Autopsy as a Source of Discovery in Cardiovascular Medicine

Abstract

This may come as a surprise to many cardiologists, but much of what we know about the normal structure and function of the heart and circulatory system and their disorders was first learned through careful postmortem dissections. Today, of course, we are drowning in information emanating from multiple sources of variable reliability―advances, big and small, are being reported almost daily. But the bedrock information, the foundation from which all new insights derived, came from seeing for one’s self ( autopsy is from the Greek, autos or self, and optos or seen) through actual observation of the human heart and circulation. Here, we undertake a brief historical survey of the autopsy as a source of discovery in cardiovascular medicine and look to its future role in the era of precision medicine. In the mid-16th century, human postmortem dissection was first used to define the anatomy and, by inference, the physiology of the cardiovascular system. In 1543 ( annus mirabilis or admirable year), De Revolutionibus Orbium Coelestium ( On Movements of Planets and Stars ) by Nicolaus Copernicus and De Humani Corporis Fabrica ( On the Building of the Human Body ) by Andreas Vesalius were published. Both authors were educated at the University of Padua, where, in 1597, students sent a letter to the university president (rector) saying, “Few or none of us have come here only for the sake of lecturers and all of us have come to learn practice. We do not lack for lecturers in our own country or elsewhere, and we also have books at home which we can just as well read there as here. It …