Dilated hearts at high altitude: words from on high.

From the time of the turn of the twentieth century, dilated hearts and presumed cardiac fatigue in expeditionary climbers and scientists have been the subject of much commentary in the medical and mountaineering literature. Although largely attributed by most, but not all, to left heart strain, the description of dilated hearts in these accounts is clearly that of right heart dilation as a consequence of high and sustained hypoxic pulmonary vasoconstriction with hypertensive remodeling. This essay will feature quotations from the writings of high altitude pioneers about dilated, strained, or enlarged hearts. It will give some brief physiology of the right side of the heart as background, but will focus on the words of mountaineers and mountaineering physicians as color commentary.

A history of medical reports on the Boston Marathon: 112 years and still running.

INTRODUCTION/METHODS: We performed a systematic search for medical reports on the Boston Marathon, run annually since April 19, 1897 and studied medically since 1899. RESULTS: We identified 66 articles: 25 were related to cardiology; 10, exercise physiology; 8, metabolism; 5, neurology; 4, gastroenterology; 3, hematology; 3, several disciplines; and 8, nephrology, orthopedics, and general topics. The predominance of cardiology articles reflects concerns about the cardiac risks of exercise present in the early 20th century and persistent to this day. The authors and contributors included luminaries from the medical and exercise community including Drs. Paul Dudley White, Samuel Levine, Kenneth Cooper, Paul Zoll, Ellsworth Buskirk, and David Costill. The articles identified or confirmed many of the presently accepted principles of marathon medicine. CONCLUSIONS: Medical studies on the Boston Marathon not only provide lessons applicable to managing modern athletes but also demonstrate the interests and concerns of researchers who have used the event to study the physiology of prolonged exercise for more than a century.

Remodelamento miocárdico: o cardiomiócito, a função do órgão / Cardiac remodeling: the cardiomyocyte, the cardiac function

Remodelamento miocárdico é o conjunto de modificações gênicas, moleculares, celulares e intersticiais que ocorrem no miocárdio e que se expressam clinicamente por alterações do tamanho, da forma e da função do coração. Este texto focaliza as modificações incidentes no cardiomiócito e as anormalidades decorrentes para a função cardíaca. Modificações...

A decade of discoveries in cardiac biology.

The heart is the first organ to form in the embryo, and all subsequent events in the life of the organism depend on its function. Inherited mutations in cardiac regulatory genes give rise to congenital heart disease, the most common form of human birth defects, and abnormalities of the adult heart represent the most prevalent cause of morbidity and mortality in the industrialized world. The past decade has marked a transition from physiological and functional studies of the heart toward a deeper understanding of cardiac function (and dysfunction) at genetic and molecular levels. These discoveries have provided new therapeutic approaches for prevention and palliation of cardiac disease and have raised new questions, challenges and opportunities for the future.

High blood pressure and the kidney: the forgotten contribution of William Senhouse Kirkes.

The realization of the key role for raised intra-arterial pressure as a pathogenetic agent in hypertension is usually credited to Ludwig Traube, but Traube in his writings gives credit for the idea to a little-known English doctor, William Senhouse Kirkes (1822-1864). Kirkes' main interest was in cardiology and vascular disease, and he gave the first account of embolism from vegetations in infective endocarditis in 1852. Three years later, he published a study of apoplexy in Bright's disease, in which he pointed clearly to the role of raised intra-arterial tension in the causation of arterial disease, a point that had eluded Bright, Johnson, and other contemporaries. Kirkes died at the age of only 42 while working on a book summarizing his work on cardiology and renal disease, and the neglect of his contribution probably resulted from his early death. We have traced his life history from the few available records; as a boy, Kirkes was apprenticed to become a surgeon and only later trained as a physician. We place his contributions within the setting of the development during the 19th century of understanding of the relationship between the kidney, vascular disease, and high blood pressure.

Significance of T1 less than T3 when R1 is greater than R3 in Einthoven's three lead electrocardiogram: an historical note.

This paper reviews the historical development and the significance of T-wave amplitudes in leads I and III in 1000 electrocardiograms of healthy, fit young men at the beginning of their training in the Commonwealth Aircrew Training Program of the Royal Canadian Airforce. It was found that only two of the 1000 electrocardiograms studied showed a pattern of T1 less than T3 with R1 greater than R3; consequently this was regarded as an abnormal finding.