Introduction to the Human Heart

About the size of our fist, heart is the most important organ of the body which supplies the blood to entire body. Human heart is made up of four chambers, Right Atrium, Right Ventricle, Left Atrium and Left Ventricle. Right side of the heart receives the blood which is low in oxygen from the veins all over the body and it can pump blood through pulmonary artery in the lungs where it can be reoxygenated. The left side of the heart receives this oxygen rich blood from the lungs and then through Arota (the body's main artery) this oxygen rich blood is pump to other parts of the body by complex network of arteries, arterioles and capillaries. The oxygen rich blood supply oxygen and nutrients to different body tissues and picks up carbon dioxide and other waste material from the tissue. This deoxygenated blood return to the right atrium of the heart and the entire cycle begins again.

Coronary Artery Disease (CAD)

Coronary Artery Disease is a disease in which coronary arteries get clogged by fatty deposits know as "Plaque". Coronary arteries are the major arteries that supply blood, oxygen and nutrients to the heart. If build up of the fats occurs in one or more of the coronary arteries then this may result in Heart Attack. This may even cause Angina or Chest pain due to insufficient supply of blood/oxygen to heart muscle. The Plaque deposited on the interior wall of coronary arteries may rapture and can cause the blood clot. If the clot becomes large enough, it can block the flow of oxygen-rich blood to the portion of heart muscle fed by the artery. Blocked blood flow to the heart muscle causes a heart attack.


Feeling of Discomfort in Chest

This is one of the common symptoms of heart attack. Symptoms of heart attacks involve discomfort in the center of the chest, which could be mild initially and can lasts for more than a few minutes. There are also chances that the pain goes away and comes back. It can feel like squeezing, fullness or pain, uncomfortable pressure on your heart.

Feeling of Discomfort in Other Body Parts

Heart attack symptoms also include pain or discomfort in one or both arms, jaw,neckand in your stomach.

Shortness of Breath

This is also one of the major warning signs of heart attack that can occur with or without chest discomfort.

Other Warning Signs of Heart Attack

Heart disease signs also include breaking out in a cold sweat, nausea or lightheadedness.

Heart Beat Rate

Irregular beating of heart rate, that too with an increased pace.

Nervousness, anxiety, sweaty skin.

Paleness or Pallor.

Feeling of impending.


Risk Factors of Coronary Heart Diseases

There are several risk factors of heart diseases. Some of them are modifiable and some of them are non-modifiable.

Non-Modifiable Risk Factors

Male over 45 years of age
Female over 55 years of age
Family History
Male relatively develop heart disease before 55 years of age.
Female relatively develop heart disease before 65 years of age.

Modifiable Risk factors

Smoking – Quit!
Excess weight/Obesity
High Cholesterol
High Blood Pressure
Erectile Dysfunction
The positive thing of having modifiable risk factor is that they can be changed and the heart disease can be prevented

Medical Treatment

Treatment aims to balance blood supply to the heart with heart oxygen demand, and prevent worsening of coronary heart disease.

Aspirin: When taken daily or every other day, aspirin reduces the risk of developing angina or heart attack by reducing the tendency of your blood to clot.

Beta-blockers: Beta-blockers decrease your heart rate and blood pressure, thus reducing your heart's demand for oxygen.

Nitroglycerin: This medication reduces chest pain both by decreasing your heart's oxygen demand and by dilating the coronary arteries, increasing the oxygen supply.

Sprays or tablets placed under your tongue are designed to be taken when you need instant relief from angina.

ACE inhibitors: Angiotensin-converting enzyme (ACE) inhibitors work by dilating blood vessels, increasing blood flow.
PTCA (Percutaneous Transluminal Coronary Angioplasty)

What is percutaneous transluminal coronary angioplasty (PTCA)?

Percutaneous transluminal coronary angioplasty (PTCA) opens blocked coronary arteries caused by coronary artery disease (CAD) and restores arterial blood flow to the heart tissue without open heart surgery. (Percutaneous means through the skin), (Transluminal means in the channel or lumen of a blood vessel)
Angioplasty physically opens the channel of diseased arterial segments, relieves the recurrence of chest pain, increases the quality of life and reduces other complications of the disease. The blockage is due to deposition of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle.

How does the procedure works?

Angioplasty is usually carried out in a room called a catheterization room, with X-ray equipment to take a picture of your arteries. You will lie on an X-ray table. You will be put on a heart monitor.

The procedure is usually done through the artery of groin region. The doctor gives a local anesthetic so that you don't feel the pain. Then a small cut in made in the skin through which a thin tube call the catheter is inserted in your body whichforms a tunnel through which Angioplasty procedure will be done.

There will be several monitor screens in the room, showing your vital signs, the images of the catheter being moved through the body into the heart, and the structures of the heart as the dye is injected.

By watching on a special X-ray screen, the doctor can move the catheter into the artery. The catheter with a thin, expandable balloon on the end is passed to the blockage.

When the catheter gets to the narrow part in your artery, the doctor blows up the balloon, squashing the fatty patches on the inside walls of the artery.. Usually the catheter carries a short hollow tube made of stainless steel/ cobalt chromium (called a stent). This opens out as the balloon is blown up and is left inside your artery. It's like a tiny piece of scaffolding that holds the artery open. If you do have a stent, the doctor will give you drugs to stop blood clots forming around it.
The doctor will check that the artery has been widened enough to allow blood to flow through more easily.
Then the catheter is taken out and small bandage is applied on the cut area to stop the bleeding.

Before the Procedure

You will need to fast for a certain period of time prior to the procedure.
Notify your physician:
If you have ever had a reaction to any contrast dye, or if you are allergic to iodine.

If you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general)

If you have heart valve disease, as you may need to Receive an antibiotic prior to the procedure.

If you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting.
If you have a pacemaker.
If you are pregnant or suspect that you may be pregnant.

Your physician may request a blood test prior to the procedure to determine how long it takes your blood to clot.
You may receive a sedative prior to the procedure to help you relax.
The area around the catheter insertion (groin area) may be shaved.

After the Procedure

Bed rest may vary from two to six hours depending on your specific condition. You may be given medication for pain or discomfort related to the insertion site or having to lie flat and still for a prolonged period. You will be encouraged to drink water and other fluids to help flush the contrast dye from your body.

Interesting facts of Human Heart

Did You Know ?

Human heart beat 35 million times a year.
Blood vessels - arteries, veins and capillaries - is over 60,000 miles (96,000 km) long. That's long enough to go around the world more than twice!
The heart beats about 100000 times each day
An adult woman's heart weighs about 8 ounces, a man's about 10 ounces
Blood takes about 20 seconds to Circulate throughout the entire vascular system

The aorta, the largest artery in the body, is almost the diameter of a garden hose. Capillaries, on the other hand, are so small that it takes ten of them to equal the thickness of a human hair.
Every day 2,700 people die of heart disease
Coronary heart disease is the most common type of heart disease. In 2005, 445,687 people died from coronary heart disease

Coronary Arteries

The heart is composed primarily of cardiac muscle tissue that continuously contracts and relaxes, so it must have a constant supply of oxygen and nutrients. The coronary arteries are the network of blood vessels that carry oxygen- and nutrient-rich blood to the cardiac muscle tissue.
Two coronary arteries, referred to as the "left" and "right" coronary arteries, emerge from the beginning of the aorta, near the top of the heart.
The initial segment of the left coronary artery (LAD) is called the left main coronary. It branches into two slightly smaller arteries: the left anterior descending (LAD)coronary artery and the left circumflex coronary artery.
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