Milestones in treatment

1912 American doctor James Herrick establishes that blood clots in the coronary arteries can cause a heart attack by cutting off the heart's blood supply. 1920s The percentage of deaths from coronary heart disease begin to rise as better hygiene, immunization programs and antibiotics reduce the number of infectious disease deaths. Coronary artery disease increases because people live longer and their standard of living increases, bringing more fatty foods and meat to their diets, and less exercise to their lives. 1929 In an experiment to deliver medicine directly to the heart, German doctor Werner Forssmann pushes a catheter into the left side of his heart through a vein in his arm. He walks down to the hospital's basement to X-ray himself to prove a catheter could be used on a living person. He was fired for his self-experimentation, but later shared a 1956 Nobel Prize for his work. 1940s One in four men die from their first heart attack. One belief was that a heart attack was a dying heart's last gasp. Treatment for a heart attack included lots of morphine and bed rest. 1948 Landmark heart study begins in Framingham, Mass. The study, which tracks the lifestyles and habits of two generations of people living in the small town, is still ongoing. It’s the first study to establish high blood pressure, high cholesterol and smoking as major risk factors for heart disease. Before Framingham, hardening of the arteries was thought to be a normal part of aging, along with high blood pressure, which experts thought was needed to push the blood through the tightened blood vessels. 1950s Framingham researchers coin term "risk factors," introducing the idea that lifestyle changes could affect the chances of becoming ill. 1953 Heart-lung machine first used to keep blood pumping through the body during surgery. An 18-year-old American woman's heart was stopped for 26 minutes while Dr. John Gibbon repaired a defect. Published paper shows coronary artery disease in U.S. soldiers killed in action in Korea, revealing the presence of atherosclerosis in early adulthood. 1956 British study shows heavy tobacco smoking increases the risk of heart attack. Dr. Ancel Keys first links dietary fat with cholesterol, causing medical experts to call for changes in eating habits. 1960 The first fully implantable pacemaker is installed in a patient. By delivering tiny shocks, it can control abnormal heart rhythms caused by coronary artery disease. It had a battery life of up to 18 months. 1960s The number of coronary care units increases in hospitals, giving heart patients round-the-clock care. 1964 First coronary bypass surgery performed. Doctors remove a vein from another part of the body and attach it to the damaged or clogged vessel, re-routing the blood flow back to the heart. 1968 First beta-blocker, propranolol, introduced. It slows nerve impulses, causing the heart to not work as hard, and require less blood and oxygen. 1969-1997 Death rate from coronary artery disease in Canada declines by almost 50 per cent. The decline is likely related to improved eating habits, lower blood pressure and cholesterol, reduced smoking rates, improved medical care and increased exercise. 1970-1990 Heart bypass operations become more common. With the help of a heart-lung machine, surgeons can graft a vessel from another part of the body to the affected artery, re-routing the blood flow around the blocked section and giving the heart back its supply of blood. Early heart bypass operations could leave the patient in hospital for up to three weeks. By 2005, a patient can be out within days. 1970s CT scan technology spreads rapidly, giving doctors a cross-sectional view of blood vessels, organs and bones. 1971 British scientist John Vane discovers Aspirin's blood-thinning properties can help prevent heart attacks by preventing blood clots from forming. 1977 Dr. Andreas Gruentzig performs first human balloon angioplasty on a conscious patient with narrowed and hardened arteries. Doctors realize the surgery, which clears clogged arteries, could play a role in preventing heart attacks.

CHART Heart disease mortality rates (requires Flash)

1980 Dr. Marcus DeWood publishes paper showing that in almost every heart attack he observed, there was a blood clot blocking the artery before the attack. Doctors realize clot-busting medications could be given early in the heart attack to prevent further damage. 1980s Using radio waves, MRI technology offers doctors a very detailed view, from any angle, of blood vessels, organs and bones. 1986 The first stent is implanted in a coronary artery. The coil is used to keep the artery from narrowing again after angioplasty. The use of stents increases through the late 1980s and 1990s. 1987 Clot-buster tissue plasminogen activator (tPA), approved for dissolving coronary clots after heart attacks. It's approved for use in strokes in 1996.

ANIMATION
How does coronary artery disease form?

SURVIVOR STORY
A 54-year-old Toronto woman on what it's like to have a quadruple bypass.

Healthy advice