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Cardiovascular Research 2001 51(4):621-624; doi:10.1016/S0008-6363(01)00365-0
© 2001 by European Society of Cardiology
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Copyright © 2000, European Society of Cardiology

The evolution of the coronary care unit

Desmond G. Julian

7 Netherhall Gardens, London NW3 5RN, UK djulian@dial.pipex.com

Received 21 May 2001; accepted 21 May 2001

The first 150 words of the full text of this article appear below.

We can now see that the development of the coronary care unit, which Braunwald [1] has called ‘the single most important advance in the treatment of AMI’, was inevitable. But this was not obvious to most cardiologists of the day because so few of them considered the management of myocardial infarction to be a primary concern. They saw the diagnosis and treatment of congenital and rheumatic heart disease to be their main function. In 1956, when I was training under Paul Wood at the National Heart Hospital, I was advised by a Professor of Medicine in London not to become a cardiologist because ‘all the mitrals had been operated on’.

Insofar as there was an interest in myocardial infarction, this was concentrated on two modes of treatment — anticoagulants and inotropic drugs. Irving Wright of New York wrote a 1000-page book on myocardial infarction, mentioning cardiac arrest and ventricular fibrillation . . . [Full Text of this Article]


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