Pulmonic regurgitation historical perspective

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Pulmonic regurgitation Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2], Aysha Anwar, M.B.B.S[3]

Overview

The pulmonary valve and its function of allowing blood to the lungs for nourishment was first described by Hippocrates. Ibn Nafis then described the pulmonary circulation. Mondino drew a sketch of the pulmonic valve. In 1888 an early blowing diastolic murmur due to pulmonary hypertension was described by Graham-steel, known as Graham-steel murmur. Techniques were then developed to diagnose pulmonary valve regurgitation via the dye method and cardiac catheterization.

Historical perspective

  • Hippocrates (460-377 BC) first described the cusps of pulmonary valve as having texture different tha the ventricles and function of the pulmonary valve, avoiding backflow of blood to the ventricles ensuring one-way flow through the heart.[1]
  • The pulmonary circulation was first described by Ibn Nafis (1210-1288 AD). The book was forgotten until 1924 when the manuscript No.62243 titled Commentary on the anatomy of the Canon of Avicenna was found in Germany.[2]
  • In a 1541 publication Anatomia Mundini, Ad Vetustis the first ever sketch design of the pulmonary valves in their anatomical position was published. It was the work of Mondino de Luzzi (1270 A.D -1326 A.D) an Italian physician, anatomist, and professor of surgery in Bologna, known as the Restorer of anatomy.[3][4]
  • Graham-Steell murmur: In 1888, Dr. Graham Steel first described the pulmonic regurgitation murmur in his two publications in Manchester Medical Chronicle. He attributed an early blowing diastolic murmur over and below the pulmonic area to the longstanding pressure in the pulmonary artery, independet of any disease or deformity of the valves. The murmur due to pulmonary hypertension has since been named after the person himself, Graham Steel murmur.[5][6]
  • It was long thought that pulmonic regurg can not be diagnosed during the life-time of a patient. Then in 1956, Ralph F. Morton and Thomas N Stern presented a case of isolated nonsurgical pulmonic regurgitation during life, suggested by the physical exam, phonocardiography, and fluoroscopy. It was definitely diagnosed by cardiac catheterization.[7]
  • Due to the transient, soft nature of the murmur and and resemblance with aortic regurgitation, the need to illustrate the regurgitation by another method arose. In 1958, Wanzer et al. first described the use of Evans blue dye to diagnose the pulmonic valve regurgitation.[8] In 1959, Collins et al. used cardiogreen dye and radioactive krypton (Kr85) to demonstrate the regurg.[9]
  • In 1968 Galen described the membranes of the valves and named them as "semilunar" in his book De Usu Partium, Volume 1.[4]

References

  1. Craik, Elizabeth (2015). The 'Hippocratic' corpus : content and context. Milton Park, Abingdon, Oxon New York, NY: Routledge. ISBN 978-1138021716.
  2. Akmal M, Zulkifle M, Ansari A (2010). "Ibn nafis - a forgotten genius in the discovery of pulmonary blood circulation". Heart Views. 11 (1): 26–30. PMC 2964710. PMID 21042463.
  3. Mavrodi A, Paraskevas G (2014). "Mondino de Luzzi: a luminous figure in the darkness of the Middle Ages". Croat Med J. 55 (1): 50–3. doi:10.3325/cmj.2014.55.50. PMC 3944418. PMID 24577827.
  4. 4.0 4.1 Paraskevas, G.; Koutsouflianiotis, K.; Iliou, K. (2017). "The first descriptions of various anatomical structures and embryological remnants of the heart: A systematic overview". International Journal of Cardiology. 227: 674–690. doi:10.1016/j.ijcard.2016.10.077. ISSN 0167-5273.
  5. Fraser AG, Weston CF (1991). "The Graham Steell murmur: eponymous serendipity?". J R Coll Physicians Lond. 25 (1): 66–70. PMC 5377079. PMID 2023159.
  6. "GRAHAM STEELL (1851-1942)--GRAHAM STEELL MURMUR". JAMA. 191: 671. 1965. PMID 14242430.
  7. Morton, Ralph F.; Stern, Thomas N. (1956). "Isolated Pulmonic Valvular Regurgitation". Circulation. 14 (6): 1069–1072. doi:10.1161/01.CIR.14.6.1069. ISSN 0009-7322.
  8. WANZER Sh, CUDKOWICZ L, DALEY R (1960). "[Diagnosis of pulmonary regurgitation by a dye method]". Br Heart J. 22: 720–2. doi:10.1136/hrt.22.5.720. PMC 1017718. PMID 13783078.
  9. Collins, N. Perryman; Braunwald, Eugene; Morrow, Andrew G. (1959). "Detection of Pulmonic and Tricuspid Valvular Regurgitation by Means of Indicator Solutions". Circulation. 20 (4): 561–568. doi:10.1161/01.CIR.20.4.561. ISSN 0009-7322.