Cardiologist pioneer of the coronary care unit

Born: April 24, 1926;

Died. December 26, 2019.

PROFESSOR Desmond Julian, CBE, FRCP, who has died aged 93, was an eminent cardiac consultant and the first to propose the coronary care unit, which today provides specialist care for people who have suffered a cardiac event such as a heart attack.

Prior to his work, people who had a heart attack were placed on general wards; the only treatment available was bed-rest and pain killers.

His interest in heart attacks and cardiac arrest was sparked by his experience of giving patients open chest cardiac massage while at the Royal Infirmary, Edinburgh, in 1959. Modern-day, closed-chest CPR was just emerging from John Hopkins, in Baltimore, and he could see the potential for monitoring patients in one place.

Recognising the need for heart patients to be treated differently from general patients, Julian proposed the first coronary care unit, in a paper in The Lancet in 1961. He set up the first coronary care unit in Sydney, Australia, in 1962.

The units kept all heart patients on one ward, monitored continuously by trained staff and with defibrillators at the ready in case patients went into cardiac arrest. He returned to Edinburgh in 1964 as a consultant cardiologist at the Royal Infirmary, and set up Europe’s first coronary care unit, its equipment funded by the newly-established British Heart Foundation. In the first year of its programme, an additional seven in 100 patients survived.

Desmond Gareth Julian was born in Liverpool; his father was a doctor and his mother a teacher. He read medicine at St John’s College, Cambridge, before training at the Middlesex Hospital Medical School. From 1949-1951 he served as a Surgeon-Lieutenant in the Royal Naval Volunteer Reserve then spent a year at a hospital in Boston, Mass. He moved to Sydney with his new wife, Mary, but she was killed in a car crash and Julian decided to return to Edinburgh with his young family.

From 1974 until 1986 he served as the BHF professor of cardiology at Newcastle University. Between 1987 and 1993 he was the foundation's medical director.

Julian organised the world’s first international conference on coronary care in 1967, and in 1969 became an adviser on coronary care to the World Health Organization.

Julian, who was made a CBE in 1993, retired from the BHF that year but continued to carry out important research and was involved in the International Study of Infarct Survival.

He was the founding editor of the European Heart Journal (1975-88), and wrote more than 20 books, including Cardiology (1972), a standard work for all medical students and now in its eighth edition. One consultant has commented, “I soaked up his textbook like a sponge.”

Julian was a kind and warm-hearted man who was generous with his time and knowledge both to patients and students. He much enjoyed listening to music, the theatre, and skiing. He enjoyed walking the moors of Scotland and the countryside in Northumberland.

While at the BHF he met Claire Marley and they married in 1988. She survives him, as do his son and daughter from his first marriage.