Cardiology and Specializations Within

What is Cardiology?

Heart DiagramCardiology is a medical specialty dealing with disorders of the heart. It is a specialty of internal medicine. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart diseaseand electrophysiology. Physicians specializing in this field are called cardiologists.

On top of cardiologists, there are also cardiac surgeons (cardiothoracic and cardiovascular) who are surgeons who perform cardiac surgery via sternotomy - open operative procedures on the heart and great vessels.
  • Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the chest - generally treatment of conditions of the hear and lungs.
  • Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Done to treat ischemic heart disease, congenital heart disease, valvular heart disease and incudes heart transplantation.


The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero, Dominique Jean Larrey, Henry Dalton, and Daniel Hale Williams. The first surgery on the heart itself was on September 4, 1895 in the present-day area of Oslo; the patient was fine for 24 hours but ended up dying after that. The first successful surgery of the heart, without complications, was in Frankfurt, Germany, on September 7, 1896.

  • Heart wounds - 1895
  • Operative management of pulmonary emboli - first attempted in 1908
  • Surgery of the pericardium - 19th century
  • Catheterization of the right side of the heart, not considered heart surgery, it is an invasive procedure and some catheter procedures have replaced heart operations. Warner Forssman is credited with the first heart catheterization.
  • Heart valve surgery before the era of cardiopulmonary bypass - first clinical attempt to open a stenotic valve was carried out by Theodore Tuffier on July 13, 1912.
  • Congenital cardiac surgery before the heart-lung machine era - first began when John Streider first successfully interrupted a ductus on March 6, 1937.
  • Development of the cardiopulmonary bypass - to bypass the heart, one needs a basic understanding of physiology of the circulation, a method of preventing the blood from clotting, a mechanism to pump blood, and a method to ventilate the blood. Alexis Carrel and Charles Lindbergh developed a device that successfully perfused the thyroid gland beginning April 5, 1935.
  • Extracorporeal life support - this is an extension of cardiopulmonary bypass. Donald Hill and colleagues treated a 24 year old man in 1972 after blunt trauma.
  • Myocardial protection - 1955
  • Evolution of congenital surgery during the era of cardiopulmonary bypass - safety of the cardiopulmonary bypass improved, and the differences between older and younger patients began to show. These differences separated pediatric and adult cardiac surgery in the 1970s.
  • Valvular surgery: cardiopulmonary bypass era - the first successful aortic valve replacement in the subcoronary position was performed by Dr. Dwight Harken and associates in 1960.
  • Coronary artery surgery - 1960s
  • Arrhythmic surgery - physicians at Duke University developed the first successful surgical treatment for cardiac arrhythmias in 1968.
  • Pacemakers - Paul Zoll is given credit for the new clinical era of pacemaking in the 1950s.
  • Heart, heart-lung, and lung transplantation - Alexis Carrel and Charles Guthrie reported transplantation of the heart and lungs in 1905.
  • Heart assist and artificial hearts - the concept of intraaortic counterpulsation was first described by Harken in 1958. The first implantation of a permanent totally artificial heart was performed by DeVries et al in 1982. On September 5, 1984, Donald Hill implanted a Pierce-Donachy left ventrical assist device in a patient.
  • Thoracic aorta surgery - Alexis Carrel is responsible for the techniques for suturing and transplanting blood vessels in the 1900s.