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.—William Harvey, 16281
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. Most historians agree that William Harvey's discovery of the circulation of blood in the early 17th century is a good place to start the modern history of cardiovascular medicine. Following Harvey, cardiology has 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.2-5 What has emerged in the 21st century is a medical specialty with incredible tools of diagnosis including blood biomarkers and multiple imaging modalities; numerous medical treatment options that include drugs, biologics, and devices; and surgical options involving complex operations that both repair and replace dysfunctional anatomy.
The introduction of the first instruments of precision—blood pressure measurement, the chest x-ray, and the electrocardiogram—in the 1890s and early 20th century, led to the creation of the specialty of cardiology. Since the 1950s, following the advent of cardiac catheterization and surgery, cardiology has evolved into multiple, highly specialized disciplines focusing on coronary artery disease, heart failure, arrhythmias, imaging, and preventive care. Early diagnosis of cardiac risk, aggressive medical treatment of cardiac diseases coupled with increasing attention to prevention have led to a gradual decrease in mortality for cardiac disease.6 A hallmark of cardiovascular medicine in the early 21st century has been its emergence at the forefront of the evidence-based medicine movement with an intense commitment to quality care7-9 through continuous investigation and incorporation of new knowledge into clinical practice guidelines by the major professional societies and public health organizations.10,11
Many of the initial key discoveries are now recalled as eponyms attached to diseases or physical signs. As the number of investigators has grown exponentially and internationally, it is increasingly difficult to assign singular credit to contributions for which many are ultimately responsible. Taking all of these considerations into account, we have chosen to provide a condensed narrative by subject, selectively highlighting important events and key figures ...