When was coronary heart disease discovered

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Please consult the latest official manual style if you have any questions regarding the format accuracy. The heart … is the beginning of life; the sun of the microcosm … for it is the heart by whose virtue and pulse the blood is moved, perfected, made apt to nourish, and is preserved from corruption and coagulation; it is the household divinity which, discharging its function, nourishes, cherishes, quickens the whole body, and is indeed the foundation of life, the source of all action.

The history and our still emerging understanding of the heart are a remarkable story, with origins in antiquity, centered initially on clinical observations.

Thought at one time to be the center of the soul and impervious to disease, the heart was long a source of mystery and wonder, studied in science and fascinated about in literature and the arts.

Following Harvey, cardiology pursued a pathway of descriptive anatomy and pathology in the 17th and 18th centuries, auscultation and its correlations in the 19th century, an understanding of cardiac disease and its pathophysiology in the second half of the 19th and first half of the 20th centuries, and major advances in the diagnosis and treatment of heart disease from there into the 21st century. What has also emerged in the 21st century is a far less positive story: the growing global epidemic of atherosclerotic heart disease and its ischemic complications; an epidemic created by the exportation of tobacco products around the world; a change in dietary patterns with decreasing amounts of fresh fruits and vegetables; and an increase in more sedentary lifestyles, in some ways facilitated by technology.

The introduction of the first instruments of precision—blood pressure measurement, the chest x-ray, and the electrocardiogram—in the s and early 20th century, led to the creation of the specialty of cardiology. Since the s, following the advent of cardiac catheterization and surgery, cardiology has evolved Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'.

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Learn More. Sign in via OpenAthens. But others elsewhere, including Obrastzow and Staschesko in Europe, had similar early insights.

Part of the historical delay and confusion in recognizing heart attacks apparently lay in the Greek word, kardialgia , which could mean either abdominal or precordial pain. Biblical and Talmudic references abound, however, about chest pain of a life-threatening nature, and Hippocrates mentions sudden death related to an episode of chest distress Leibowitz Charles Parry, in a reading before the Royal Society in July , also attributed angina to partial obstruction of the coronaries ibid.

As modern science developed from the telescope and the microscope, so modern cardiology and its partner, epidemiology, owes much to technology, not least to the electrocardiograph ECG. After centuries of irregular progress toward understanding the clinical, physiological, and pathological pictures of atherosclerosis, coronary occlusion, and myocardial infarction, their integration was immensely facilitated by the remarkable recording device, the string galvanometer of Wilhelm Einthoven of Leiden, which magnified the surface potentials produced by the electrical activity in the heart beat and indicated its disturbances.

Nevertheless, it was the pioneering British clinical investigator, Sir Thomas Lewis, who in the s made the ECG an essential and practical instrument allowing diagnosis not only of disturbances of heart rhythm but also an inadequate blood supply ischemia and muscle damage infarction , the hallmarks of coronary heart disease.

Paul Dudley White, as a youthful clinical fellow from Boston, came to study with the famous clinical investigator, Sir Thomas, in the s and, as did other contemporaries, brought home to the U. They had to be rediscovered. Thus was recognition of coronary occlusion, thrombosis and damage to the myocardium clearly differentiated from the ancient notion of sudden death and angina pectoris of effort.

As important, original, and well-documented as these two classic papers were on cardiac infarction, neither stirred excitement when they were first published. Even by the s, cardiologists had not widely embraced the concept of infarction with survival. Morris When he eventually faced the reality of his infarct, Sir Thomas became profoundly depressed, resigning himself to the view of the time that the diagnosis meant a sedentary and short future.

Paul White in his text, Heart Disease , first published in , was next among the cardiological elite to maintain that one could recover from an infarct and carry on a full life. Laboratory confirmation came along via measurement of elevated white blood count and then, starting in the s with Ladue and Wroblewski, through identification of enzymes released by infarcted myocardium in rough proportion to the muscle damage and the ability to measure accurately the course of their blood levels in an evolving clinical case Thus, the full-blown picture of myocardial infarction was not high in the awareness of even the best medical diagnosticians until well into the twentieth century.

And not until the confirmatory evidence of electrocardiographic findings indicating muscle ischemia and damage was it widely recognized that not only did people die suddenly from this condition, but that many did not die and some lived extended lives with healed muscle and collateral circulation.

And even White, as late as his third edition in , makes no mention of prevention. Indeed, the recognition of coronary disease as a common, epidemic and therefore preventable condition is a recent phenomenon. It came from reports that acute coronary events rose before and subsided greatly during World War II and re-emerged following the war. Then it was noted to increasingly involve middle-aged and younger men in industrial societies. It seems likely that the dramatic circumstance of the emerging epidemic, perhaps along with its predominance in men stricken suddenly in their prime years, precipitated the intense study of coronary disease in clinics and laboratories and gave impetus to studies in populations, manifestations of the new disciplines of CVD epidemiology and preventive cardiology.

Henry Blackburn. In this paper, we took the t -test based Adaboost algorithm as a feature selection method to establish the diagnosis pattern of QDS in the context of UA for three reasons. The first one is that the algorithm is very simple to implement. The second one is that it performs feature selection on large sets of features.

The final reason is that it is with fairly good generalization. Among the five parameters, CHO and LDL have been proposed to be independent predictors of atherosclerotic vascular disease [ 12 , 13 ]. CHO is an essential component of cell membranes where it is required to establish the proper permeability and fluidity of membrane.

In addition, CHO is an important precursor molecule for the biosynthesis of bile acids, steroid hormones and several fat soluble vitamins [ 14 ]. But high CHO is one of the major risk factors for developing heart disease. It is a type of lipoprotein that transports CHO and triglycerides from the liver to peripheral tissues.

LDL concentration is an important predictor of cardiovascular events and progression of coronary artery disease [ 16 ].

PDW expresses the distribution of the size of platelets produced by the megakaryocyte. Although PDW have been available now for quite a long time, their clinical usefulness hitherto is not obvious.

PDW has been found highly useful in the differential diagnosis of thrombocytosis [ 17 ]. MCH is the average mass of hemoglobin per red blood cell in a sample of blood. Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red cells of the blood in human. Hemoglobin transports oxygen from the lungs to the rest of the body where it releases the oxygen. We need more oxygen and usually feel tired in sports. Insufficient oxygen transportation usually leads to short breath and lassitude, which are the typical symptoms of QDS.

Hemoglobin also has a variety of other gas-transport and effect-modulation function. It has been reported to have association with heart failure [ 18 ].

TCO 2 is a reflection of acid-base balance. Measurement of the total CO 2 content can help us explain acid-base balance disorders. It is relative with the breath of lungs. Sports can increase respiratory frequency and cause tiredness, lassitude and short breath which are important characteristics of QDS. It has been reported that there is a relationship between breath obstacle and cardiovascular disease [ 19 ].

To sum up, the associated biomedical literatures support the finding. The five parameters are certainly ignored in clinics. However, combined and associated with the other two biological parameters, the classification model reaches a highest accuracy, which suggests that the five parameters have significant difference between the two groups. So many documents have shown that inflammation system has significantly associated with UA and the syndromes in the context of it [ 11 ].

A syndrome called blood stasis syndrome was found to be diagnosed by several inflammation parameters. However, the association between QDS and inflammation system is not studied in the paper; the diagnosis accuracy of QDS by using biological parameters from inflammation system is need to be further investigated in our continuous research efforts and be compared with the results obtained in the paper.

The further research directions would focus on three parts. The first is to enlarge the amount of clinical epidemiology samples and use the data mining methods to establish diagnosis methods for all syndromes in the context of UA, i. Alternatively, the association of five biological parameters and QDS needs to be investigated by using animal models to study the inner mechanism of it.

Finally, the diagnosis pattern should be studied in the context of other diseases than UA, which provides a basis for uncovering the biological basis of syndrome in TCM. This study was devoted to establish the diagnosis method of QDS by using microcosmic biological parameters in the context of UA.

The highest diagnosis accuracy of the patterns could reach The further clinical validation showed that the five parameters have significant association with QDS in the context of UA. The association between symptoms that are significantly associated with QDS also confirms the finding. We conclude that the syndrome in TCM can be diagnosed in the microcosmic level and the t -test-based Adaboost algorithm may have high value in diagnosis in the clinics.

The authors would like to thank reviewers for their excellent comments. Zhao, J. Chen, and N. Hou contributed equally to this work. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Special Issues. Received 25 Jun Accepted 01 Dec Published 21 Aug Abstract Coronary heart disease CHD is still the leading cause of death for adults worldwide. Introduction Coronary heart disease CHD remains the single leading cause of death for adults worldwide [ 1 ]. Figure 1. Table 1. Figure 2. The illustration of a 3-fold cross validation technique.

Figure 3. The absolute value of 10 biological parameters is given in a descending way. Figure 4. The t -test-based algorithm calculated different biological parameters combinations by nine times. The optimal number of biological parameters is five. Table 2. Biological parameter P -value MCH 0. Table 3. The five indexes and their P value in the pattern included. Table 4. The clinically further validation of the association established: it is found that the results are in accordance with the cross-validation counterpart.

Table 5. The association between symptom and the five biological parameters was established by the algorithm.