The Heart of the Matter

As Heart Month comes to an end, as The Titanic and Celine Dion taught us, your “heart will go on.” How does it do it though? The heart is a well-oiled machine and requires that a few different things are functioning properly. The heart’s function can be broken into 3 parts: 1) Electricity; 2) Plumbing; 3) Pumping. It’s a lot to coordinate and the good news is, you don’t have to remember to do any of it. For most people, your heart knows what to do.

1. The electricity is what tells the heart to beat at the right time. When normal, which is called sinus rhythm, it travels in a very specific way so that each part of the heart pumps at the right time. It starts in the top 2 chambers (called the atria) and travels down to the bottom 2 chambers (called the ventricles). When the electrical impulse goes through the heart muscle, it causes the muscle to contract resulting in the pumping of blood. Your heart is smart and does this on its own, but when the heart rhythm becomes abnormal, the condition is called an arrhythmia. Arrhythmias can be too fast, too slow, or just plain disorganized. The test that most commonly analyzes the heart’s rhythm is called an electrocardiogram, or EKG (also known as ECG).

EKG

2. The plumbing of the heart falls into 2 categories. The first is the pipes, called arteries, that bring oxygen-rich blood to the heart muscle so it has the energy to do its job. These coronary arteries, as they’re called, run along the surface of the heart. When blockages develop such as the ones that cause heart attacks, it refers to blockages in these arteries. When not enough blood can get through, the heart muscle doesn’t get enough oxygen. This condition is known as ischemia. The clogs that develop and cause this take years to do so and are the result of cholesterol, inflammation, and fat. The most common test to diagnose blockages in the arteries without doing an invasive procedure is called a stress test, which involves analyzing your heart during exercise. Exercise requires your heart to work harder, so any significant blockages will become more obvious during a stress test. This is also why people with significant blockages can get certain symptoms such as chest discomfort during exercise.

Stress test

The second type of plumbing issue is of blood flowing through the heart’s chambers properly. In order to do that, the heart has one-way valves between each of the chambers. The order of blood flow is as follows: blood comes from the body into the right atrium -> goes through a valve (tricuspid valve) to the right ventricle -> through another valve (pulmonic valve) to the lungs where the blood picks up oxygen and gets rid of carbon dioxide -> comes back to the left atrium -> goes through another valve (mitral valve) to the left ventricle -> and goes through the last valve (aortic valve) before it enters the aorta and gets distributed to the different organs and tissues of the body. When the valves aren’t working, either because of infections, inflammation, or other reasons, blood can go backwards in the circuit. As you can tell, plumbers – I mean Cardiologists – may be necessary to help diagnose and treat these issues. The test that’s usually used to look at the heart valves is an ultrasound video of the heart called an echocardiogram.

Heart cartoon

3. The pump function of the heart depends on the ability of the muscle to contract properly when it’s told to do so by the electrical system. If it’s weak, from heart attacks, infection, inflammation, or arrhythmias, it can cause a variety of symptoms. An echocardiogram is also the test that is usually used to check for these types of issues.

Echo 2 picture

Now that you know all the hard work your heart does for each and every beat, treat it well so it can last for many years to come. Say thanks to it… from the bottom of your heart!

If you have questions about your heart, send us a message.

 

Published by: Mark P. Abrams, MD

I'm an Internist, Educator, and Cardiology fellow in training. As the Director of Patient Engagement at Heartbeat Health, my goal is to make trustworthy information easily accessible and more available so that people can become more active members of their healthcare teams. By joining together, we can work toward keeping more people healthier, happier, and living longer fulfilling lives.

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