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Cardiovascular Pathology 13 (2004) 282 – 292

Education

A light-hearted look at a lion-hearted organ


(or, a perspective from three standard deviations beyond the norm)
Part 1 (of two parts)$
Matthew J. Loea, William D. Edwardsb,*
a
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
b
Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street S.W., Rochester, MN, USA

Received 21 January 2004; received in revised form 19 March 2004; accepted 10 May 2004

Abstract

Throughout history, the heart has been associated not only with its life-sustaining function but also with its close ties to the human
emotions. In this literature and Internet review, we attempt to gather and organize information from both of these perspectives as they relate to
the heart in the following 11 categories: (1) fun facts, (2) medical photography, (3) history, (4) languages (etymology), (5) nonmedical
English expressions, (6) death, (7) the arts, (8) movie titles, (9) song titles, (10) Shakespeare, and (11) the Bible. Part 1 will cover the first five
topics, and Part 2 will cover the last six topics. These data may be useful to those who are engaged in teaching about the cardiovascular
system. D 2004 Elsevier Inc. All rights reserved.

Keywords: Heart; Facts; Photography; History; Etymology; Expressions

1. Introduction material has been added (by M.J.L.). This information


may be useful to those who prepare lectures dealing with
A wealth of interesting cardiovascular information is the cardiovascular system.
available in nonmedical sources, but these are numerous
and often not readily accessible. The purpose of the
current report is to compile and organize this information
in a single reference for easy access. The material that 2. The heart in fun facts
follows includes data presented (by W.D.E.) in lectures
for medical students, residents, and fellows, and at The heart is an amazingly resilient fist-sized bundle of
national meetings over the past 14 years. Much of the muscle, both in health and in disease, and the vasculature is
old material has been updated, and substantial new no less remarkable (Table 1) [1–15]. Each day, the heart
beats approximately 100,000 times and pumps over
$ 7500 liters of blood.
Presented, in part, by Dr. Edwards during the Cardiovascular Unit of
the Pathophysiology Course, Mayo Medical School (October 1992–2002,
Heart rate is inversely related to body size. This is true
and January 2004); during the Internal Medicine Morbidity–Mortality not only for humans of various ages and sizes (Table 1)
Conference, Mayo Graduate School of Medicine (near Valentine’s Day, but also for animals (Table 2) [15–17]. The heart of a blue
1993–1996, 2000, 2002, and 2004); during the Cardiovascular Pathology whale is the size of a compact car and beats 5–6 times/min
Specialty Conference, United States–Canadian Academy of Pathology in shallow water but only 3–4 times/min during deep
Annual Meeting (March, 1995–1997); and for the Division of Anatomic
Pathology (February 14, 1996).
dives. For extremes among land mammals, the heart rate
* Corresponding author. Tel.: +1 507 284 9342; fax: +1 507 284 1599. of an elephant is 30 beats/min (bpm), and that of a shrew
E-mail address: edwards.william@mayo.edu (W.D. Edwards). is 1000 bpm. Among birds, the blue-throated hummingbird

1054-8807/04/$ – see front matter D 2004 Elsevier Inc. All rights reserved.
doi:10.1016/j.carpath.2004.05.001
M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292 283

Table 1
Cardiovascular fun facts [1–15]
Heart
Heart size is proportional to body size and is about the size of your clenched fist.
Heart weight is proportional to body size (about 25 g at birth, 50 g at age 2 years, 100 g at age 10 years, and 200 g at age 15 years).
In adults, the heart weighs 0.40% to 0.45% (or about 1/200th) of one’s total body weight.
The heart weighs about 300 g (10.5 oz) in adult women and 325 g (11.5 oz) in adult men.
The developing heart of a human embryo begins to beat 23 days after conception.
The cardiovascular system is the first organ system to become fully functional in utero, at approximately 8 weeks after conception.
Heart rate is inversely proportional to body size (140 beats per minute [bpm] in a fetus; 120 bpm in a neonate; and 90 bpm in a 7-year-old).
The normal resting heart rate in an adult is 60–90 bpm.
The normal resting heart rate is lowest in the morning and highest in the early afternoon.
In a well-trained endurance athlete, the resting heart rate may often only be 30–45 bpm.
The lowest recorded resting heart rate is 28 bpm (Miguel Induráin, Spanish cyclist).
In 1 day, the human heart beats approximately 100,000 times.
In 1 year, the heart beats approximately 37 million times.
In a 70-year lifetime, the heart will beat more than 2.5 billion times.
At rest, the heart pumps about 80 mL (3 oz) of blood per beat.
At rest, the heart pumps more than 1 L (more than 1 quart) every 10 s.
At rest, the heart pumps approximately 5 L (about 5 quarts) of blood per minute.
During the third trimester of pregnancy, the heart pumps 7–9 L/min.
At peak exertion, the heart can pump 20–35 L/min.
The heart pumps about 250 mL/min to the coronary circulation.
In 1 day, the heart pumps more than 7500 L (2000 gal) of blood.
In 1 day, the heart exerts enough power to lift a 1-ton weight 12.5 m (41 ft).
In 1 year, the heart will pump more than 2.5 million L (700,000 gal) of blood.
In 10 years, the heart will pump more than 25 million L (7 million gal) of blood.
In a 70-year lifetime, the heart will pump about 200 million L (more than 1 million barrels) of blood, or enough to fill three super tankers.
Vasculature
The blood vessels (arteries, capillaries, and veins), laid end-to-end, would measure about 100,000 km (60,000 miles), or approximately 2.5 times the
circumference of the earth.
Capillaries account for about 80,000 km (50,000 miles) of vasculature in an adult.
Capillaries average 0.5 mm (1/50th in.) in length.
Capillaries average 8 Am (1/3000th in.) in diameter.
It would take 50 capillaries to equal the diameter of one human hair.
Tissue the size of a pinhead contains 2000 to 3000 capillaries.
Blood travels 1000 times faster in the aorta (30 cm/s) than in the capillaries (0.03 cm/s).
Blood
The body of an average adult contains 5–6 L (6 quarts) of blood.
Blood accounts for about 7.5% (1/13th) of the body’s weight.
The entire blood volume circulates through the body about once per minute.
Every day, red blood cells travel approximately 19,000 km (12,000 miles) or about four times the distance from New York to Los Angeles.
Red blood cells are the most abundant cell in the human body.
In an average adult, the blood contains 25–30 trillion red blood cells (51012/L).
The bone marrow makes about 2 million red blood cells every second.
Stacked atop one another, the body’s red blood cells would span 50,000 km (30,000 miles).
U.S. cardiovascular statistics
Cardiology is the most popular nonprimary care, nonsurgical discipline (20,000 members).
One in every five adults has a cardiovascular disorder.
Cardiovascular disease has been the number one killer every year since 1900, except 1918 (the year of the influenza epidemic).
Cardiovascular disease is the number one killer of women as well as men.
Every day, more than 2600 U.S. citizens die of cardiovascular disease.
Nearly every 30 s, a U.S. citizen dies of cardiovascular disease.
Myocardial ischemia kills more U.S. citizens in one day than handguns kill in a year.
The annual estimated cost of heart disease in the United States is more than USD 285 billion.
Other cardiovascular trivia
The smallest reported tumor (2 mm) to cause sudden death is a mesothelioma of the AV node.
The lowest reported serum cholesterol level is 3 mg/dL for HDL and 9 mg/dL for LDL.
The highest reported total serum cholesterol level is 980 mg/dL.
The highest reported serum triglyceride level is 5880 mg/dL.
The highest reported creatine kinase MB fraction (CK-MB) is 530 U/L (27% of total).
The longest reported cardiac arrest before beginning successful resuscitation is 4 h (in a Norwegian hypothermia victim).
284 M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292

has a heart rate of 1260 bpm during flight but only 36 bpm increase heart weight by 2.5–3.0 times its expected mean
during torpor (nighttime cooling), when its body temper- value, but generally no more than this. Similar limits
ature drops by as much as 208C (358F). appear to exist for dilatation, as determined by the short-
The heart has a great but limited capacity for axis diameter of the left ventricle. As atherosclerosis
enlargement in various disease states. Hypertrophy can develops, coronary arteries can remodel and dilate to
about twice their normal diameter, but expansion beyond
this constitutes an aneurysm.

Table 2
Average heart rates for various animals [15–17]
Animal Heart rate (bpm) 3. The heart in medical photography
Mammals
Blue whale 5 Photographs of the heart and vessels may appear
Elephant 30 abstract to medical students and others. To relate disease
Camel 30 states to commonly encountered objects, pathologists
Lion 40 traditionally have made food analogies, such as bbread-
Horse 45
Pig 65
and-butterQ pericarditis (Fig. 1). A nonfood analogy is the
Cow 65 bfishmouth deformityQ of rheumatic mitral stenosis
Giraffe 65 (Fig. 2). Such photographs have great teaching value
Sheep 75 and are often long remembered by students [18,19].
Human 75 Topics are limited only by one’s imagination. For
Goat 90
Dog 100
example, to emphasize short-axis ventricular shapes, a
Seal 120 cross-section could be shown beside a croissant and a
Cat 130 bagel or doughnut (Fig. 3).
Skunk 170
Monkey 190
Rabbit 210
Squirrel 250
Guinea pig 280 4. The heart in history
Rat 360
Hamster 450 The history of cardiovascular discoveries may be appro-
Mouse 550 priate to include in our lectures (Table 3) [10,13,14,20–37].
Bat 750
Shrew 1000
More than 1800 years ago, Galen concluded that the heart
pumped blood throughout the body, although he did not
Birds recognize that blood was contained within vessels. Over
Ostrich or emu 45 1400 years elapsed before William Harvey, in 1628,
Turkey 100 demonstrated the circulation of blood within the cardiovas-
Herring gull 130
Blue jay 165
cular system.
Parrot 275 Other important events include the description of cardiac
Chicken 300 anatomy by Vieussens (1706), the invention of the
Crow 345 stethoscope by LaJnnec (1816), and the development of
Sparrow 460 electrocardiography by Einthoven (1903). The 20th
Robin 550
Canary 600
century was characterized by a virtual explosion of
Blue-winged teal 1000 exciting cardiovascular discoveries and developments.
Hummingbird Since 1987, the Society for Cardiovascular Pathology
Ruby-throated 600 has recognized 23 investigators with Distinguished
At rest 250 Achievement Awards for their outstanding contributions
In flight 1220
Blue-throated 600
toward an understanding of cardiovascular diseases
In torpor 36 (Table 4).
In flight 1260

Reptiles, amphibians, and fish


Crocodile 20
Python 25
5. The heart in languages (etymology)
Sea turtle 25
Frog 50 The Indo–European root word for heart is bkerdQ, which
Fish 60 has its derivation in the Sanskrit word bhridQ (bhQ corre-
Abbreviation: bpm = beats per minute. sponds phonetically to bkQ). [14,34] From these arose bcorQ
M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292 285

Fig. 1. Bread-and-butter pericarditis. (A) Heart and parietal pericardium, showing severe diffuse fibrinous pericarditis. (B) Two pieces of buttered bread that
have been pulled apart from one another. (Reproduced with permission [18].)

Fig. 2. Mitral fishmouth deformity. (A) Rheumatic mitral stenosis (short-axis view). (B) Fish (anterior view) showing actual shape of fishmouth. (Reproduced
with permission [18].)
286 M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292

in Germanic languages, the words for heart literally mean


bthe leaperQ [34]. To our ancestors, the heart seemed to
leap or bound within the chest. Even today, we may say,
bMy heart leapt for joyQ.

6. The heart in nonmedical English expressions

Emotional events cause catecholamine release and a


rapid change in the rate and force of myocardial
contractility. Without having to understand the underlying
physiology, nearly every culture (and nearly every person)
has recognized a link between the heart and the emotions.
In love and in fear, our hearts may skip a beat or pound in
our chests. As Dr. Bernadine Healy [25] reminds us, bA
beating heart is the joyous first sign of life, and it’s the sad
final thump that marks the moment of deathQ.
The heart was associated with feelings in Sumerian
poetry written over 4500 years ago. In India, the heart was
tied to emotions, intelligence, life, and being, and in
ancient China, the heart was considered to be the center of
the intellect. For ancient Egyptians, the heart was the
central organ of the body and the seat of conscience [34].
According to the Egyptian Book of the Dead, it was the
only organ that was retained within the mummified body
[14]. In ancient Greek culture, the heart was the center of
feelings, passions, and love. Hippocrates maintained that
the soul and intelligence were situated in the head, but the
doctors of his day could not agree. Among philosophers,
Plato held that the immortal soul rested in the head and
Fig. 3. Food analogy with ventricular shapes. (A) Normal ventricles (short- that the mortal soul (feelings and intelligence) resided in
axis view), showing crescentic right ventricle and circular left ventricle. (B) the heart. For Aristotle, there was only one soul, and it
Croissant and bagel.
occupied the heart [34]. The ancient Romans were
influenced by Greek culture and, generally, although less
frequently, also referred to the heart metaphorically in
terms of love and feelings.
In virtually every language, the word bheartQ has been
(Latin), bkardiaQ (Greek), and bhertonQ (German). Our used to denote not only the anatomical organ but also our
English words bcordialQ, bcourageQ, and bdiscordQ come emotions. Both perspectives are found in one sage
from bcorQ, whereas bcardiacQ and bcardiologyQ are derived observation by Bernard Baruch: bTwo things are bad for
from bkardiaQ. the heart: running up stairs and running down peopleQ.
The English word bheartQ has been in common usage Over the years, numerous nonmedical metaphors and
since the 16th century [14,38]. Its roots can be traced to expressions have come into common usage in the English
bhertQ or bherteQ (Middle English) and bhoerteQ (Old language [3,14,25,38–41]. Many originated during the 18th
English) back to the 10th century. They are related to century [34].
bhartQ (Dutch), bHerzQ (German), bherzaQ (Old High Ger- Such expressions are not limited to the cardiovascular
man), bhjartaQ (Swedish and Old Norse), bhjerteQ (Danish system. They abound for the digestive system, e.g., with
and Norwegian), and bhairtoQ (Gothic). [14,38–40] such colorful examples as bbig-mouthQ, bdon’t give me
Interestingly, the word for the male European red deer, any lipQ, bmy teeth are on edgeQ, bI can’t stomach thisQ,
bhartQ, is derived from bhertQ (Middle English) and blily-liveredQ, ba lot of gallQ, bhow jejuneQ, bintestinal
bheorotQ (Old English) and is related to bhertQ (Dutch), fortitudeQ, bgut-wrenchingQ, bdon’t get your bowels in an
bHirschQ (German), bhjortrQ (Old Norse), and bhiruzQ uproarQ, and bdon’t go into sphincter spasmQ. Never-
(Indo–European)—root words that are very similar with theless, the number of nonmedical expressions involving
those for heart [34,38–40]. The deer leaps and bounds as the heart far outstrips those of all other organs (221 are
it runs. bKridQ or bkurdQ (Sanskrit) means bto leapQ, and listed in Table 5) and includes such common terms as
M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292 287

Table 3
Historical landmarks for cardiovascular descriptions, discoveries, and developments [10,13,20–37]
Yeara Person Countrya Description, discovery, or development
2980 bc Imhotep Egypt Observation of the pulse
1500 bc (Ebers papyrus) Egypt Relationship between heart and pulse
1000 bc (Canon of Medicine) China Heart is a repository for the pulse
~400 bc Hippocrates Greece Heart related to flow of blood
~350 bc Herophilus (Greek) Egypt Heart has chambers and valves
~300 bc Erasistratus (Greek) Egypt Heart pumps blood throughout body
~175 Galen Greeceb Heart pumps blood throughout body
1242 Ibn an-Nafis Egypt Aeration of blood occurs in the lungs
1519c Leonardo da Vinci Italy Cardiac valves ensure unidirectional flow
1543 Andreas Vesalius Italy Anatomy of cardiovascular system
1554 Ambrose Paré France Syphilitic aortic aneurysms
1594 Girolamo Fabrici Italy Venous valves ensure unidirectional flow
1628 William Harvey England Circulation of blood occurs within vessels
1640 Pierre Gassendi France Patent foramen ovale
1661 Marcello Malpighi Italy Microscopic capillary circulation (in lungs)
1664 Niels Stensen Denmark Heart consists primarily of muscle
1669 Richard Lower England Cardiac structure; blood transfusion
1671 Niels Stensen Denmark First description of tetralogy
1705 William Cowper England Aortic insufficiency
1706 Raymond de Vieussens France Structure of heart, coronary circulation
1708 Anton van Leeuwenhoek Holland Concept of the pulse
1728 Giovanni M. Lancisi Italy Cardiomegaly and congestive heart failure
1733 Stephen Hales England Measured blood pressure in animals
1749 Jean-Baptiste de Sénac France Quinidine for arrhythmias
1755 Albrecht von Haller Switzerland Calcified pericardium
1761 Leopold Auenbrugger Austria Thoracic percussion
1761 Giovanni B. Morgagni Italy Aortic and mitral stenosis; aortic aneurysm;
coronary calcification; heart block
1770 John Hunter England Valve disease; coronary calcification
1772 William Heberden England Angina pectoris
1785 William Withering England Digitalis (foxglove) for heart failure
1786 Edward Jenner England Coronary theory of angina pectoris
1793 Everard Home England Calcific coronary artery disease
1799 Caleb H. Parry England Coronary artery disease and its prevention
1804 Antonio Scarpa Italy Atherosclerosis and aneurysms
1806 Jean-Nicolas Corvisart France Signs of valvular stenosis
1812 William C. Wells United States Heart disease due to rheumatic fever
1816 René T. H. LaJnnec France Stethoscope
1818 James Blundell England Blood transfusion, human to human
1819 René T. H. LaJnnec France Cardiac auscultation
1827 Robert Adams Ireland Heart block
1830 George J. Guthrie England Arterial aneurysms and dissections
1832 Dominic J. Corrigan Ireland Signs of aortic regurgitation
1839 Jan E. Purkinje Czechoslovakia Bundle branches (Purkinje fibers)
1840 Jean-Baptiste Bouillaud France Rheumatic fever and endocarditis
1841 Carl von Rokitanski Austria Thrombotic theory of atherosclerosis
1842 Christian Doppler Austria Doppler effect
1844 Claude Bernard France Cardiac catheterization in animals
1845 Rudolph L. C. Virchow Germany Inflammatory theory of atherosclerosis
1846 Henry I. Bowditch England Cardiac auscultation and murmurs
1850 Joseph Skoda Czechoslovakia Cardiac sounds and murmurs
1854 William Stokes Ireland Stokes–Adams syndrome
1854 Armand Trousseau France Pericardiocentesis
1856 Rudolf von Koelliker and Heinrich Mqller Germany Heart generates electricity
1858 Thomas B. Peacock England Congenital heart disease
1862 Austin Flint United States Murmur of aortic insufficiency
1866 Wilhelm Ebstein Germany Tricuspid anomaly; metabolic diseases
1867 Pierre-Carl E. Potain France Jugular venous pulse
1867 Thomas L. Brunton England Amyl nitrate for angina pectoris
1868 Heinrich Quincke Germany Venous and capillary pulse
1869 Alexander Muirhead England Capillary electrometer for ECG
1870 Samuel Wilks England Bacterial endocarditis
(continued on next page)
288 M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292

Table 3 (continued )
Yeara Person Countrya Description, discovery, or development
1870 Adolf Fick Germany Measurement of cardiac output
1873 Adolf Kussmaul Germany Pericardial constriction and paradoxical pulse
1875 Carl von Rokitanski Austria Congenital heart disease
1876 Sigmund R. von Basch Austria Early sphygmomanometer
1878 Adam Hammer United States Coronary thrombosis (debatable)
1881 William R. Gowers England Hypertensive retinopathy
1885 William Osler United States Bacterial endocarditis
1888 Graham Steell England Murmur of pulmonary insufficiency
1891 Friedrich Maass Germany External cardiac massage
1893 Wilhelm His, Jr Germany Atrioventricular (His) bundle
1896 Scipione Riva-Rocci Italy Modern mercury sphygmomanometer
1896 Francis H. Williams United States Cardiac fluoroscopy
1888 Étienne-Louis A. Fallot France Tetralogy of Fallot
1897 Victor Eisenmenger Germany Congenital shunts and Eisenmenger complex
1897 William H. Broadbent England Pericarditis
1897 Ludwig Rehn Germany Surgical repair of cardiac laceration
1901 Luis Morquio Uruguay Congenital heart block; Morquio syndrome
1903 Willem Einthoven Holland String galvanometer for ECG
1904 Ludwig Aschoff Germany Microscopy of rheumatic myocarditis
1906 Sunao Tawara Germany Atrioventricular node
1907 Arthur Keith and Martin Flack England Sinus node and prediction as pacemaker
1908 James Mackenzie England Atrial fibrillation
1908 Leo Buerger United States Thromboangiitis obliterans
1910 Henri Vaquez France Left and right heart failure
1912 Ernest H. Starling England Cardiac physiology; Starling’s law
1912 Nikolai Anitschoff Russia Atherosclerosis
1912 James B. Herrick United States Coronary thrombosis and acute MI
1919 Adolf Spitzer Austria Pathogenesis of congenital heart disease
1923 Elliott C. Cutler and Samuel A. Levine United States Valvulotome for rheumatic mitral stenosis
1924 Carey F. Coombs England Murmur of acute rheumatic mitral valvulitis
1925 Nikolai Anitschoff Russia Myocarditis
1929 Werner Forssmann Germany X-ray of catheter (within his own heart)
1930 Frank N. Wilson United States Modern electrocardiography
1932 Albert S. Hyman United States Transthoracic electrical stimulation
1933 William S. Tillet United States Streptokinase (streptococcal fibrinolysin)
1936 Maude E. Abbott Canada Categorized 1000 malformed hearts
1939 Robert E. Gross United States Closure of patent ductal artery
1941 André Cournand and Dickinson W. Richards United States Catheterization of right heart
1944 Leo Loewe United States Penicillin for subacute bacterial endocarditis
1944 Clarence Crafoord Sweden Repair of coarctation of aorta (at two
Robert E. Gross United States separate institutions)
1945 Alfred Blalock and Helen B. Taussig United States Subclavian to pulmonary artery shunt for
tetralogy of Fallot
1945 L. Royal Christensen United States Mechanism of streptokinase
1946 Arthur M. Vineberg Canada IMA inserted directly into myocardium
1947 Claude Beck United States Open-chest resuscitation with defibrillator
1948 Dwight E. Harken United States Closed mitral commissurotomy (at three
Charles P. Bailey United States separate institutions)
Sir Russel C. Brock England
1948 Thomas H. Sellers England Closed pulmonary valvotomy (at two
Sir Russell C. Brock England separate institutions)
1949 Paul Dudley White United States Development of National Heart Institute;
"father of American cardiology"
1949 Thomas R. Dawber and William B. Kannel United States Framingham Heart Study begun
1950 Ignacio Chávez Mexico Founded International Society of Cardiology
1952 Charles Hufnagel United States Descending aortic ball-valve for chronic AI
1952 F. John Lewis United States Open heart surgery (well technique), with
repair of atrial septal defect
1952 Charles Dubost France Repair of abdominal aortic aneurysm
1953 John H. Gibbon, Jr United States Open heart surgery (pump-oxygenator), with
repair of atrial septal defect
1953 Inge Edler and C. Hellmuth Hertz Sweden Trans-thoracic M-mode echocardiography
(continued on next page)
M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292 289

Table 3 (continued )
Yeara Person Countrya Description, discovery, or development
1954 Sol Sherry United States Mechanism of streptokinase
1955 C. Walton Lillihei United States Closure of ventricular septal defect
1955 C. Walton Lillihei United States Repair of complete AV septal defect
1955 John W. Kirklin United States Repair of tetralogy of Fallot
1956 Michael E. DeBakey United States Repair of abdominal aortic aneurysm
1956 Don C. Sutton United States Transthoracic needle biopsy of heart
1956 Paul M. Zoll United States External cardiac defibrillation
1956 Shigeo Satomura Japan CW Doppler echocardiography
1958 F. Mason Sones, Jr United States Selective coronary angiography
1958 Anthony P. Fletcher United States Intravenous streptokinase for acute MI
1958 Dennis Melrose England Cold cardioplegia during heart surgery
1958 Donald Teare England Hypertrophic cardiomyopathy
1958 Michel Fernex and Claude Fernex Switzerland Mitral valve prolapse
1958 Rune Elmqvist and 2ke Senning Sweden External implantable pacemaker
1958 Seymour Furman and John B. Schwedel United States Internal implantable pacemaker (lead)
1959 Shigeo Satomura Japan CW Doppler vascular sonography
1960 William Chardack and Wilson Greatbatch United States Implantable pacemaker (lead and battery)
1960 Albert Starr United States Mechanical prosthetic mitral valve
1960 Dwight E. Harkin United States Mechanical prosthetic aortic valve
1960 Robert H. Goetz United States IMA graft to LAD (ring anastomosis)
1960 Norman E. Shumway and Richard Lower United States Successful canine cardiac transplantation
1961 Desmond G. Julian England Concept of coronary care unit
1961 Masamichi Oka and Alfred Angrist United States Mitral valve prolapse
1961 James R. Jude, G. Guy Knickerbocker and United States External cardiopulmonary resuscitation
William B. Kouwenhoven
1962 Bernard Lown United States Electric shock cardioversion
1962 Sigeru Sakakibara and Souji Konno Japan Transvenous endomyocardial biopsy
1962 Donald Ross England Homograft prosthetic aortic valve
1964 William T. Mustard Canada Intraatrial baffle repair for transposition
1964 Carlos Duran and Alfred Gunning England Xenograft prosthetic valve
1964 Vasilii I. Kolesov Russia IMA graft to LAD (suture anastomosis)
1965 Gian C. Rastelli United States Conduit repair of PA-VSD
1965 Michael B. DeBakey and Adrian Kantrowitz United States Mechanical left ventricular assist device
(LVAD)
1966 William J. Rashkind United States Balloon atrial septostomy
1967 Christiaan N. Barnard South Africa Cardiac allotransplantation in human
1967 René G. Favaloro United States Saphenous vein graft to RCA
1967 Bernard Lown United States Drug therapy (lidocaine) for arrhythmias
1967 Eugene Strandness United States Sonography for peripheral vascular flow
1968 Will C. Sealy United States Surgical ablation of WPW pathway
1968 Francis Fontan France Repair of single functional ventricle
1969 Peter N. T. Wells England PW Doppler echocardiography (three
Pierre Péronneau France separate institutions)
Donald W. Baker United States
1970 Barouh V. Berkovits Israel Dual-chamber pacemaker
1973 Nicolaas Bom Netherlands Linear array 2-D echocardiography
Donald L. King United States (two separate institutions)
1974 Christiaan N. Barnard South Africa Cardiac piggy-back implantation
1974 Leon J. Frazin United States Transesophageal echocardiography
1975 Adib D. Jatene Brazil Arterial switch repair for transposition
1976 Olaf T. von Ramm United States Phased array 2-D echocardiography
1976 Eugene I. Chazov Russia Intracoronary streptokinase for acute MI
1977 Andreas R. Grqentzig Switzerland Percutaneous transluminal coronary
angioplasty (PTCA)
1978 Guy Fontaine France Arrhythmogenic RV cardiomyopathy
1979 Peter Rentrop Germany Intracoronary streptokinase for acute MI
1980 Michel Mirowski United States Implantation of AICD in human
1981 Masayuki Matsumoto Japan Three-dimensional echocardiography
1982 Mark I. Singer United States Balloon angioplasty for coarctation
1982 Willem DeVries and Robert Jarvik United States Permanent artificial heart (implanted into
Barney Clarke)
1982 James J. Gallagher United States Catheter ablation of AV junction for SVT
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Table 3 (continued )
Yeara Person Countrya Description, discovery, or development
1983 William I. Norwood United States Repair of aortic valve atresia (HLHS)
1984 Leonard L. Bailey United States Cardiac xeno-transplantation in human
1991 Juan C. Parodi Argentina Endovascular repair of aortic aneurysm
1994 Randas Batista Brazil Left ventriculoplasty
1998 Michel HaRssaguerre France Pulmonary veins as source of AF
2003 (FDA approval) United States Drug-eluting coronary artery stents
Abbreviations: AF = atrial fibrillation; AI = aortic insufficiency; AICD = automatic implantable cardiac defibrillator; AV = atrioventricular; CW = continuous
wave; 2-D = two-dimensional; ECG = electrocardiogram; FDA = Food and Drug Administration; HLHS = hypoplastic left heart syndrome; IMA = internal
mammary (thoracic) artery; LAD = left anterior descending coronary artery; MI = myocardial infarction; PA-VSD = pulmonary atresia with ventricular septal
defect; PW = pulsed wave; RCA = right coronary artery; RV = right ventricle; SVT = supraventricular tachycardia; WPW = Wolff–Parkinson–White syndrome.
a
bYearQ indicates the year of publication, not the year of accomplishment. bCountryQ indicates the place of the accomplishment, not the national origin of
the individual.
b
Galen (c 129–199) was born in Pergamum, a city then within the Roman Empire and now called Bergama in modern-day Turkey. Nevertheless,
Galen is generally considered Greek. During his lifetime, he taught in Turkey, Greece, Egypt (Alexandria), and Italy (Rome). His Latin name is
Claudius Galenus.
c
Da Vinci studied human anatomy from 1485 until this activity was banned in Italy in 1513. Although he completed over 600 folios containing thousands
of drawings, they were never published during his lifetime. Only after his death in 1519 did his pupil, Francesco Melzi, release them. Many are now housed at
the Royal Library at Windsor Castle in England.

blight-heartedQ, bbrokenheartedQ, bsweetheartQ, and byoung photography, (3) history, (4) language (etymology), and (5)
at heartQ. nonmedical English expressions. Part 2 will review six
additional topics: (1) death, (2) the arts, (3) movie titles, (4)
song titles, (5) Shakespeare, and (6) the Bible.
7. Summary

Part 1 of this literature and Internet review organizes Table 5


medical and nonmedical information about the cardiovas- Two hundred twenty-one nonmedical English expressions containing the
cular system into five topics: (1) fun facts, (2) medical word bheartQ [3,14,25,38–41]
Happy, content, or encouraged Sad, depressed, or discouraged
Contented heart Heart discouraging
Table 4 Light-hearted Heavy-hearted
Twenty-three recipients of the Distinguished Achievement Award from the Bright-hearted Heart of darkness
Society for Cardiovascular Pathology (1987–2004) Happy-hearted Sad-hearted
Take heart Downhearted
Year Recipient Heartened Disheartened
a
1987 Jesse E. Edwards Heart-warming Heart-stricken
Reginald E. B. Hudson Peaceful heart Heart-struck
Maurice Lev Quiet heart Heartbroken
Robert W. Wissler Restful heart Brokenhearted
1988 Donald B. Hackel Heart at rest Heartache
1989 Earl P. Benditt Heart at ease Cry your heart out
1990 Guido Majno Heart’s-ease Heart piercing
1991 Margaret E. Billingham Heart healthy Heartsick
1992 Victor J. Ferrans Heart cheering Heart-wringing
1993 Jack L. Titus Does your heart good Cut to the heart
1994 William C. Roberts A song in my heart Eats at your heart
1995 Malcolm D. Silver Heart leapt for joy My heart sank
1996 Robert B. Jennings Heart danced for joy Heart in your boots
1997 Ramzi S. Cotran To your heart’s content Heart-rending
Michael J. Davies Heart swelled with pride Heart-wrenching
1998 Russell Ross Heart burst with pride Heart-sore
1999 Richard Van Praagh Heart right Heart-wounded
Stella Van Praagh Rejoice the heart Lose heart
2000 Giorgio Baroldi Warms the cockles of your heart Heart grief
2001 Hugh A. McAllister, Jr. Object of one’s affection, in love Excited, frightened
2002 Ariela Pomerance Sweetheart Heart skipped a beat
2003 Keith A. Reimer Heartthrob Heart in your throat
2004 Anton E. Becker Dear heart Heart in your mouth
a
1987 was the first year the awards were presented. (continued on next page)
M.J. Loe, W.D. Edwards / Cardiovascular Pathology 13 (2004) 282–292 291

Table 5 (continued ) Table 5 (continued )


In your heart Racing heart Private thoughts or feelings Self-aware
Near to your heart Heart pounding Search your heart Know your heart
Next to your heart Heart-stopping Listen to your heart Heart-wise
Close to your heart Makes your heart stop In your heart of hearts At one with your heart
Dear to your heart Be still my heart Crimes of the heart Commune with your heart
Give your heart to Heart appalling Strong desire Energetic, robust
Win your heart Heart chilling Heart’s desire Young at heart
Locked in your heart Heart scare Set your heart on Wild at heart
Lost your heart for Not in love Heart-consuming Wild-hearted
Steal your heart Heart-free Heart-stirring Hearty
Sets your heart ablaze Heart quelling Speaking frankly Show emotions
Heart burns with passion Lonely heart Heart to heart Pour your heart out
Heart melting Heart is a lonely hunter Openheartedly Wear your heart on your sleeve
Heart-alluring Flirtatious, coquettish Plea for mercy Opposed to
Heart-some Heartbreaker Have a heart Set your heart against
Hearts in love Jealousy, envy Find it in your heart Heart rising
Like a mother’s heart Heart-burning Preference or taste Love life
Kind, generous, or helpful Unkind, cruel, or harmful After your own heart Affairs of the heart
Big-hearted Small-hearted Persevere Lacking enthusiasm
Large-hearted Iron-hearted Keep heart Half-hearted
Great-hearted Flint-hearted Persuade, convince Change your mind
Warm-hearted Cold-hearted Win your heart over Change of heart
Soft-hearted Hard-hearted Self-assured Object of pity
Tender-hearted Mean-hearted Know in your heart Poor heart
Gentle-hearted Dog-hearted Openness, tolerance Deeply immersed in
Good-hearted Bad-hearted Heart-expanding Heart buried
Wide-hearted Black-hearted Stimulating, coffee Frigid weather
Openness of heart Closed-hearted Heart-starter Colder than a whore’s heart
Heart-touching Heart offending Mind-boggling Bragging
From the heart Heartless Heart swelling Eat your heart out
Giving heart Heart robbing Memorize Excessively sympathic
Heart in the right place Heart corroding Learn it by heart Bleeding heart
Heart of gold Heart of stone Seal of a promise Seeking forgiveness, penitent
Cold hands, warm heart Heart of ice Cross your heart Contrite heart
Heart as big as all outdoors Rip your heart out Enthusiastic cooperation Originating in the heart
Compassion, concern Basic, central, vital Heart and hand Heart bred
Loving heart At heart Essence of life Life is at stake
On your heart At the heart of Heart blood For my heart
Lay on your heart Deep in the heart of Thankfulness U.S. military decoration
Take it to heart Heart of the issue Bless your heart Purple heart
Touch your heart Heart of the matter
Has a heart for Heart of the problem
Have the heart to Heart of America
Open your heart to Heart of Dixie References
My heart goes out to you Heartland
Soft place in your heart Heartbeat of America [1] The heart facts: University of Ottawa. http://www.ottawaheart.ca/
Tug at your heartstrings Home is where the heart is hcisheartfacts.htm.
Strong or brave Cowardly or weak [2] Amazing heart facts: NOVA. http://www.pbs.org/wgbh/nova/eheart/
Lion-hearted Chicken-hearted facts.html.
Strong-hearted Weak-hearted [3] Bianco C. How your heart works. http://science.howstuffworks.com/
Brave-hearted Faint-hearted heart.htm.
Stout-hearted Hare-hearted [4] Heart facts: Cleveland Clinic. http://www.clevelandclinic.org/
Valiant-hearted Dead-hearted heartcenter/pub/guide/heartworks/heartfacts.htm.
Full-hearted Foolish heart [5] Seiler S. Heart facts and trivia. http://home.hia.no/~stephens/
High-hearted Deceit, treachery hrtfacts.htm.
In good heart False-hearted [6] Guinness world records 2004. New York: Time Inc Home Entertain-
Heart of grace Hollow-hearted ment, 2003. pp. 12–5, 49.
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Plain-hearted Heart and soul Worldwide, 2000. pp. 9, 22.
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Lay to heart True heart [10] Fye WB. American cardiology: the history of a specialty and its college.
From the bottom of your heart Be true to your heart Baltimore: The Johns Hopkins University Press, 1996. pp. 1, 111–2,
174–7, 301.
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