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Harrison's Principles of Internal Medicine, 18e
| Part 10. Disorders of the Cardiovascular System > Section 2. Diagnosis of Cardiovascular Disorders > |
Chapter 230. Diagnostic Cardiac Catheterization and Coronary Angiography
Sections: Diagnostic Cardiac Catheterization and Coronary Angiography: Introduction, Cardiac Catheterization, Coronary Angiography, Further Readings.
Topics Discussed: cardiovascular testing; coronary angiography; diagnostic cardiac catheterization, coronary arteriography.
Excerpt:"Diagnostic cardiac catheterization and coronary angiography are considered the gold standard in the assessment of the anatomy and physiology of the heart and its associated vasculature. In 1929, Forssmann demonstrated the feasibility of cardiac catheterization in humans when he passed a urological catheter from a vein in his arm to his right atrium and documented the catheter's position in the heart by x-ray. In the 1940s, Cournand and Richards applied this technique to patients with cardiovascular disease to evaluate cardiac function.These three physicians were awarded the Nobel Prize in 1956. In 1958, Sones inadvertently performed the first selective coronary angiography when a catheter in the left ventricle slipped back across the aortic valve, engaged the right coronary artery, and power-injected 40 mL of contrast down the vessel. The resulting angiogram provided superb anatomic detail of the artery, and the patient suffered no adverse effects. Sones went on to develop selective coronary catheters, which were modified further by Judkins, who developed preformed catheters and allowed coronary artery angiography to gain widespread use as a diagnostic tool. In the United States, cardiac catheterization is the second most common operative procedure, with nearly three million procedures..."
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