THE EARLY YEARS OF THE CORONARY INTENSIVE CARE UNIT

The first Intensive Care Unit in the world emerged in the USA in 1963; followed later in the United Kingdom and Ireland with the aim of treating and regularly monitoring coronary patients. This happened following the high mortality rate due to myocardial infarction and the discovery that it could be drastically reduced when certain arrhythmias were diagnosed and treated early.

Years before, in 1937, a policy was developed in the USA consisting of some services, namely firemen, police or vigilantes, with qualifications to get the patient to the Intensive Care Unit as soon as possible. The basic principles were: speed, efficiency and vital support. At a conference held in Bethesda, in 1965, the Coronary Units system was accepted.

The success of this programme depended on the coordination of several factors such as the joint efforts, speed, the ability to communicate information, to choose the best transport and the existence of a hospital network suitably equipped.

INTENSIVE CARE UNIT IN PORTUGAL

It was in April 1969, 50 years ago, that the Intensive Care Unit for Coronary Patients, of the Cardiology Service of Santa Maria Hospital integrated in the Department of Heart and Vessels of the North Lisbon University Hospital Centre (NLHC) was created. It was the first of its kind in our country and one of the first in Europe. In 1972 the Intermediate Care Unit was officially opened to complement the Department’s project.

It is due to Professor Arsénio Cordeiro, a cardiologist with visionary and entrepreneurial character, highly regarded in Portugal and at the time Director of the Internal Medicine Service of Santa Maria Hospital, the creation of this Unit. It was In association with the clear and progressive spirit of Azeredo Perdigão, who promptly accepted that challenge by approving the financing of that initiative by the Calouste Gulbenkian Foundation, of which he was then President.

Arsénio Cordeiro and Azeredo Perdigão

Subsequently, in 1981, it was renamed Coronary Intensive Care Unit (UTIC), with the acronym “AC” in recognition of its founder, Prof. Arsénio Cordeiro..

Over the following years, UTIC has achieved enormous success through its techniques, protocols and efforts in the treatment of patients, which has contributed to a reduction in mortality from myocardial infarction and to an enormous projection of Portuguese cardiology both at a national and International level.

A BRIEF BIOGRAPHY OF PROFESSOR ARSÉNIO CORDEIRO

Professor Arsénio Cordeiro is considered one of the most prominent figures in Portuguese medicine in the second half of the 20th century, due to his qualities as a physician, researcher, teacher, pedagogue, his personality and a unique and multifaceted nature, ranging from medicine to various sports activities.

Arsénio Luís Rebello Alves Cordeiro, was born in Lisbon on June 21, 1910 and died here on May 7, 1982 at UTIC, the unit he founded. Walking amongst a careful and cultural circle, where medicine was so familiar to him, since he was the son of doctor Dr. Arsenio Júlio Cordeiro and nephew of distinguished Prof. Sílvio Rebelo, this certainly contributed so that his exceptional characteristics would be recognised throughout his life. He retired on June 21, 1980.

An excellent student, after attending Pedro Nunes High School at the capital, he graduated in Medicine from Lisbon Medical School in July 1935, with the high grade of 18 points. He received his doctorate in1947 and unanimously obtained the classification of 19 marks after defending his thesis “Contribution to the study of Wolff-Parkinson-White Syndrome.””.

He also specialised in Sports Medicine, as a fellow of the Institute of Higher Culture, visiting Rome, Bologna, Berlin and Hamburg.

He worked in several medical specialities such as Internal Medicine, Cardiology, Sports Medicine, Occupational Medicine and Aeronautical Medicine, having participated in numerous international congresses in these areas.

He was appointed Professor of Medical Pathology in 1958 and of Medical Clinic at Lisbon Medical School in 1964.

There were many prominent positions he held in his profession, among them are: Director of Internal Medicine Service; founding member, secretary general, honorary president of the Portuguese Society of Cardiology, member of several scientific societies (Spanish, French, Italian and English); Fellow of the American College of Cardiology;, representative of the Iberian Peninsula at the International Society of Cardiology, etc.

He held several postgraduate courses directed to physicians, under the topic of Cardiology and Coronary Intensive Care. Between 1969 and 1973, Specialisation Courses were held for Nurses on Coronary Units.

He was the author of several books as well as numerous scientific articles published in national and foreign magazines.

We can distinguish several professional aspects of Prof. Arsénio Cordeiro: as a researcher, teacher, pedagogue or physician.

Professor Arsénio Cordeiro

As a researcher, Professor Arsénio Cordeiro defended how important the practice of scientific research was. He stated that using a correct methodology, associated with persistent work would always give rise to new knowledge. This concept is easily understood in the practical part of his PhD thesis carried out at the Institute of Physiology directed at the time by Professor Marck Athias..

His research had great international projection; as a result, he was invited many times to participate in world congresses.

He was a brilliant teacher, scholar, with an excellent memory and sharp reasoning. His classes were enthusiastic both in content and form, having had enormous influence in preparing generations of future physicians.

Lectoring

Recognised as a unique pedagogue, his communication was easy and simple, without arrogance, intoning the voice according to the importance of the information to be given, always showing availability to clarify any doubts elicited by the students at the end of the classes.

As a physician, Prof. Arsénio Cordeiro, was an upright humanist, giving it all to the service of the patient, putting him above any sacrifice, as the patient would always come first.

In addition to being a sportsman of great merit, he distinguished himself as a national fencing and sword champion in 1939, also obtaining the European record for white marlin fishing. In 1955 and 1958 he did it again with swordfish fishing.

Professor Arsénio Cordeiro, first from left, at Serra da Estrela

He was also involved in Ichthyology (he was a member of the International Bureau of Fish Classification), oenology and cuisine, and collaborated in a culinary treaty.

In 1945 he subscribed to the MUD list, but claimed that he did so by mistake after being confronted and considered by PIDE as a “Situationist.”

He was distinguished with several awards, among them the Specia Award, awarded to the highest-rated student of its Course (1935); Lisbon University Gold Medal (1980); Medal with his portrait stamped in bronze created by the Portuguese Cardiology Society (1980); Nameplate, with his name, placed in the Medical Clinic Classroom by the FML Direction (1980); Bestowed by the President of the Republic with the decoration of Grand Officer of the Military Order of Sant’Iago da Espada.

Awards

Tributes to Professor Arsénio Cordeiro

In early 1992, ten years after his death, a tribute was paid in memory of Prof. Arsénio Cordeiro. In this context, a ceremony was held on October 18 of the previous year to unveil a toponymic plaque with his name on a street in the Telheiras neighbourhood in Lisbon, where there are other streets with various names of distinguished professors of FMUL such as, Pulido Valente and Henrique de Vilhena.

Toponymic plaque, Telheiras, Lisbon

On June 21, 2010 under the coordination of Professor Carlos Ribeiro a tribute was paid to Professor Arsénio Cordeiro at the FMUL’s Aula Magna .

An exhibition was held where emblematic pieces, medical equipment and personal objects of the honouree were exhibited.

In addition to having been distributed two publications on Professor Arsénio Cordeiro, it was also unveiled an acrylic painting that his friends offered to the Medical School to be later put on display at the UTIC-Arsénio Cordeiro.

Arsénio Cordeiro Award

In 1992 the Arsénio Cordeiro Award was created by the Scientific Council of FMUL with the support of Mapfre Life Foundation. This award had the distinctiveness of rewarding a class and not the student individually.

Presentation of the Arsénio Cordeiro Award to one of the students in the winning class, 1992/1993

Those who knew and dealt with Prof. Arsénio Cordeiro, described him as a man of strong personality, cultured, of fine treatment, very elegant, integral, transparent, sincere, active, cheerful, enthusiastic but also combative, persistent and disciplined, fond of literature, especially of Eça de Queirós, and of classical music, particularly Vivaldi, attributes that he maintained throughout his life.

Lurdes Barata

Library and Information Centre

Editorial Team

Bibliography:

Santa Maria Hospital: 1954-1994

Santa Maria Hospital: 1954-2004: 50 years of education and investigation. Organizing Committee for the Commemorations of the Fiftieth Anniversary of Santa Maria Hospital: Lisbon: Hosp. Santa Maria, 2005?

Alves, Valente. University of Lisbon Medical School: a look at its history. Lisbon: Gradiva, 2011

Bulletin FML, III, n. January, 1st, 1992

Coronary intensive care units. Portuguese Medical Act, 5, 1984: 157-164

https://hscarchives.com/photographs/photographs-interior-views-of-icu/

http://news.medicina.ulisboa.pt/2010/07/31/cerimonia-de-homenagem-ao-prof-arsenio-cordeiro-na-faculdade-de-medicina-de-lisboa/