The heart and history: Prying open its secrets
No other bodily organ has inspired poets and philosophers over the centuries the way the human heart has
The one technology that most catapulted knowledge of the living heart was cardiac catheterization. The notion that one could touch the beating heart without peril was unthinkable in 1929. But Berlin's Werner Forssmann, fresh out of medical school, felt otherwise. When his professor dismissed his pipe dreams, Forssmann catheterized himself by threading a bladder catheter through an artery in his left arm into his heart. Catheter in place, he walked to radiology for a chest X-ray, the in-your-face proof that he had both succeeded and survived. His continued self-experimentation brought him more ridicule than recognition. Such boldness fared better in New York City, where 10 years later Andre Cournand and Dickinson Richards began catheterizing heart patients. This won all three physicians the Nobel Prize and, more important, changed cardiovascular medicine forever.
Catheterization became the looking glass and the portal for mending hearts. When in 1958 Mason Sones of the Cleveland Clinic discovered how to slip catheters directly into coronary arteries in motion and inject them with dye, the ability to detect coronary atheromas in living patients suddenly became reality. This opened the door for coronary artery bypass surgery and then, 20 years later, for coronary angioplasty, using catheters and stents instead of surgery to restore blood flow. Catheterization triggered other lifesavers. Intensive care units monitor sick patients with right-heart catheters. After transplant, the heart is biopsied through catheters to detect rejection. And electrical wires threaded into hearts enable permanently implanted pacemakers to sustain rhythm--or wait on standby to interrupt the drama of sudden death with a stored jolt of electricity.
Armed with knowledge of heart disease in its many forms, modern-day chemists and molecular biologists jumped in with their technologies. Bulging medicine cabinets, filled with ever more drugs to treat and prevent heart problems, are daily testimony to this, as are genetic, metabolic, and behavioral portraits that help people ward off their own heart risks. Now in our sights are therapies to reverse atherosclerosis with drugs and to restore vigor to damaged heart muscle with stem cells from marrow. Indeed, the boundless talent and technology that define cardiology have us on the very edge of declaring the death of today's scourge of coronary artery disease. It's not too early to wonder, What next?