RESUMO
With little training in physics, Guglielmo Marconi developed the invention that stunned the world by wirelessly connecting ships and continents. Ten years before his death, he sustained a myocardial infarction followed by unmistakable angina pectoris. His personality and unhappy family life limited his ability to cope with his disease and to deal with Italy's most respected physicians. But their descriptions of his diagnosis and management are surprisingly few. Poor record keeping, intentional news suppression of his failing health or limited medical opportunities could be the reason for this lack of information. He died in 1937 when the value of electrocardiograms and X-rays were recognized (he had neither), but therapeutic options were severely limited. To gain insight into his care, we compared contemporary Italian understanding of coronary heart disease to British and American teachings. When he died of an acute coronary syndrome, heart failure and dysrhythmias, he was attended only by medical staff, but by none of his large family.
Assuntos
Síndrome Coronariana Aguda/história , Arritmias Cardíacas/história , Pessoas Famosas , Insuficiência Cardíaca/história , Inventores/história , Tecnologia sem Fio/história , História do Século XIX , História do Século XX , Humanos , Itália , MasculinoAssuntos
Humanos , Síndrome Coronariana Aguda/história , Síndrome Coronariana Aguda/terapia , Tratamento de Emergência/classificação , Hospitais de Emergência , Ambulatório Hospitalar , Assistência Ambulatorial , Anticoagulantes/efeitos adversos , Estudos Clínicos como Assunto/história , Identificação da EmergênciaRESUMO
Acute coronary syndrome (ACS) remains a major burden on morbidity and mortality in the United States. Medical professionals and students often use the mnemonic 'MONA' (morphine, oxygen, nitroglycerin and aspirin) to recall treatments for ACS; however, this list of therapies is outdated. We provide a historical perspective on 'MONA,' attempt to uncover its origin in the medical literature, and demonstrate the myriad changes that have occurred over the last 50 years of ACS management. We have developed a novel mnemonic, 'THROMBINS2' (thienopyridines, heparin/enoxaparin, renin-angiotensin system blockers, oxygen, morphine, beta blocker, intervention, nitroglycerin, statin/salicylate) to help bedside clinicians recall all the elements of contemporary ACS management. We demonstrate the mortality benefit for each component of contemporary ACS management, correlating the continued improvement with historical data on mortality after myocardial infarction. We encourage providers to utilize this mnemonic to explore options and guide treatments in ACS patients.
Assuntos
Síndrome Coronariana Aguda/história , Síndrome Coronariana Aguda/classificação , Síndrome Coronariana Aguda/tratamento farmacológico , Antagonistas Adrenérgicos beta/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Aspirina/uso terapêutico , Gerenciamento Clínico , Heparina/uso terapêutico , História do Século XX , História do Século XXI , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Morfina/uso terapêutico , Nitroglicerina/uso terapêutico , Oxigenoterapia , Intervenção Coronária Percutânea , Fatores de Risco , Tienopiridinas/uso terapêuticoRESUMO
Predicting acute cardiovascular ischemic events is a crucial and urgent issue in the current cardiovascular field. An enormous effort to develop methodologies to achieve this purpose is being undertaken in cardiovascular institutes worldwide. However, currently, there is no established method of determining acute cardiovascular ischemic events in advance. This article reviews the latest progress on understanding how these events occur and how they can be detected. This goal represents a great dream that has realistic expectations.
Assuntos
Síndrome Coronariana Aguda/diagnóstico , Infarto do Miocárdio/diagnóstico , Síndrome Coronariana Aguda/etiologia , Síndrome Coronariana Aguda/história , História do Século XX , História do Século XXI , Humanos , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/históriaAssuntos
Ecocardiografia/história , Síndrome Coronariana Aguda/diagnóstico por imagem , Síndrome Coronariana Aguda/história , Doença Aguda , Animais , Doença Crônica , Meios de Contraste/história , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/história , Doença da Artéria Coronariana/fisiopatologia , Ecocardiografia/métodos , História do Século XX , História do Século XXI , HumanosRESUMO
The first cardiac catheterization in a living human was performed in 1929 by Werner Forssmann.(1) Forssmann was a young urologist in training who catheterized his right atrium from his left anticubital vein and took a picture of the catheter in the right atrium. He also showed that it was safe to exercise with a catheter in the right atrium since he had to walk to the radiology department.
Assuntos
Síndrome Coronariana Aguda/história , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/terapia , História do Século XX , HumanosRESUMO
As I advanced through medical school at Johns Hopkins, and throughout my subsequent training, I was constantly reminded of the contributions made to medicine by our predecessors. Many of whom were at Johns Hopkins, but many were not. As I continue active involvement in the education of medical students and physicians, it seems to me we have not done a good job of relating the history of how the modern management of patients with cardiovascular disease developed to our students, house staff, and fellows.