbibed by this great man from Mexico !

Sodi pallares

Reference

http://onlinelibrary.wiley.com/doi/10.1002/clc.4960110616/pdf

Sodi-Pallares D,Medrano GA, Bisteni A, Ponce de Leon J:
Deductive and Poly-paramerric Elecrocardiography.Instituton acionalde
Cardiologia de Mexico, Mexico,DF1970,VII,VIII
Sodi-Pallares D, Testelli MR, Fishleder BL, Bisteni A, Medrano GA, Friendland C, De Micheli A. Effects of an intravenous infusion of a potassium-glucose-insulin solution on the electrocardiographic signs of myocardial infarction: a preliminary clinical report. Am J Cardiol. 1962;9:166–181

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This man enters your cath lab  every morning !  . . .  He is Mr Stent !

Endo-prothe`ses coronariennes autoexpansives.”

    “Endo-prothe`ses coronariennes autoexpansives.”  This is the official name given to coronary stents  when it was first used in man in 1986 in France . The first  stent in human coronary artery was implanted by Puel . Followed by Sigwart  ,Puel combine .

Later on  , the name Stent came into vogue . Surprisingly stent is not a technical name . It is a name of British dentist. To know more about the historical aspects of coronary stents read the following review from Circulation.

References

http://www.fauchard.org/history/articles/jdh/v49n2_July01/charles_stent_49_2.html

1 .Puel  J, Joffre  F, Rousseau  H;  et al.  Endo-protheses coronariennes auto-expansives dans le prevention des restenoses apres angioplastie transluminale, Arch Mal Coeur 8 1987 1311-131

2. Sigwart U, Puel J, Mirkovitch V, Joffre F, Kappenberger L. Intravascular stents to prevent occlusion and restenosis after
transluminal angioplasty. N Engl J Med. 1987; 316: 701-706.

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