Today, Sept 16, is the 46th anniversary of the first #coronary angioplasty on the human #heart. Here’s a short thread on how it happened and the brilliant innovator at the center of it all. (1/x) If, as Osler said, the tragedies of life are mostly arterial, then the source of most of mankind’s misery is the fatty plaque. By cutting off blood flow, obstructive arterial plaque is responsible for heart attacks and strokes, the most common ways we die. (2/x)

The electronic medical record today is bloated and inaccurate, mainly because of rampant copying and pasting.

I wrote about this in @statnews. Here’s a short summary... (1)

statnews.com/2023/06/20/med… Some years ago, I remember reading the case of a patient who went to the ER with chest pain. The patient’s chart showed a history of “PE,” so an ER physician ordered a CT scan to rule out recurrence of a “pulmonary embolism,” a blood clot in the lungs. (2)

130 yrs ago this month, Dr. Daniel Hale Williams, a Black surgeon at Provident Hospital in Chicago whose ancestors were slaves, performed what was then believed to be the first open #heart #surgery. A thread... (1) The patient, 24yo James Cornish, had been stabbed with a knife in the chest in a saloon scuffle. He was bleeding profusely when he was dropped off at the hospital by a horse-drawn ambulance. (2)

In honor of #HeartMonth, I’ve been posting threads on the rich history of the human heart. This one is on the development of angioplasty, and the brilliant innovator at the center of it. (1/) If, as Osler said, the tragedies of life are mostly arterial, then the source of most of mankind’s misery is the fatty plaque. By cutting off blood flow, obstructive arterial plaque is responsible for heart attacks and strokes, the most common ways we die. (2/)

People have been debating whether #DamarHamlin should get an implantable defibrillator. For the medical history buffs out there, here’s a thread on how this incredible device was invented. (1/n) Though several groups were involved in the invention of external defibrillation, only one, led by Michel Mirowski at Sinai Hospital in Baltimore, was responsible for the creation of the implantable defibrillator. (2/n)

With all the talk about external defibrillation stemming from the #DamarHamlin case, I thought I’d offer a short thread about how it was invented. (1/n) In 1947, the American surgeon Claude Beck successfully used electrical defibrillation for the first time in an operating room, on a 14yo boy in Cleveland who went into cardiac arrest following a chest operation. (2/n)

Since there’s been so much talk about commotio cordis with regard to #DamarHamlin, I figured I’d give a short explainer.
 
Commotio cordis was discovered by a guy named George Mines who worked in Montreal in the early 1900s. By a cruel twist, it was also the reason he died. (1/n) Mines determined that there is a narrow period in the cardiac cycle— a “vulnerable period,” he called it, about 10 milliseconds in duration— during which a stimulus—an electrical shock or even a punch to the chest—can cause a perfectly normal heart to fibrillate and stop. (2/n)

There is a vulnerable period in the cardiac cycle. A blow to the chest during this period can cause cardiac arrest. Happens to healthy young athletes every year. It's one of the worst things I've seen as a cardiologist. If this is what happened to Damar Hamlin, he needed an AED on the field. Chest compressions can help, but what he needed most was a defibrillator.

The morgue was inside Brooks Brothers. I was standing at the open-air triage center at the corner of Church and Dey, right next to the rubble of the World Trade Center, when a policeman shouted that doctors were needed at the men's-wear emporium inside the 1 Liberty building. Bodies were piling up there, he said, and another makeshift morgue on the other side of the rubble had just closed down. I volunteered and set off down the debris-strewn road.

My father died last Friday. His body was cremated today.

A short thread to commemorate a man who meant so much to me. 2/ For a few years now, dementia had taken his memory away. But he always said, “It’s not what you remember, but what others remember about you.” And so, allow me to share a few things I remember about him.

I wrote about the hidden toll of the #coronavirus pandemic in an essay in the @wsj. Since it’s behind a paywall, I’ll summarize it below: wsj.com/articles/the-h… For the past few weeks, hospitals across the world, including hospitals in Detroit, Atlanta, Boston, Milan, Madrid, and my own in New York, have seen massive drops in the number of heart attack cases. 1/

1/ As epidemiologists explain about the #coronavirus #COVID2019 (or indeed any epidemic), the rate of spread R = D x O x T x S (explained below). We want to drive R as low as possible so the epidemic will die out. How do we do that? 2/ Some things we can’t control right now, others we can. D is the duration of the infection. Longer someone is infectious, the more spread. If we had a treatment, we could lower D. But we don’t (right now).