Saving the Heart: The Battle to Conquer Coronary Disease

Recent advances in the treatment of coronary artery disease based on collaborations between engineers, surgeons and cardiologists have led to procedures once undreamed of but now almost routine. Coronary angiography, bypass surgery, angioplasty and stent placement (supporting sagging arteries) have not cured coronary disease, which is still the country's leading cause of death, but they have contributed to a 50% decline in its morbidity rate since 1963. Klaidman's engrossing account traces the development of these interventions, the personalities behind them and the complex questions they raise. A senior research fellow at Georgetown University's Kennedy Institute of Ethics and author of Health in the Headlines, Klaidman finds that innovative surgeons share with artists the qualities of ""courage, intuition, and imagination,"" but often bring monumental egos, arrogance and greed into the mix as well. Recognizing the obvious genius behind cutting-edge coronary research, Klaidman nevertheless suggests that high-tech interventions may now be overused, may be prescribed for the wrong reasons--including increased profits for companies in which doctors or surgeons hold financial interests--may deflect attention in medical training away from important clinical skills, and may not offer patients better overall options than drugs. Klaidman offers specific guidelines for coronary patients and argues forcefully for balance between profit-driven research and patient-centered practice in this sometimes harrowing but always fair-minded analysis of some of the most pressing concerns facing modern medicine. 20 illustrations. (Jan.)