Book Review

Journey into the Heart: A Tale of Pioneering Doctors and Their Race to Transform Cardiovascular Medicine

N Engl J Med 2007; 356:1595-1596April 12, 2007

Article

Journey into the Heart: A Tale of Pioneering Doctors and Their Race to Transform Cardiovascular Medicine
By David Monagan, with David O. Williams. 386 pp., illustrated. New York, Gotham Books, 2007. $27.50. ISBN: 978-1-592-40265-6

Coronary artery disease, the leading cause of death in the United States, occurs when the blood vessels that supply the heart become blocked, in part, with fatty deposits. One of the procedures used to reopen these conduits is balloon angioplasty, which involves inserting a balloon-tipped catheter into a blocked coronary artery. The balloon is inflated, the fatty deposits are compressed, and normal blood flow is restored to the heart muscle.

Behind the development of this seemingly simple procedure is one of the most fascinating stories in the history of cardiology. Journey into the Heart is an excellent account of the successes and failures that the pioneers of cardiac catheterization and balloon angioplasty encountered along the way. In the first few chapters, the authors pay tribute to daring investigators — Werner Forssmann, André Cournand, Dickinson Richards, Frank Mason Sones, and Charles Dotter — and chronicle the establishment of cardiac catheterization in clinical medicine. The rest of the book is devoted to the life, accomplishments, and untimely death of Andreas Roland Gruentzig, the architect of balloon angioplasty for the treatment of coronary artery disease.

I was pleased to find that this book not only contains biographical information but also explores the human characteristics of Gruentzig and other pioneers in the field. The book delineates Gruentzig's vision, passion, and unrelenting desire to succeed, despite the doubts of his peers, while also exploring his disappointments, uncertainties, and weaknesses. Ultimately, the reader is witness to Gruentzig's achievement of his final goal with the clinical application of balloon angioplasty.

The information included in the book was obtained from various publications and, perhaps more important, from interviews with people who were part of Gruentzig's personal life and medical career. What I most enjoyed about this book was the depth of the character analysis. Against the backdrop of a rather technical story about the development of a medical procedure, a much more intriguing drama emerges as the authors show the key players dealing with their own ambitions, envy, competitiveness, tempers, insecurities, and desire for wealth. The result is a compelling narrative written in familiar language, understandable by any reader, that also happens to be a first-rate source of information regarding cardiac catheterization and interventional coronary procedures.

The varied coronary interventions that are performed all over the world today exist primarily because of a single catalyst: Andreas Gruentzig. Journey into the Heart pays tribute to this maverick who succeeded despite considerable opposition and explains how he did it. Gruentzig, like other great pioneers in cardiology and other fields, does not appear to have entertained the possibility of failure.

Hector O. Ventura, M.D.
Ochsner Medical Center, New Orleans, LA 70121
hventura@ochsner.org