PDF icon Download PDF
Semin Thromb Hemost 2014; 40(05): 535-543
DOI: 10.1055/s-0034-1383544
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Of MIs and Men—A Historical Perspective on the Diagnostics of Acute Myocardial Infarction[*]

Gianfranco Cervellin
1   Emergency Department, Academic Hospital of Parma, Parma, Italy
,
Giuseppe Lippi
2   Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
26 June 2014 (online)

   Permissions and Reprints
Preview

Abstract

The history of myocardial infarction (MI) diagnostics has gone through a continuous evolution over the past century, when several new discoveries have contributed to remarkably increase the number of patients appropriately diagnosed with this condition. The tale “of MIs and Men” displays rather a long history, since atherosclerosis was found to be present in humans several centuries before modern civilization and the identification of the most prevalent risk factors. It was only at the end of the 19th century and at the beginning of the 20th century that the physicians acknowledged that MI is principally sustained by coronary thrombosis, and that the clinical picture of MI could be subsequently confirmed at autopsy. With the first description of the electrocardiogram (ECG) in the 1910s and 1920s, the history of modern MI diagnostics really began. Additional important discoveries followed, which are mainly represented by radiography, echocardiography, computed tomography, and magnetic resonance imaging of the heart. Another major breakthrough occurred at the down of the third millennium, with the development of commercial immunoassays for the measurement of cardiac troponin I and T, which represent now the cornerstones for identifying any kind of myocardial injury, thus including MI. The major advancements in the understanding of MI pathophysiology and the progressive introduction of efficient diagnostic tools will be described and discussed in this narrative historical review.

Keywords

myocardial infarction - acute coronary syndrome - history - electrocardiogram - biomarkers

* Dedicated to Willem Einthoven [1860–1927], a Dutch physician and physiologist who invented the electrocardiogram and received the Nobel Prize in Medicine in 1924. Einthoven was born in Semarang in Java within the Dutch East Indies (now Indonesia), on May 21, 1860, and died in Leiden in the Netherlands, on September 29, 1927.