The Evolution of Heart Disease

Heart attacks and strokes cost Canadians 20 billion dollars a year. Yet this is a relatively recent phenomenon. Prior to the First World War it was quite rare.

The medical name for a heart attack, coronary thrombosis, was only coined in 1912 by a Chicago Physician named James Herrick. Thus, the condition where a piece of the coronary, or heart artery wall, ruptured causing a clot or obstruction in the artery did not even have a specific name before that. Mind you the condition of coronary arteries had been known for hundreds of years. The Ancient Greeks labelled it atherosclerosis: literally hardened porridge.

Another condition ascribed to atherosclerosis was pain in the centre of the chest, often radiating to the jaw and to the arms, and especially on exertion. This was labelled angina pectoris in 1768 by an English Physician called William Heberden. The treatment was to give brandy: alcohol does have a vasodilating effect on arteries. But this condition did not lead to death and appears to have been chronic over many years in those afflicted by it.

But then something in the early twentieth century created a new, unstable disease. Instead of arteries leading to bouts of chest pain on exertion, the new condition resulted in a totally blocked artery requiring the patient to be hospitalized. Now the blockage, or plaque, ruptures and spills its contents, liquid fat, into the arterial stream where it acts like crazy glue and forms a clot. In the 1970s a medication, streptokinase, was developed which was injected in the emergency room to dissolve the clot and restore the circulation.

This new disease of coronary thrombosis had become an epidemic in the 1950s. What happened around the time of the First World War to make old, stable plaque into unstable plaque with a soft centre? Probably the biggest social change was in food manufacture with adultered grain products and artificial feeding of animals. Also, transportation changed completely. People did not walk: they rode. Rode on cars, buses and trains. And, of course, the First World War saw the popularization of the cigarette and a huge escalation of its chemical byproducts into the human bloodstream.

Society has proved very reluctant to ban plaque-forming food products. Cigarettes are still on sale. And, regrettably, levels of activity continue to decrease even among children. So buy yourself a cookbook which was written in 1880, buy yourself a bicycle for transportation, and never let a cigarette get within ten yards of you.

By Dr. Stafford W. Dobbin

A graduate of Queens University Belfast, Dr. Dobbin founded Heart Niagara in 1977. He established the first Department of Emergency Services in Niagara at the Greater Niagara General Hospital in 1976. Through Heart Niagara he initiated the teaching of Citizen Cardio-Pulmonary Resuscitation in Niagara and of Advanced Cardiac Life Support for Critical care personnel prior to the establishment of the Regional Paramedic programme. His initial design for Heart Niagara included a Cardiac Rehabilitation Programme for survivors of Cardiac events staffed by qualified Physicians and Nurses for which he was the Medical Director to 2002. And through Heart Niagara he started the Niagara Schools’ Healthy Heart Programme in 1987 and is the Medical Director. His EMS system for coverage of Mass Participation events was first used at the US Olympic Marathon trials in 1980 and he served on the first Executive of the International Marathon Directors Association. He is presently a partner in the Niagara Medical Group, a Family Health Team, in Niagara Falls.

Disclaimer: The views and opinions expressed in blog entries are those of the author(s) and do not necessarily reflect the official policy or position of Heart Niagara.

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