The History of Coronary Disease

Like so many other things of body and sky, man's first inspection of coronary artery disease was likely conducted by da Vinci. Although his concepts were rudimentary, they inspired other physicians to understand and treat a disease that would skyrocket and kill millions in the wake of the industrial revolution.

Significance

• Death from coronary artery disease (CAD) and its byproduct, heart disease, was relatively rare before 1900. The industrial revolution and modern comfort is believed to have contributed significantly to the rise.

  "The combination of a sedentary lifestyle and a rich diet led to an increase in clogged blood vessels, heart attacks and strokes," according to the Franklin Institute. "Heart disease became commonplace. The rate of heart disease increased so sharply between 1940 and 1967 that the World Health Organization called it the world's most serious epidemic."

Early Research

• Leonardo da Vinci is among the first scientists documented to have studied coronary arteries and their purpose. One hundred more years passed before an English doctor, William Harvey, described the circulation of blood in 1628. Knowledge in the field continued to grow, and in the 1700s, cardiologist Friedrich Hoffmann established the link between heart disease and decreased blood flow through the coronary arteries.

20th Century

• The end of the 19th and start of the 20th centuries heralded the onset of new understanding concerning CAD. William Osler played a large role, studying angina and painting an accurate description of the coronary vessels, while his fellow cardiologist, James Herrick, is credited with coining the phrase "heart attack."

  According to Dr. P.R. Lichtlen, in his paper "History of Coronary Heart Disease," Werner Forssmann conducted the first coronary heart catheterization, on himself, in 1929. This groundbreaking work sparked other advances and by the 1950s physicians were developing angiography, the process of making blood vessels viewable by X-ray.

Bypass

• The first coronary bypass surgery occurred at the Cleveland Clinic in 1967. Dr. Rene Favaloro pioneered the open-heart technique, which allows a physician to remove a vein from another part of a patient's body and use it to connect the aorta and arteries in the heart, creating a "bypass" around blocked, coronary arteries.

Angioplasty

• Dr. Andreas Gruentzig performed the first coronary angioplasty in 1977 at a hospital in Switzerland. "During the procedure, Dr. Gruentzig inserts a catheter into a coronary artery that is largely blocked and inflates a tiny balloon (made at his kitchen table), compressing the buildup of plaque against the walls of the artery," according to The Society for Cardiovascular Angiography and Interventions.

Stents

• 1986 saw the development of stents, tiny metal tubes that serve to prop open the artery and keep it from closing again after balloon angioplasty. The usage of stents became commonplace, drastically reducing the need for invasive, higher-risk surgeries. By 2002, more than 2 million coronary angioplasties were performed annually across the globe.

21st Century

• As a result of these advances in the treatment of coronary artery disease, the likelihood of surviving a first heart attack has risen tremendously. In the early 1980s, 40 percent of heart attack victims died within the first year. In 2009, with coronary angioplasty and stents in regular use, that rate of mortality has fallen to between 4 and 8 percent.