Little attention was paid to etiologic factors in heart disease until Dr. Richard Cabot emphasized the importance of such classification in 1914.1 Since that time the causes of clinically important cardiac disease appear to have changed substantially. Whereas rheumatic fever, hypertension, and syphilis predominated in the specialty's early years after World War I, no one needs to be told that coronary heart disease has the distinction of leadership now.
Many etiologic cardiac diagnoses are recognized, but the cause of much important heart disease is not known. Most familiar in the idiopathic or unknown group is primary myocardial disease, that peculiar and morbid entity characterized by progressive hypertrophy, dilatation, fibrosis,and biventricular congestive failure. The title of this illness proclaims our ignorance, but at least we recognize how little is known about the problem and do not assign a more conventional diagnosis for convenience.
Many of the heart's electrical disturbances similarly
Kastor JA. Electrical Disorders of the Heart. JAMA. 1973;224(7):1031–1033. doi:10.1001/jama.1973.03220210047014
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