The patient with heart disease and the cardiovascular physician and surgeon: 1958-1983.

The patient with heart disease and the physician providing cardiovascular health care have experienced dramatic change since the American College of Cardiology first published its journal 25 years ago. During the decade before 1958, cardiology and cardiovascular surgery emerged as specialties. Surgery by closed techniques flourished and open heart surgery began. Since 1958, spectacular progress has occurred. Closed chest massage and defibrillation, electronic monitoring, advances in electrophysiology and a new pharmacology have changed cardiology. The coronary care unit has evolved into a comprehensive coronary care system. Pacemakers, myocardial revascularization and open heart surgery have become commonplace and percutaneous angioplasty an option. As custodians of cardiology's historic advances, the cardiologist and cardiovascular surgeon are cast in a role of decision maker and problem solver. Today's diagnostic and therapeutic cardiology, used appropriately, has great potential for good--used inappropriately, for great harm. The patient has the right to expect the physician to act objectively and appropriately in dealing with problems that may threaten his or her livelihood or life. The physician who does less is an unworthy heir to cardiology's great legacy of 1983.