Major Milestones in Cardiology
Cardiology has undergone a remarkable evolution over the past century alone, marked by advancements that have redefined the diagnosis, treatment, and prevention of heart disease. Explore some of the significant milestones the field has seen over the past 100 years.
Electrocardiography (ECG)
The invention of the electrocardiograph by Willem Einthoven in the early 20th century enabled non-invasive monitoring of the heart’s electrical activity, revolutionizing the way cardiac conditions are diagnosed and managed.1,2 Einthoven's early work earned him the Nobel Prize in Physiology or Medicine in 1924. His development of the ECG, which he dubbed the "Einthoven triangle," provided the foundation for modern electrocardiography. Today, ECG technology is one of the most widely used diagnostic tools worldwide.3
Cardiac catheterization
In 1929, Werner Forssmann performed the first human cardiac catheterization — on himself! This bold act paved the way for André Cournand and Dickinson Richards to refine the technique in the 1940s. Their work allowed direct measurement of intracardiac pressures and blood sampling, laying the foundation for modern diagnostic and therapeutic cardiology.1,4 Although Forssmann’s procedure was initially met with skepticism from the community, it ultimately proved to be a game changer in cardiology.
Timeline of major cardiology events
Coronary angiography and percutaneous coronary intervention
Mason Sones’ introduction of coronary angiography in the 1960s, followed by Andreas Gruentzig’s development of percutaneous coronary intervention (PCI) in the 1970s, provided cardiologists with powerful tools to visualize and treat coronary artery disease.1,2,5 Sones’s breakthrough, which involved injecting dye into coronary arteries to visualize blockages, was a significant milestone in both diagnosis and treatment.1,2,5 Gruentzig’s pioneering work in balloon angioplasty, which evolved into PCI, has since saved countless lives by enabling minimally invasive coronary interventions.1,2
Coronary care units
The creation of dedicated coronary care units (CCUs) in the 1960s brought continuous monitoring and early intervention for acute myocardial infarction, leading to significant reductions in in-hospital mortality.1,2,6 The first CCU was established at the Baltimore City Hospital in 1961 and became a model for hospitals globally.
Cardiovascular surgery
Open-heart surgery and coronary artery bypass grafting (CABG), both introduced in the mid-20th century, revolutionized the management of complex cardiac conditions.1,2
In 1967, Dr. Christiaan Barnard performed the first successful human heart transplant, another huge leap in the world of cardiovascular surgery. CABG, which was developed in the early 1960s, enabled patients to bypass blocked coronary arteries, greatly expanding the range of treatable heart diseases.
Today, CABG remains one of the most common and life-saving procedures performed worldwide.7
Cardiac imaging
Innovations in echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) have enabled detailed, non-invasive assessments of cardiac structure and function, greatly enhancing diagnostic accuracy.1,2,8 The development of Doppler ultrasound in the 1960s revolutionized echocardiography, making it an invaluable tool for diagnosing conditions like valve disease and heart failure.9 Today, MRI and CT scans provide incredibly detailed images of the heart, allowing for the precise detection of structural and functional abnormalities.
Implanted cardiac devices
The development of pacemakers and implantable cardioverter-defibrillators (ICDs) has been critical for managing arrhythmias and preventing sudden cardiac death.1,2
The pacemaker, developed in the late 1950s, was the first device to regulate heart rhythm through electrical impulses, significantly improving the quality of life for patients with bradycardia.1,2
The ICD, introduced in the 1980s, was designed to monitor and shock the heart back to normal rhythm in case of life-threatening arrhythmias, further improving survival and preventing sudden cardiac death.
Preventive cardiology
The recognition of risk factors such as hypertension, smoking, and hyperlipidemia — and the implementation of lifestyle interventions and pharmacotherapy — has played a crucial role in reducing the incidence of cardiovascular disease.1,2 In the 1980s, studies like the Framingham Heart Study revealed the long-term impact of these risk factors, leading to the development of preventive measures and lifestyle modifications aimed at reducing cardiovascular disease risk.10 The Framingham Heart Study, started in 1948, is one of the longest-running and most influential public health studies ever conducted and has provided essential data on heart disease risk factors.
These are just a few of the key milestones that have driven progress in cardiovascular medicine. From early detection to effective interventions, each has helped improve outcomes and expand how we care for heart disease. With the advance of AI-enabled diagnostics, such as Eko's SENSORA™ cardiac disease detection platform, it’s exciting to imagine what the next 100 years will bring.
References
1. Braunwald E. The ten advances that have defined modern cardiology. Trends Cardiovasc Med. 2014 Jul;24(5):179-83. doi: 10.1016/j.tcm.2014.05.005
2. Braunwald E. The rise of cardiovascular medicine. Eur Heart J. 2012 Apr;33(7):838-45, 845a. doi: 10.1093/eurheartj/ehr452
3. Fisch C. Centennial of the string galvanometer and the electrocardiogram. J Am Coll Cardiol. 2000 Nov 15;36(6):1737-45. doi: 10.1016/s0735-1097(00)00976-1
4. Bourassa MG. The history of cardiac catheterization. Can J Cardiol. 2005 Oct;21(12):1011-4
5. Weintraub WS, Taggart DP, Mancini GBJ, Brown DL, Boden WE. Historical Milestones in the Management of Stable Coronary Artery Disease over the Last Half Century. Am J Med. 2018 Nov;131(11):1285-1292. doi: 10.1016/j.amjmed.2018.05.039.
6. Armstrong PW. Evolution of the CCU from rhythm, function and protection to reperfusion and beyond: a personal journey and perspective. Can J Cardiol. 1996 Oct;12(10):909-13
7. Squiers JJ, Mack MJ. Coronary artery bypass grafting-fifty years of quality initiatives since Favaloro. Ann Cardiothorac Surg. 2018 Jul;7(4):516-520. doi: 10.21037/acs.2018.05.13
8. Fraser AG, Monaghan MJ, van der Steen AFW, Sutherland GR. A concise history of echocardiography: timeline, pioneers, and landmark publications. Eur Heart J Cardiovasc Imaging. 2022 Aug 22;23(9):1130-1143. doi: 10.1093/ehjci/jeac111
9. Martin RP. Clinical Implementation of Continuous-Wave Doppler: It Made All the Difference. J Am Soc Echocardiogr. 2018 Dec;31(12):1323-1329. doi: 10.1016/j.echo.2018.09.003
10. National Heart, Lung, and Blood Institute. Framingham Heart Study (FHS). NHLBI. Accessed April 1, 2025. https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs
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