Friday, November 7, 2008

3. How the heart works

Had to spend some time to undertand how the heart works, before I could comprehend how it can fail.


The heart has two pairs of chambers or "rooms," the right atrium and ventricle, and the left atrium and ventricle. Oxygen-poor blood from the body is drawn through the vena cava into the right atrium. The right ventricle draws in this blood from the right atrium through the tricuspid valve, and then pumps it out through the pulmonary valve to deliver the oxygen-poor blood to the lungs through the pulmonary artery.

Oxygen enriched blood from the lungs return via the pulmonary veins and enters the left atrium. The left ventricle sucks in this blood through the mitral valve and pumps it out through the aortic valve, to the aorta which then supplies the oxygenated blood to various parts of the body, including the heart muscles.
When the heart's valves open and close, they make a "lub-DUB" sound that a doctor can hear using a stethoscope.
The first sound—the “lub”—is made by the mitral and tricuspid valves closing at the beginning of systole. Systole is when the ventricles contract, or squeeze, and pump blood out of the heart.
The second sound—the “DUB”—is made by the aortic and pulmonary valves closing at beginning of diastole. Diastole is when the ventricles relax and fill with blood pumped into them by the atria.

What is coronary artery disease?

Coronary artery disease occurs when fatty deposits called plaque builds up inside the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen from the aorta. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to your heart. This can lead to serious problems, including heart attack. Plaque is a fatty material made up of cholesterol, calcium, and other substances in the blood.


The accumulation of cholesterol plaque over time causes narrowing of the coronary arteries, a process called arteriosclerosis. Arteriosclerosis can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. When coronary arteries become narrowed by more than 50% to 70%, they can no longer meet the increased blood oxygen demand by the heart muscle during exercise or stress. Lack of oxygen to the heart muscle causes chest pain (angina).
An angiogram has to be done to identify the location and number of blocked arteries, and to determine the corrective actions required.

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