Tuesday, February 17, 2009

Brainy Tidbits on the Heart

I received a text message yesterday telling me that the orientation for Cardiology fellowship starts this Monday. All spiced up and excited, I visited my favorite spot in UP College of Medicine since med school days - the UP Medicine Library. Don't get me wrong here. I didn't go there to start reading Braunwald! Geeez, the last thing in my genes is the competitive spirit.

I went there to indulge in something I know I'll never get to do once fellowship starts - read a little bit on cardiac anatomy and physiology at leisure, without being pressured to memorize or even understand anything at all. But instead of anatomy and physiology, I was distracted by another topic I enjoy - history of medicine. I ended up spending several hours on the history of cardiology.

This is the age of cardiovascular revolution. Overwhelming invention and discovery started only in the last few decades. No wonder cardiology fellowship training took only 1 year in the early 1980s. Here are interesting information I discovered:
(Sorry, medyo nerdy information, but this is interesting, I promise)
  • The ECG machine, invented by Willem Einthoven in the early 1900s, used to be a 600-lb apparatus requiring 5 people to operate. Wow! I'm glad I wasn't a doctor during those times.
  • The 2DEcho was invented only in the 1970s. The color-flow doppler in 1982 and the CT-angiogram in 2005! What, no 2DEcho in the 1970s!? No wonder Dr. Abarquez relies on the ECG so much!
  • Modern cardiac catheterization started in the 1950s after a 29-year old surgical resident inserted a ureteral catheter into his own antecubital vein until the tip reached his right atrium! Angioplasty started only in 1997! (I was already a 1st year college kid in UP Manila at that time.)
  • Cardiovascular medications as we know them now began rather recently. Beta-blockers started only in 1975, ACE inhibitors in 1981, statins in 1985, Aspirin (for the heart) in 1988 (wow!), and angiotensin-receptor blockers in the 1990s. What were they giving then? And more importantly, what were they studying and memorizing then?
Da Vinci's rendition of the human heart - generally accurate but he got the anatomical position wrong. Hence, the wrong image of the "Valentine" heart. Be smart everyone. The next time you have to create a figure of a heart, it should be lying down with the apex directed to the left. (photo from mordicaicaeli on flickr)

Too nerdy ba? Here comes the juicy and the cheesy part of this entry. Even before I picked CVS, I always had a fondness for the heart - not the literal heart but the metaphorical images it invokes. I wonder if these great researchers really wanted to prove a literal point, or they just wanted to send a metaphorical message across...
  • Heberden, in 1768, who was the first to describe angina said:

"But there is a disorder of the breast marked with strong and peculiar symptoms, considerable for the kind of danger belonging to it, and not extremely rare."

  • In 1908, Mackenzie in his attempt to explain that it was the exhaustion of the heart muscle that led to symptoms and signs of heart failure, briefly and poignantly stated:

"A heart is only what a heart can do."

  • This is my favorite quote. In the 1960s, in his advocacy for CPR, Beck wonderfully explained"

"The heart wants to beat, and often it needs only a second chance. The heart is too good to die..."

I closed the book. The library light became too strong my eyes hurt...

Hmmm, isn't it a mystery that despite the advances of modern medicine, there is still no way we can regenerate infarcted myocardium? That would be the ultimate discovery, right?

What are we talking about here? Haha! Metaphorically? Figuratively? Literally? Go figure.

Whatever it is, something tells me I chose the right subspecialty... =)


Regina said...

Thank you for the information. :)

loved this quote "The heart wants to beat, and often it needs only a second chance. The heart is too good to die..."

The Commuter said...

Nerdy, nerdy, nerdy.
But really when you want to get into something being a bid nerdy is forgivable. Good luck on your fellowship.

Walking on Water said...

@regina, those were from dr. beck himself (of the beck's triad). i wonder what he was feeling when he wrote that. kunwari pa-CPR, i'm sure he's talking about something else.=)

@commuter, sir i think this post is more sappy than nerdy. hahaha!

Reena said...

hmmm... i like that quote. atch out for my next post. i have a feeling magagamit ko siya. hahahah