Harvard Heart Letter

Taming a killer

Heart attacks aren't nearly as deadly as they used to be.

Decades ago, a heart attack was often deadly, killing up to half of its victims within a few days. With only a vague understanding of the physiological processes underlying heart attacks, doctors couldn't do much but let nature take its course. "When I was in medical school in the 1970s, what we were taught to do for people having heart attacks was to keep them calm and quiet, ease their chest pain, do what we could to prevent heart rhythm problems, and hope that another heart attack wasn't on its way," says Dr. Thomas Lee, editor in chief of the Harvard Heart Letter.

Today, more than 90% of people survive myocardial infarction. That's the technical term for heart attack; it means an area of damaged and dying heart muscle caused by an interruption in the blood supply. Some of the decline in deaths is due to doctors' ability to diagnose and treat smaller, less deadly heart attacks. Some is due to the institution of specialized coronary care units in the early 1960s (see time line), what Heart Letter adviser Dr. Eugene Braunwald once called "the single most important advance in the treatment of acute myocardial infarction."

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