Abstract
The history of myocardial infarction (MI) diagnostics has gone through a continuous
evolution over the past century, when several new discoveries have contributed to
remarkably increase the number of patients appropriately diagnosed with this condition.
The tale “of MIs and Men” displays rather a long history, since atherosclerosis was
found to be present in humans several centuries before modern civilization and the
identification of the most prevalent risk factors. It was only at the end of the 19th
century and at the beginning of the 20th century that the physicians acknowledged
that MI is principally sustained by coronary thrombosis, and that the clinical picture
of MI could be subsequently confirmed at autopsy. With the first description of the
electrocardiogram (ECG) in the 1910s and 1920s, the history of modern MI diagnostics
really began. Additional important discoveries followed, which are mainly represented
by radiography, echocardiography, computed tomography, and magnetic resonance imaging
of the heart. Another major breakthrough occurred at the down of the third millennium,
with the development of commercial immunoassays for the measurement of cardiac troponin
I and T, which represent now the cornerstones for identifying any kind of myocardial
injury, thus including MI. The major advancements in the understanding of MI pathophysiology
and the progressive introduction of efficient diagnostic tools will be described and
discussed in this narrative historical review.
Keywords
myocardial infarction - acute coronary syndrome - history - electrocardiogram - biomarkers
