Cardiology

Cardiology is the branch of medicine concerned with the heart and blood vessels, known as the cardiovascular system. It encompasses a wide variety of disorders related to different parts of the heart and the vascular system. A physician who specializes in cardiology is called a cardiologist. In theWestern world, cardiology is an ever-growing field within internal medicine. Extensive studies have identified risk factors for heart disease, including diabetes mellitus and obesity. Both are on the increase within the general population and this will inevitably lead to increased incidence of heart disease, even with growing public awareness of these health matters.

In a recent publication, Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC), highlighted the fact that over 70 million Americans have cardiovascular disease and that cardiovascular-related deaths account for 40 percent of annual deaths. It has been estimated that the cost of heart disease and stroke, including lost productivity, was $403 million in 2006. This figure is set to rise annually as the general population ages and larger numbers of this group have age-related cardiovascular problems.

The first physician to describe the blood vessels was William Harvey, an English physician, in 1628. In 1706 a French anatomist, Raymond de Vieussens, first characterized the structure of the heart chambers and valves. These two key contributions allowed a major work, considered to be the true beginning of the field of cardiology, to be written. In 1749, Jean-Baptiste Sénac published Traité de la structure du coeur, de son action, et de ses maladies (Treated structure of the heart, of its action, [Page 348]and of its diseases). The publication discussed the physiology and anatomy of the heart and even discusses some heart diseases that are still present today. When the stethoscope was invented in 1816 by René Laënnec, the art of auscultation, a key tool in the study of the heart, took off.

There have been many advances in cardiac medicine and surgical procedures. In 1952, John F. Lewis at Northwestern University in Evanston, Illinois, performed the first successful open heart surgery. Not long after, Christiaan Barnard performed the first whole-heart transplant in 1967, at Groote Schuur Hospital, Cape Town, South Africa. He continued to pioneer further developments in cardiology. In 1982, the first permanent artificial heart was implanted into a human by William DeVries and Robert Jarvick. In 2006 various trials began looking at injecting stem cells into hearts damaged following myocardial infarction (heart attack) to see whether they can repair the damage. In the United States, training to become a cardiologist is very competitive.

Physicians graduate from medical school as a doctor of medicine; this is usually a four-year program. They then go on to an internal medicine program of three-year duration. On completion of this program, they then progress to a cardiology fellowship, which usually lasts another three years, although the whole process can last up to eight years with research included. On completion of the licensing examinations, including regional licensing examinations, the physician will then be a qualified cardiologist. He or she may then stay within the field of cardiology or branch out to teach, conduct research, or even go on to become a cardiovascular surgeon.

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