Historical figures transforming cardiac knowledge over two centuries.

Unlocking the Heart's History: How Doctors Finally Understood Angina

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Jordan Keane in Health & Wellness November 2025 • 5 min read.

"Explore the two-century journey of understanding angina pectoris, from early descriptions to modern cardiology breakthroughs and treatment."


In the wake of natural disasters, a rise in acute cardiac events is often expected. Cardiologists and emergency services become adept at managing the influx of patients, yet documenting this increase remains a challenge. Now is a perfect time to consider the evolving understanding of angina, a condition that has puzzled medical minds for centuries. While William Heberden and his contemporaries are credited with the earliest descriptions, Scottish medicine significantly contributed to unraveling this complex ailment.

The journey to understanding heart disorders and their management has been challenging and full of breakthroughs over time. William Heberden (1710-1801) is often credited with providing the first comprehensive description of angina. A Cambridge graduate, Heberden practiced in London for 34 years before retiring, even attending King George III during an illness in 1788. In 1768, he presented a groundbreaking paper on angina to the Royal College of Physicians of London.

In his Commentaries, written that same year to guide his son (though published posthumously), Heberden detailed the experiences of those afflicted: 'Those who are afflicted with it, are seized while they are walking (more especially if it be uphill, and soon after eating) with a painful and most disagreeable sensation in the breast, which seems as if it would extinguish life, if it were to increase or to continue, but the moment they stand still, all this uneasiness vanishes... The pain... very frequently extends from the breast to the middle of the left arm.'

The Progression of Understanding Angina

Historical figures transforming cardiac knowledge over two centuries.

Heberden recognized that the disorder was progressive. 'After it has continued a year or more, it will not cease so instantaneously upon standing still, and it will come on not only when the persons are walking, but when they are lying down, especially if they lie on the left side... The termination of the angina pectoris is remarkable. For if no accident intervene, but the disease go on to its height, the patients all suddenly fall down, and perish almost immediately.'

However, in his written account, Heberden only referred to 'a disorder of the breast' and didn’t fully appreciate that coronary artery disease was the origin of the described condition. Edward Jenner (1749-1823), who corresponded with Heberden, is credited with furthering this understanding. Jenner wrote, 'How much the heart must suffer, from the coronary arteries not being able to perform their functions I need not enlarge upon.' Jenner also corresponded with Caleb Parry, whose 1799 text on angina advanced well-documented opinions with due acknowledgment to Jenner.

  • John Hunter’s Cardiac History: Jenner’s interest may have stemmed from the cardiac history of his teacher, John Hunter (1728-93). Hunter experienced his first heart attack in 1772.
  • Jenner's Observation: John Lettsom described a later attack in 1785, noting, 'He declares he was the other day dead for four minutes, not having pulsation in the heart or arteries.'
  • Hunter's Awareness: Although Jenner didn't discuss his views with Hunter out of respect, Hunter seemed aware of his condition, stating his life was 'at the mercy of any rogue who cares to anger me.'
  • Post-Mortem Findings: After Hunter's death in 1793, an autopsy by his brother-in-law, Everard Home (1756-1832), revealed that 'the coronary arteries had their branches... in the state of bony tubes which were with difficulty divided with the knife.'
Matthew Baillie (1761-1823), Hunter's nephew, included Home's information in his publication Morbid anatomy. The 1797 edition noted that 'ossification of the coronary arteries would seem to produce the symptoms of angina pectoris.' This work was hailed as one of the greatest contributions to pathology by anatomist-bibliophile Kenneth Russell.

The Legacy of Understanding Heart Pain

From the initial descriptions by Heberden to the groundbreaking discoveries by Black, the journey to understanding and treating angina pectoris has been transformative. Today, with advanced diagnostic tools and treatments, we continue to build upon the foundational knowledge established by these pioneers. Reflecting on this history not only honors their contributions but also reminds us of the ongoing quest to improve cardiac health and well-being.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4997/jrcpe.2011.416, Alternate LINK

Title: A Story Of Heartache: The Understanding Of Angina Pectoris In The Pre-Surgical Period

Subject: Education

Journal: The Journal of the Royal College of Physicians of Edinburgh

Publisher: Royal College of Physicians of Edinburgh

Authors: Aw Beasley

Published: 2011-12-15

Everything You Need To Know

1

Who provided the first comprehensive description of angina and what were the limitations of his understanding?

William Heberden provided the first comprehensive description of angina pectoris. In 1768, he presented a groundbreaking paper to the Royal College of Physicians of London, detailing the painful sensations experienced by those afflicted, especially during physical activity. However, Heberden only referred to it as a 'disorder of the breast' and didn’t fully appreciate coronary artery disease was the origin.

2

How did Edward Jenner contribute to the understanding of angina pectoris, and what was the basis for his interest in the condition?

Edward Jenner furthered the understanding of angina pectoris by connecting it to coronary artery disease. He wrote about how the heart suffers when coronary arteries cannot perform their functions. Jenner corresponded with Caleb Parry, and his interest may have stemmed from the cardiac history of his teacher, John Hunter.

3

What role did John Hunter's cardiac history and subsequent autopsy play in linking coronary artery disease to angina?

John Hunter's cardiac history significantly contributed to the understanding of angina. Hunter experienced heart attacks, and after his death, an autopsy revealed that his coronary arteries had turned into 'bony tubes'. This finding, included in Matthew Baillie's publication Morbid Anatomy, suggested that ossification of the coronary arteries could produce symptoms of angina pectoris.

4

How did Matthew Baillie's publication 'Morbid Anatomy' contribute to the understanding of angina pectoris, and what key finding did it highlight?

Matthew Baillie, John Hunter's nephew, played a crucial role by including Everard Home's autopsy findings in his publication Morbid Anatomy. The 1797 edition noted that 'ossification of the coronary arteries would seem to produce the symptoms of angina pectoris.' This work marked a significant contribution to pathology, helping to link the physical condition of the arteries to the symptoms of angina.

5

Considering the historical journey of understanding angina pectoris, what are the key takeaways regarding the progression of knowledge and the interplay of different medical minds?

The journey to understanding angina pectoris, as described, highlights the importance of recognizing the progressive nature of the disorder, the limitations of early descriptions, and the gradual realization of the role of coronary artery disease. The initial observations by William Heberden, combined with the insights from Edward Jenner, the cardiac history of John Hunter, and the pathological findings documented by Matthew Baillie, collectively advanced the understanding of angina, paving the way for modern diagnostics and treatments. Modern cardiology has been built upon the foundational knowledge established by these pioneers.

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