Chapter 1: Introduction To Heart

The Heart (Heading)

Your heart is a muscular organ that pumps blood to your body. Your heart is at the center of your
circulatory system. This system consists of a network of blood vessels, such as arteries, veins,
and capillaries. These blood vessels carry blood to and from all areas of your body.

An electrical system controls your heart and uses electrical signals to contract the heart's walls.
When the walls contract, blood is pumped into your circulatory system. Inlet and outlet valves in
your heart chambers ensure that blood flows in the right direction.

Anatomy of the Heart (Heading)

Your heart is located under your ribcage in the center of your chest between your right and left
lungs. Its muscular walls beat, or contract, pumping blood to all parts of your body.

The size of your heart can vary depending on your age, size, and the condition of your heart. A
normal, healthy, adult heart usually is the size of an average clenched adult fist. Some diseases
can cause the heart to enlarge.

The Exterior of the Heart (Sub-heading)

Below is a picture of the outside of a normal, healthy, human heart.

Heart Exterior (figure caption)

Figure A shows the location of the heart in the body. Figure B shows the front surface of the
heart, including the coronary arteries and major blood vessels.

In figure B, the heart is the muscle in the lower half of the picture. The heart has four chambers.
The heart's upper chambers, the right and left atria (AY-tree-uh), are shown in purple

The Right Side of Your Heart (Sub-Sub-heading)

In figure B above, the superior and inferior vena cavae are shown in blue to the left of the heart
muscle as you look at the picture. These veins are the largest veins in your body.

After your body's organs and tissues have used the oxygen in your blood, the vena cavae carry

The Left Side of Your Heart (Sub-Sub-heading)

Oxygen-rich blood from your lungs passes through the pulmonary veins (shown in red to the
right of the left atrium in figure B above). The blood enters the left atrium and is pumped into the
left ventricle.

From the left ventricle, the oxygen-rich blood is pumped to the rest of your body through the
aorta. The aorta is the main artery that carries oxygen-rich blood to your body.

The Interior of the Heart (Sub-heading)

Below is a picture of the inside of a normal, healthy, human heart.

Heart Interior (figure caption)

Figure A shows the location of the heart in the body. Figure B shows a cross-section of a healthy
heart and its inside structures. The blue arrow shows the direction in which oxygen-poor blood
flows through the heart to the lungs. The red arrow shows the direction in which oxygen-rich
blood flows from the lungs into the heart and then out to the body.

Heart Chambers (Sub-Sub-heading)

Figure B shows the inside of your heart and how it's divided into four chambers. The two upper
chambers of your heart are called the atria. They receive and collect blood.

The two lower chambers of your heart are called ventricles. The ventricles pump blood out of
your heart to other parts of your body.

The Septum (Sub-Sub-heading)

An internal wall of tissue divides the right and left sides of your heart. This wall is called the
septum. .

Heart Valves (Sub-Sub-heading)

Figure B shows your heart's four valves. Shown counterclockwise in the picture, the valves
include the aortic (ay-OR-tik) valve, the tricuspid (tri-CUSS-pid) valve, the pulmonary valve,
and the mitral (MI-trul) valve.

Blood Flow (Sub-Sub-heading)

The arrows in figure B show the direction that blood flows through your heart. The light blue
arrow shows that blood enters the right atrium of your heart from the superior and inferior vena
cavae. From the right atrium, blood is pumped into the right ventricle. From the right ventricle,
blood is pumped to your lungs through the pulmonary arteries.

The light red arrow shows oxygen-rich blood coming from your lungs through the pulmonary
veins into your heart's left atrium. From the left atrium, the blood is pumped into the left
ventricle. The left ventricle pumps the blood to the rest of your body through the aorta.

Heart Contraction and Blood Flow (Heading)

The animation below shows how your heart pumps blood. Click the "start" button to play the
animation. Written and spoken explanations are provided with each frame. Use the buttons in the
lower right corner to pause, restart, or replay the animation, or use the scroll bar below the
buttons to move through the frames.
Heartbeat (Sub-heading)
Almost everyone has heard the real or recorded sound of a heartbeat. When your heart beats, it
makes a "lub-DUB" sound. Between the time you hear "lub" and "DUB," blood is pumped
through your heart and circulatory system.

A heartbeat may seem like a simple, repeated event. However, it's a complex series of very
precise and coordinated events. These events take place inside and around your heart.

Pumping Action (Sub-heading)

Your heart uses its four valves to ensure your blood flows in only one direction. Healthy valves
open and close in coordination with the pumping action of your heart's atria and ventricles.

Each valve has a set of flaps called leaflets or cusps that seal or open the valve. The cusps allow
pumped blood to pass through the chambers and into your blood vessels without backing up or
flowing backward.

Oxygen-poor blood from the vena cavae fills your heart's right atrium. The atrium contracts
(atrial systole). The tricuspid valve located between the right atrium and ventricle opens for a
short time and then shuts. This allows blood to enter the right ventricle without flowing back into
the right atrium.

Taking Your Pulse (Sub-heading)

When your heart pumps blood through your arteries, it creates a pulse that you can feel on the
arteries close to the skin's surface. For example, you can feel the pulse on the artery inside of
your wrist, below your thumb.

You can count how many times your heart beats by taking your pulse. You will need a watch
with a second hand.

Circulation and Blood Vessels (Heading)

Your heart and blood vessels make up your overall blood circulatory system. Your blood
circulatory system is made up of four subsystems.

Arterial Circulation (Sub-heading)

Arterial circulation is the part of your circulatory system that involves arteries, like the aorta and
pulmonary arteries. Arteries are blood vessels that carry blood away from your heart. (The
exception is the coronary arteries, which supply your heart muscle with oxygen-rich blood.)
Healthy arteries are strong and elastic (stretchy). They become narrow between heartbeats, and
they help keep your blood pressure consistent. This helps blood move through your body.

Venous Circulation (Sub-heading)

Venous circulation is the part of your circulatory system that involves veins, like the vena cavae
and pulmonary veins. Veins are blood vessels that carry blood to your heart.

Veins have thinner walls than arteries. Veins can widen as the amount of blood passing through
them increases.

Capillary Circulation (Sub-heading)

Capillary circulation is the part of your circulatory system where oxygen, nutrients, and waste
pass between your blood and parts of your body.

Pulmonary Circulation (Sub-Sub-heading)

Pulmonary circulation is the movement of blood from the heart to the lungs and back to the heart
again. Pulmonary circulation includes both arterial and venous circulation.

Oxygen-poor blood is pumped to the lungs from the heart (arterial circulation). Oxygen-rich
blood moves from the lungs to the heart through the pulmonary veins (venous circulation).

Your Heart's Electrical System (Heading)

The animation below shows how your heart's electrical system works. Click the "start" button to
play the animation. Written and spoken explanations are provided with each frame. Use the
buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar
below the buttons to move through the frames..

ECG Waveform (figure caption)

Your heart's electrical system is made up of three main parts:

 The sinoatrial (SA) node, located in the right atrium of your heart
 The atrioventricular (AV) node, located on the interatrial septum close to the tricuspid
valve
 The His-Purkinje system, located along the walls of your heart's ventricles

A heartbeat is a complex series of events. These events take place inside and around your heart.
A heartbeat is a single cycle in which your heart's chambers relax and contract to pump blood.
This cycle includes the opening and closing of the inlet and outlet valves of the right and left
ventricles of your heart.

Each heartbeat has two basic parts: diastole and systole. During diastole, the atria and ventricles
of your heart relax and begin to fill with blood.

At the end of diastole, your heart's atria contract (atrial systole) and pump blood into the
ventricles. The atria then begin to relax. Your heart's ventricles then contract (ventricular
systole), pumping blood out of your heart.

Heart Disease (Heading)

Your heart is made up of many parts working together to pump blood. In a healthy heart, all the
parts work well so that your heart pumps blood normally. As a result, all parts of your body that
depend on the heart to deliver blood also stay healthy.

The table 1 below represents the percentage of Men with high cholesterol and prevalence of
CHD from years 1994 to 2006.

Table 1: Statistical Analysis on Heart Diseases

Heart disease can disrupt a heart's normal electrical system and pumping functions. Diseases and
conditions of the heart's muscle make it hard for your heart to properly pump blood.

Damaged or diseased blood vessels make the heart work harder than normal. Problems with the
heart's electrical system, called arrhythmias (ah-RITH-me-ahs), can make it hard for the heart to
pump blood efficiently.

Arrhythmia (Sub-heading)
An arrhythmia (ah-RITH-me-ah) is a problem with the rate or rhythm of the heartbeat. During an
arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.

Outlook (Sub-Sub-heading)

There are many types of arrhythmia. Most arrhythmias are harmless, but some are not. The
outlook for a person who has an arrhythmia depends on the type and severity of the arrhythmia.

Even serious arrhythmias often can be successfully treated. Most people who have arrhythmias
are able to live normal, healthy lives.

Heart Attack (Sub-heading)

A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle suddenly
becomes blocked. If blood flow isn't restored quickly, the section of heart muscle begins to die.

Heart attacks are a leading killer of both men and women in the United States. The good news is
that excellent treatments are available for heart attacks. These treatments can save lives and

Overview (Sub-Sub-heading)

Heart attacks most often occur as a result of coronary heart disease (CHD), also called coronary
artery disease. CHD is a condition in which a waxy substance called plaque (plak) builds up
inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

When plaque builds up in the arteries, the condition is called atherosclerosis (ath-er-o-skler-O-
sis). The buildup of plaque occurs over many years.
 Heart with Muscle Damage and a Blocked Artery (figure caption)

Figure A shows a heart with dead heart muscle caused by a heart attack. Figure B is a cross-
section of a coronary artery with plaque buildup and a blood clot.

A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The
spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't
affected by atherosclerosis.

Heart attacks can be associated with or lead to severe health problems, such as heart failure and
life-threatening arrhythmias (ah-RITH-me-ahs)..

Get Help Quickly (Sub-Sub-heading)

Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your
heart. Treatment works best when it's given right after symptoms occur.

Heart attack symptoms include:

 Chest pain or discomfort. This involves uncomfortable pressure, squeezing, fullness, or pain in
the center or left side of the chest that can be mild or strong. This discomfort or pain often lasts
more than a few minutes or goes away and comes back.
 Upper body discomfort in one or both arms, the back, neck, jaw, or upper part of the stomach.

Symptoms also may include sleep problems, fatigue (tiredness), and lack of energy.

If you think you or someone else may be having a heart attack, call 9–1–1 right away. Quick
treatment can save your life.
Outlook (Sub-Sub-heading)

Each year, about 1.2 million people in the United States have heart attacks, and many of them
die. CHD, which often results in heart attacks, is the leading killer of both men and women in the
United States.

Heart Block (Sub-heading)

Heart block is a problem that occurs with the heart's electrical system. This system controls the
rate and rhythm of heartbeats. ("Rate" refers to the number of times your heart beats in a minute.
"Rhythm" refers to the pattern of regular or irregular pulses produced when the heart beats over
time.)

With each heartbeat, an electrical signal spreads across the heart from the upper to the lower
chambers. As it travels, the signal causes the heart to contract and pump blood. This process
repeats with each new heartbeat.

Overview (Sub-Sub-heading)

Heart block is a type of arrhythmia (ah-RITH-me-ah). An arrhythmia is any problem with the
rate or rhythm of the heartbeat.

Some people are born with heart block, while others develop it during their lifetimes. If you're
born with the condition, it's called congenital (kon-JEN-i-tal) heart block. If the condition
develops after birth, it's called acquired heart block.

Congenital heart block may be found before or after a baby is born. Certain diseases that may
occur during pregnancy can cause heart block in a baby. Some congenital heart defects also can
cause congenital heart block. These defects are problems with the heart's structure that are
present at birth. Often, doctors don't know what causes these defects.

Outlook (Sub-Sub-heading)

The symptoms and severity of heart block depend on which type you have. First-degree heart
block may not cause any severe symptoms.

Second-degree heart block may result in the heart skipping a beat or beats. This type of heart
block also can make you feel dizzy or faint.

Third-degree heart block limits the heart's ability to pump blood to the rest of the body. This type
of heart block may cause fatigue (tiredness), dizziness, and fainting. Third-degree heart block
requires prompt treatment because it can be fatal.