Heart Problems: How Did I Get Here?
The Structure of Your Heart
In the middle of your chest tilted slightly to the left, you have an amazing, mostly hollow, pumping machine about the size of a clenched fist. It is divided into two parts by the septum, a thick band of muscle tissue.
The right side of your heart receives blood returning from the organs of your body. It then pumps it to your lungs where your blood receives a fresh supply of oxygen and releases carbon dioxide, a waste product.
The left side of your heart receives the oxygen rich blood from your lungs and pumps it out to your body through the major artery, your aorta. The left side of your heart is thicker because it has to supply blood to your whole body while the right's job is just to send it to your lungs.
There are four chambers within your heart. The upper two are called atria, where your blood is briefly stored when returning to your heart. The atria then send your blood to the lower chambers, the ventricles, the main pumping chambers of your heart.
The blood flows from the upper to the lower chambers of your heart through valves that work as one-way doors. The blood passes through them in only one direction. Four valves regulate the flow of blood from one part of the heart to another, the mitral, the aortic, the pulmonary, and the tricuspid.
Where does your heart get its own oxygen?
From the coronary arteries that surround the heart muscle and pump blood into every portion of it. The right coronary artery supplies blood to the right and left sides of your heart. The left main coronary artery has two main branches - the left anterior descending artery, which feeds the front left side of the heart, and the circumflex artery that feeds the back of your heart. These main coronary arteries have many branches that supply your heart muscle with oxygen-rich blood.
The term "heart attack" or myocardial infarction refers to damage to the heart muscle due to complete blockage of a coronary artery. It can be caused by a blood clot plugging the coronary artery (coronary thrombosis) or a severe narrowing or obstruction in the coronary arteries (coronary artery disease) or a combination of both.
We know that clots are more likely to occur in narrowed or blocked arteries. These blockages, which interfere with the blood flow to the heart muscle, decrease the oxygen supply. When there is total blockage of blood flow, a part of the heart muscle is without oxygen. This can cause damage to the muscle and is called a heart attack.
With procedures such as clot reducing medicine and angioplasty, heart damage can be kept to a minimum if the patient comes to the hospital immediately. If the heart is permanently damaged because of a lack of oxygen, a scar forms as the heart heals. Severe damage to the heart leads to a condition known as heart failure.
Angina pectoris is Latin for "chest pain". It is the heart's way of telling us that it needs more oxygen rich blood during or shortly after physical exertion, a stressful event, cold weather, or a large meal. Chest pain may even occur during rest. Angina is not a heart attack and it does not cause permanent damage to the heart unless it continues for more than approximately 20 minutes, and is not relieved by rest or nitro-glycerin.
Angina is a symptom of a temporary lack of blood flow to the heart muscle. Some people have occasional chest pain or discomfort and never have a heart attack. Others have silent ischemia (a lack of blood flow but no pain) and can go on to experience a heart attack.
Coronary Artery Disease
Coronary artery disease or atherosclerosis is a process in which small fatty layers (plaque) are deposited over many years along the inner wall of the artery. The constant depositing of plaque narrows the vessel and can eventually close off the flow of blood through the coronary arteries. This can be caused by high blood pressure, smoking, high cholesterol levels and diabetes.
Coronary Artery Bypass Surgery
A surgical procedure where blood vessels from another part of the body, usually a vein from the leg or an artery foun in the chest, is used to bypass the blocked coronary artery. This procedure allows detoured blood to reach the heart muscle beyond the blockage.
A thin, flexible tube with a balloon at the tip is threaded through an artery in the groin or arm and guided to the narrowed cornoary artery. Then a device - a balloon catheter - is used to open the narrowed artery allowing more blood to flow to the heart muscle.
During an angioplasty procedure, a small wire mesh tube, known as a stent, is sometimes permanently placed inside an artery, at the site of the original blockage. The stent pushes against the inner wall of the artery to help keep it open, which helps to improve blood flow and relieve the symptoms of the blockage. Some stents are also coated with a medication to help prevent further blood clotting and to help maintain adequate blood flow through the artery.
It's easy to deny warning signs and symptoms. Even if you have had a heart attack, it's wise to review the warning signs of a heart attack or angina:
- Pain or discomfort - a feeling of heavy pressure, squeezing or burning in the chest, back, neck, arms, jaw or shoulders.
- Unusual shortness of breath.
- Weakness, dizziness or fainting associated with the pain or discomfort as described above.
- Unusual sweating.
- Rapid or irregular heartbeat.
- A vague feeling of anxiety or doom.
Remember: Seek immediate medical attention if any of these symptoms are a new occurence or are not relieved by rest or nitroglycerin. Seek the advice of your physician if unexpected mild episodes of angina or chest pain occur.
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