History of the diagnosis and treatment of critical limb ischemia and diabetic foot.

The history of the recognition and surgical treatment of lower limb ischemia dates back to the Middle Ages. The twin Saints Comas and Damian were ascribed to have saved a gangrenous limb in the 13th century and became patrons of future surgeons. The physicians that followed developed the theories of blood flow, anatomy of the arterial circulation, and recognition that occlusive disease was the cause of limb ischemia and gangrene. Innovative physicians developed the techniques of arterial surgery and bypass grafting to restore limb blood flow and allow healing of lesions. In the 1960s, the era of endovascular intervention by the pioneering work of Charles Dotter, who developed techniques to image diseased arteries during a recanalization procedure. The development of guide wires, angioplasty balloons, and stents quickly followed. Management of lower limb ischemia and the diabetic foot will continue to evolve, building on the history and passion of preceding physicians and surgeons.

Early achievements in cardiovascular care as reflected in the Journal of Internal Medicine.

This review mirrors progress in cardiovascular medicine as reflected by scientific contributions published in the Journal of Internal Medicine (from 1989), Acta Medica Scandinavica (from 1919 until 1989) and Nordiskt Medicinskt Arkiv (before 1919). A total of 149 articles were identified within this field since the first, published work in this field 1877-1970. The latter year was set as and end for the review since this was the year the first contribution by the author of this review was published in the journal. To cope with the large number individual publications related to different aspects of cardiovascular medicine were grouped together into fields in which Scandinavian contributions were pioneering or for other reasons of particular interest. These articles were briefly summarized together with some information of the author(s) and the contributions were put into the perspective of subsequent importance and/or scientific and clinical development. Among topics with insightful contributions published in the journal are electrophysiology, diagnostic techniques including standardization, endurance exercise and the heart, electrocardiography, myocardial infarction, atrio-ventricular block and cardiac pacing. Some of these early contributions were indeed, considering the methods available at the time for the investigations impressive and many predictions truly insightful and imaginative. Other contributions may, at least by the present day reader, seem somewhat odd.

Atrial fibrillation: a historical perspective.

Atrial fibrillation (AF) has undoubtedly become one of the most well-studied arrhythmias today in terms of pathophysiology and diagnostic and therapeutic (interventional) electrophysiology. Although it lends itself to an apparently easy diagnosis on the surface electrocardiography, myriad electromechanical mechanisms underlie its origin. We have now reached an era of technology that makes AF not only "treatable" but potentially "curable." This article aims at walking through the historical "corridors" and "mazes" that led to the present day understanding of this common yet complex arrhythmia.

Atrial fibrillation: a historical perspective.

Atrial fibrillation (AF) undoubtedly has become one of the most well studied arrhythmias today in terms of pathophysiology and diagnostic and therapeutic (interventional) electrophysiology. Although it lends itself to an apparently easy diagnosis on a surface ECG, myriad electromechanical mechanisms underlie its origin. An era of technology has been reached that makes AF not only "treatable" but also potentially "curable." This article aims at walking through the historical corridors and maze that have led to the present-day understanding of this most common yet complex arrhythmia.

Mitral valve prolapse: now you see it; now you don't: recalling the discovery, rise and decline of a diagnosis.

Mitral valve prolapse has been recognized as a clinical entity for only the past 50 years, although the auscultatory findings of this condition had been recognized since the mid-19th century. On the evidence of only a few autopsies, it was concluded that the basis for these were pleuropericardial adhesions. Left ventricular angiographic studies performed in the 1960s clearly documented the true nature of the condition, although it was not until the advent of echocardiography that large numbers of patients began to be referred for evaluation by this new technique. Because of the wide variety of symptoms in patients with suspected mitral valve prolapse, similar to those with other conditions, many patients with the latter were referred for evaluation and diagnosed with mitral valve prolapse because of misleading M-mode and then 2-dimensional criteria. It is now recognized, with the use of improved, more restrictive echocardiographic criteria, that the prevalence of the disorder is much less than previously believed. No test has been devised that will prove 100% sensitive and 100% specific for any disorder. In conclusion, this sobering fact should encourage the use of all modalities available, including clinical skills, to make proper diagnoses when these may be in doubt.

[The cardiovascular examination in the light of the medical papyruses of old Egypt]. / L'examen cardiovasculaire a la lumière des papyrus médicaux de l'Egypte ancienne.

The cardiovascular complaints take up a significant place in the medical papyri which inform us about the medical knowledge of Ancient Egypt. The heart was depicted circa 3000 BC) with remarkable accuracy. The Ebers papyrus contains the first Essay on Cardiology of Humanity. The Egyptian physicians were the pioneers of the rigorous cardiovascular examination. They worked out an innovative design of cardiovascular anatomy and physiology which influenced all the civilizations of the Mediterranean Basin and lasted more than thirty centuries.

Cardiopatías congénitas: presente y futuro / Congenital heart disease: present situation and future prospects

No disponible