British Cardiology in the 20th Century

1 British Cardiology 1900–50.- Heart failure.- Cardiac arrhythmias.- Conduction defects.- Electrocardiography.- Ischaemic heart disease.- Angina.- Myocardial infarction.- Chronic rheumatic heart disease.- Infections of the heart.- Hypertensive heart disease.- Pulmonary heart disease.- Congenital heart disease.- Da Costa’s syndrome and related conditions.- The Development of the Speciality.- 2 The Second World War and the NHS — the Framework for the Development of Cardiology.- Hospitals and specialists before the war.- Planning for district hospitals.- Speciality development.- Development of cardiology and cardiac surgery.- NHS organisation and specialist services.- London issues.- Equity, cost, and quality.- 3 The Training, Number, and Distribution of Cardiologists.- Training within the NHS.- of formal training.- Regulating numbers.- Growth and geographical distribution.- The Organisations Involved in the Growth of Cardiology.- 4 Societies, Journals, and Books.- The Cardiac Club.- The British Cardiac Society.- Other British cardiology organisations.- Journals and books.- 5 The British Heart Foundation.- Founding committee.- Statement of purpose.- Fundraising.- Governance.- The medical department.- Research.- Professorial chairs.- Education.- Cardiac care.- 6 Part I. The National Heart Hospital: The First of its Kind.- London hospitals prior to special hospitals.- The rise of special hospitals.- Special hospitals gain recognition.- The origins of the National Heart Hospital.- The Dr Eldridge Spratt melodrama.- The hospital gains sound footing and respect.- The Second World War period.- The National Heart Hospital and Institute of Cardiology.- Cardiac catheterization and cardiovascular surgery.- Closure and rebirth of the Heart Hospital.- Acknowledgements.- II. The Institute of Cardiology and the National Heart and Lung Institute.- Formation of special institutes for postgraduate education.- National Heart Hospital.- Institute of Cardiology.- Formation of the National Heart and Lung Institute.- 7 The Hammersmith Hospital and the Royal Postgraduate Medical School.- Foundation.- Voluntary hospitals and research.- The Hammersmith model.- Cardiac catheterisation.- The Second World War.- Cardiac surgery.- Further research.- Diagnosis and Treatment in Cardiology.- 8 Bedside Diagnosis.- Principles of examination.- Development of the phonocardiogram.- Studies on identifying components of the second heart sound.- Studies on components and intensity of the first heart sound.- Studies on early systolic sounds.- 9 The Chest X Ray in Cardiac Diagnosis, 1930–60.- Early use of the chest x ray.- Improvement in radiological methods.- First techniques.- Cardiac enlargement and the pulmonary blood vessels.- Heart failure.- Cardiac catheterisation helps interpretation.- Investigating pulmonary blood flow and oedema.- Pulmonary hypertension.- 10 Electrocardiography, Electrophysiology, and Arrhythmias.- Electrocardiography.- Intracardiac electrocardiography.- Developments in surface electrocardiography.- Antiarrhythmic therapy.- 11 Cardiac Catheterisation.- Early work.- The Paul Wood era.- Work in the 1960s and 1970s.- Angioplasty.- 12 Nuclear Medicine and Cardiology.- The MRC medical cyclotron unit.- Cardiac imaging.- New tracers.- Emission tomography.- British Nuclear Cardiology Society.- Cost-benefit analysis of scintigraphy.- 13 Cardiovascular Magnetic Resonance.- Early days of imaging.- CORDA.- Brompton Magnetic Resonance Unit.- Magnetic resonance spectroscopy.- Coronary and myocardial perfusion imaging.- Specialist societies.- 14 The Development of Cardiac Ultrasound.- Beginnings.- Developments in the 1970s and 1980s.- Importance in paediatric cardiology.- Transoesophageal echo.- Ultrasound’s role in cardiology.- The next millennium.- 15 Prevention of Heart Disease.- Rheumatic heart disease.- Coronary heart disease.- Epidemiological studies.- Prevention.- Decreasing mortality from coronary heart disease.- Hypertension.- 16 Cardiac Surgery.- Back to the beginning.- Closing in on the heart.- Specialisation develops.- Next wave of valvular surgery.- Disseminating information.- Impact of hypothermia and stopping the circulation.- Further developments in valve surgery.- Transplantation.- Coronary artery surgery.- Issues of conflict and quality.- 17 Cardiac Pacing.- Early Days of Pacing at St George’s Hospital.- From St George’s to the National Heart Hospital.- Recollections of Pacing from a Regional Centre.- 18 Cardiac Rehabilitation.- Moving on from bed rest.- Cardiac rehabilitation as a developing speciality.- Cardiology and rehabilitation.- Psychosocial factors in cardiac rehabilitation.- Safety and effectiveness of rehabilitation services.- Expansion of services.- Reviewing service provision.- Consumer involvement.- Where are we now?.- 19 Clinical Trials.- Prevention and treatment of thrombosis.- ? adrenergic blocking drugs, calcium antagonists, nitrates, and magnesium in and after myocardial infarction.- Hypertension.- Heart failure.- The coronary care unit.- Coronary artery bypass surgery and angioplasty.- Lifestyle, diet, and lipid modifying drugs.- Methodology of randomised clinical trials.- Selected Cardiac Disorders.- 20 Cardiovascular Pathology.- Morphology.- Academic pathology.- Atherosclerosis research.- Cardiomyopathy and myocarditis.- Reginald Hudson.- Cardiovascular pathology in the 1990s.- 21 Paediatric Cardiology.- Pioneers and pioneering procedures.- Establishing paediatric cardiac units.- Establishment of consultant posts.- Professional associations.- Development of a paediatric cardiac service.- Academic units.- Conclusions and prospects.- 22 Grown Up Congenital Heart (GUCH) Services for Adolescents and Adults.- Development of paediatric cardiology and cardiac surgery.- Establishing a service.- Other aspects of GUCH.- GUCH information and services across the world.- 23 Rheumatic Fever.- History.- Murmurs.- Cardiac dilatation.- Chorea.- Aetiology.- Changing prevalence.- Canadian Red Cross Memorial Hospital, Taplow.- Treating rheumatic fever.- Remaining problems.- 24 Valvular Disease, Endocarditis, and Cardiomyopathy.- Valvular heart disease in Britain.- Infective endocarditis.- Cardiomyopathy.- 25 Hypertension.- Work of Pickering.- Battle of the knights.- Epidemiological studies.- Benign and malignant hypertension.- Early drug treatments.- Trial ethics.- Research at the Hammersmith in the 1950s and 1960s.- ? blockers.- MRC trial of drug treatment in mild hypertension.- Role of meta-analysis.- 26 Atherosclerosis Research after the Second World War.- Early post war history.- Increasing incidence of coronary heart disease.- Risk factors.- The arterial wall.- Thrombosis research.- Lipid and lipoprotein research.- Organisational developments.- Cardiovascular survey methods.- Major research developments after 1970.- Clinical trials on the reduction or prevention of atheromatous coronary heart disease.- 27 Clinical Coronary Heart Disease.- Myocardial infarction — 1945–60.- Myocardial infarction — 1960 onward.- Unstable angina.- Variant angina.- Stable angina.- 28 Leaders of British Cardiology.- Russell Claude Brock, Lord Brock of Wimbledon.- Sir Thomas Lewis.- Sir James Mackenzie.- Sir John McMichael.- Sir John Parkinson.- Paul Hamilton Wood.