It is Valentines month, and everywhere you look, there are hearts, hearts and more hearts. Which is inaccurate, really, because when you say “I love you with all my heart” the technically correct way of saying it would actually be “I love you with all my hypothalamus, that tiny glob of neurons buried deep within the sulci and gyri of my brain.” Not very romantic though, as a bunch of roses go better with a red hot heart-shaped card than with a pale gray brain-shaped card.
Sad to say, but not all heart stories have happy endings. Many, if not all, have experienced some kind of heartbreak in their lives. So where do broken hearts go? Do they ever heal? And if they do, will they ever be as strong as before?
If you are looking for answers to the emotional kind of broken heartedness, perhaps this is not the article to read, because the focus of this column is on physical injury of the heart, definitely not the seat of strong emotion, but rather the power pump of the body, sending life giving blood, carrying oxygen and nourishment, to the top of the head, to the tips of the toes and to all other organ systems in between.
When the heart is injured, there are two possible results. Either the heart survives or it does not. The human body is amazing. Given the right environment and the right nutritional support, it has the ability to heal itself. Whether the heart lives or dies depends on a lot of factors, foremost of which is the magnitude of the initial insult. Insult, by the way, is a term used in medicine to mean any kind of event or condition that threatens the integrity and function of the body, in part or as a whole.
Insults to the heart can come in the form of faulty electrical wiring causing irregular rates and rhythms, direct injury like a stab or gunshot wound, pressure injury due to a tumor growth or accumulation of fluid in the special chamber containing the heart, or perhaps a congenital anomaly like a hole in any of the many walls of the heart.
The heart, being a blood pump, is constantly in contact with a lot of blood. Ironically, the most notorious insult to the heart is lack of blood. Not in its chambers, but in its muscles. The supplier of blood to the entire body needs its own blood supply. There is a special network of blood vessels, called the coronary arteries, dedicated to making sure the heart muscles have enough sustenance to do its literally lifelong work. Any compromise in this supply jeopardizes the entire blood delivery business.
If the “initial insult” is so great, the heart is unable to recover from the injury and it dies. People die of “massive heart attacks” but many survive “mild heart attacks”. Many babies are born with a “hole in their heart” but some babies are stillborn or survive for only a few hours because of severe inborn cardiac abnormalities.
So what determines who survives and who does not after heart injury, aside from magnitude and intensity of the initial insult? The first two important determinants of outcome would be heart preparedness and extent of actual damage incurred.
How healthy was the heart before the injury? A strong, healthy heart has a better chance of surviving injury. The following are wise moves to maintain a healthy heart: Eat a balanced diet, engage in regular exercise, get enough rest and relaxation, monitor blood pressure, blood sugar, cholesterol levels, stop smoking because nicotine constricts the coronary arteries and reduces blood flow to the heart, drink alcoholic beverages moderately, and stay within your ideal body weight.
There are two kinds of damage to heart muscle: ischemia and infarction. Ischemia is the lack of blood supply to heart muscle manifesting as chest pain, mandibular, upper extremity or abdominal discomfort, shortness of breath, palpitation, sudden fatigue, or excessive sweating. If not treated immediately, this can lead to a full blown heart attack. A myocardial infarction is the full blown heart attack. Heart muscle that is deprived of oxygen dies. It can no longer contract and pump blood. Heart failure ensues. The bigger the area that is infarcted, the poorer is the outcome.
The third important determinant of outcome would be how the initial insult was managed. There are now modern medicines and maneuvers that can support heart function at the time when the heart is very weak. The timely application of the proper medication under careful monitoring by a qualified physician is of utmost priority.
Now, if the heart survives, how strong can it be? Will it be as good as new? Stronger or weaker? How much physical activity will the survivor be able to do? To be continued….
__________________________________
Author’s email: bagacaycarm@gmail.com
