It was New Year’s Eve, 1982, when I was called upon to assist a man who was experiencing unrelenting chest pain coupled with a foreboding sense of doom. I was new in town celebrating the changing of the year with friends when the emergency room called.
Someone was having a heart attack, the result of a blockage in one of the coronary arteries that feeds a large segment of the muscles of his heart. The EKG showed that injury was occurring across the front part of the left ventricle, which is to say it was “the big one,” representing a significant chance of death. If he did survive, he could have had a profound weakening of the heart resulting in weakness and disability. For my patient, on a night when others were celebrating, the pain would not let up. This meant that permanent destruction was spreading to more and more of his heart.
It was the dawning of a new age for treating coronary artery blockages. In the 1960s a pediatric cardiologist at the Cleveland Clinic began snaking skinny plastic tubes from the groin up and around the aortic arch. After injecting X-Ray dye, the coronary arteries could then be visualized under fluoroscopy. They called it an angiogram, coming from the Greek words angeion meaning “vessel” and gramma meaning “that which is written or drawn.”
In the early 1980s, physicians began exploring novel ways to open arteries and improve blood flow to save heart muscle before and during heart attacks. In the weeks before that fateful night, I had read an article in the New England Journal of Medicine about how researchers were able to inject clot busters into closed off coronary arteries. If this was done early enough during the heart attack, before complete damage had occurred, many hearts and lives could be saved.
During that early morning hour, I found a cardiologist who had just learned to do such a procedure, and I urgently sent him the patient by ambulance. The man with the dangerous chest pain was treated successfully. His pain went away, and he lived for several more years before finally dying of something other than heart disease.
It was the dawn of a new year, and, in caring for those with coronary artery disease, it was the dawn of a new age.
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