Dr. F. Mason Sones, Jr. (October 28, 1918 – August 28, 1985) was a prominent cardiologist. Was his accidental discovery really a fluke? Was this unpremeditated discovery appreciated by his peers? The article gives an insight into these questions.
The triumph of cardiovascular medicine is evident due to concrete discoveries made continually from the 19th century until now. These great success stories have helped to lower cardiovascular mortality and morbidity. In the early 18th century, the proper terminology ‘angina pectoris’ was coined by Dr. William Heberden. In 1867, nitroglycerine was first used by Lauder Brunton, the father of modern pharmacology to treat angina. However, the years between 1930 to 1967 modified the vision of cardiovascular medicine.
The emergence of modern cardiology started in early 1950 when Dr. John Gibbon made a ground-breaking discovery by the correction in an atrial septal defect of a young 23-year-old woman (4). By this time, Blalock-Taussig was popularly used in the Tetralogy of Fallot (3). Though this was the advent of intervention, very little was known about ischemic heart diseases.
On 30th October 1958, a momentous discovery was made by F. Mason Sones, Jr. which earned him the title of ‘Father of angiography’ (5). On the morning of this day in the basement of Cleveland Clinic, Dr. Sones was attempting to view the heart valves of a 26-year-old with rheumatoid arthritis. This particular procedure required injecting a large amount of contrast dye into the Sinus of Valsalva, however, the tip squirted into the right coronary artery and led to an accidental injection(6). The size of the right coronary artery is usually tiny in a left-dominant heart which was the scenario in this case. Dr. Sones and Dr. Julio Sosa (colleague) prepared themselves for the worst but to their surprise, the narrative was the opposite. Instead of going into fibrillation, the heart went into asystole on which Dr. Sones advised the patient to cough loudly leading to the recovery of normal heart rhythm (5) (7). Sones registered that he has developed a technique.
Sones later reported, "If a human could tolerate such a massive injection of contrast directly into a coronary artery, then it might be possible to accomplish this kind of opacification with smaller amounts of a more dilute contrast." With considerable fear and trepidation, they embarked on a program to accomplish this goal (5). Although this procedure gave cardiologists the push to inject contrast, they often feared the incidence of non-oxygenated contrast medium into the coronaries.
Later in 1958, Sones used a special catheter to inject a smaller amount of dye of contrast into the patient’s right coronary artery leading to no fibrillation. This gave more evidence-based confidence to use the dye among the patients.(8)
In 1967 Dr. René Favaloro performed the world's first coronary bypass surgery which he said to Sones "the most important contributor to modern cardiology” (8). The idea of seeing a photographic image of arteries carrying blood in the heart muscle was inconceivable, but a pioneer like Dr. Sones made it possible.
Dr. Sones passed away in 1985 due to lung cancer. He couldn’t see how angioplasty and stent placement became as commonplace as they are today. His vision to execute modern cardiology was so modified that it stays relevant in today’s day and age. Millions of lives have been saved due to the use of angiography. He left behind a legacy and inspiration to all cardiologists and cardiac scientists to thrive and adapt in the future. His famous line after injecting a small amount of dye into the patient’s coronaries reflected the same result as that of a large amount, he said “I’ve just made history!”. Indeed, even today we live by it.
References:
1. Khan IA, M. N. (2002 Apr;22). Initial historical descriptions of the angina pectoris. J Emerg Med, doi: 10.1016/s0736-4679(01)00489-9. PMID: 11932097.
2. N Marsh 1, A. M. (2000 Apr). A short history of nitroglycerine and nitric oxide in pharmacology and physiology. Clin Exp Pharmacol Physiol, 27(4):313-9.
3. Textbook of Cardiology . (2011, December 2nd ). Retrieved from https://www.textbookofcardiology.org/wiki/Historical_timeline:_1852-1967: https://www.textbookofcardiology.org/wiki/Historical_timeline:_1852-196
4. Kurusz, M. (2012 Jan-Feb). May 6, 1953: the untold story. PubMed.
5. Leggett, H. (2009, October 30). Oct. 30, 1958: Medical Oops Leads to First Coronary Angiogram. Retrieved from Wired : https://www.wired.com/2009/10/1030first-coronary-angiogram/
6. WILLIAM L. PROUDFIT, M. .. (1986). F. Mason Sones, Jr., M.D. (1918-1985):. Cleveland Clinic Journal of Medicine, 121-124.
7. Wheat, M. P. (n.d.). F. Mason Sones, MD (1918–1985). Retrieved from Society of Cardiovascular Angiography and Interventions: https://scai.org/f-mason-sones-md-1918-1985
8. Hall, R. J. (1985). "In Memoriam: F. Mason Sones, Jr., M.D". Texas Heart Institue Journal , 12 (4): 356–358.
9. F. Mason Sones . (n.d.). Retrieved from Wikipedia : https://en.wikipedia.org/wiki/F._Mason_Sones#cite_note-2
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