Cardiology

“ . . . a new clinical perception of the heart. Instead of being interested in the statics and mechanics of the heart’s action and the natural history of valvular disease, what began to matter to clinicians was the heart’s dynamics; what the heart could do. . . . There was thus a shift from pathological anatomy to pathophysiology and from an ontological to a physiological concept of disease. . . . The new cardiology involved a revolution in this perspective. The clinician perceived a patient with multiple indications of a ‘failing’ heart owing to changes in one or more of its muscular properties. The physician’s task was thus to elucidate what these changes were and make a prognostic assessment of the patient in terms of the heart’s capacity to deliver blood. The state of the valves was simply another factor, and often a minimal one, influencing this assessment” (Lawrence, 12).