Hi guys, it’s Jarred for another blog post. Firstly, I am soon to go on a residential to James Cook Hospital in Middlesbrough, where i’ll be participating in not only the shadowing of many different Doctors and specialties, but also learning many clinical skills and useful bits of knowledge! I am really excited for this, so I’ll give you a run down on it after I have visited. But now, I was looking at the Health section of BBC news, and found as the headliner an interesting advancement in Cardiology. Hence, today, I will be talking about the specialization of Cardiology, the problem of heart disease and the advancement that I saw (along with other essential medical health methods).
So, firstly, two simple definitions to set up for the detailed information: A tissue is a group of specialized cells working together to perform a similar function, and an organ is a group of specialized tissues that work together to perform a particular function. These two together describe the basic anatomy of the heart, in that of the fact that the heart is an extremely important organ in the body, created from cardiac tissue. Now, the function of the heart is to act as a pump to push blood around the body under pressure (to supply the cells with oxygen), hence being a main organ in the body. The fact that the heart is made from cardiac tissue is really useful, as cardiac tissue is a special type of tissue that is known to be myogenic- as it can create it’s own electrical excitation (hence can beat without impulses from the brain). So, the heart is made up of 4 chambers, the right and left atria and ventricles, with the right and left side being separated by the septum, and the atria and ventricles being separated by the atrio-ventricular valves. Finally, on the structure of the heart, the heart functions with waves of electrical excitation that are produced in two pacemaker nodes (SAN- Sinoatrial node, and the AVN- atrioventricular node), these cause the contraction of both the atria and the ventricles by traveling down the conductive Purkyne fibres, hence being the reason for the heart acting as a pump, and why it is able to squeeze blood around the body.
Now, the heart can malfunction in many different and varied ways, with most of the consequences being fatal. The main ways that this can happen are:
1)Changes in the rhythm of the heart beat (eg. due to changes in the impulses) causing abnormal rhythms.
3)Blockages in the arteries surrounding the heart (eg. coronary or pulmonary) causing Heart Disease.
So firstly, the heart beat can be shown by an ECG (electrocardiogram) which shows the electrical activity of the heart, and hence, they can also be used to identify arrhythmic heartbeats. Now, arrhythmic heartbeats can be anything from too fast (Tachycardia- caused by either exercise, or by disruptions in the activity) to too slow (Bradychardia- which can sometimes be found in professional athletes, or when the electrical activity is not as often). It can also include ectopic heartbeats – which are random extra heartbeats or missed ones – and even atrial/ventricular fibrillation, which is the random, irregular contractions of either of these chambers. Now, some of these can be harmless, but more than often they can cause problems, so treatment is necessary.
The next problem with the heart tends to be damaged valves. So, there are two types of valve damage: valve stenosis (the valve doesn’t open properly) which results in partial blockage and restriction of blood flow, and valve incompetence (the valve doesn’t close properly) which results in leakage and therefore extra strain on the heart. The causes of this damage, are cardiomypathy (thickness and stiffness of the walls), general aging of the heart tissue, damage of tissue due to heart attack etc.
The final huge problem is Heart Disease! This is also known as coronary heart disease, as it is caused by the blockage of the coronary arteries, which supply the the heart with blood and oxygen, by fat and cholesterol. The fatty substances will continue to build up, into what is called an Atheroma/plaque, by a process known as atherosclerosis. This causes a huge problem, as it narrows the blood vessel, reducing the amount of blood and consequently the amount of oxygen getting to the heart tissues. Hence, the heart muscle can end up dying (or partially dying), or an even bigger problem can occur, a Myocardial Infarction- heart attack. This is serious, as it can be fatal. Now, the original build up of fatty substances is down to many reasons: smoking, hypertension, high cholesterol levels and diabetes. So, to reduce the chances of CHD, lifestyle changes could occur.
Now, problems with the heart are some of the hugest killers in Britain, with it, “being the number 1 killer in Britain.” So extensive help and treatments are developed to help/prevent the diseases. Firstly, Angioplasty can be used, this is basically the use of balloons and stents to widen blood vessels and arteries. This will help increase the amount of blood reaching the heart, but requires invasive surgery. Next, artificial valves can be fitted in patients hearts who have damaged ones. These will perform the exact same function as normal valves, so are extreme life savers, however again, they require invasive open-heart surgery. In addition to these, a common treatment for arrhythmic heartbeats is either medication (which helps control it), a pacemaker- which is used in controlling the rhythms by producing electrical excitation to help. Finally, Cardioversion is used. This uses a defibrillator to shock the heart carefully, to attempt to restore normality. Now, advancements are constantly being made in methods of treatment for heart problems and one that I recently saw in the news was called the MiniVAD (VAD=Ventricular assist device). Now, this is aimed at starting clinical trials in 2018, and is one of the first heart pumps to not cause damage to the blood it pumps. The VAD will be fitted into seriously ill patients who have failing hearts, hence allowing it to take over the function of the heart. Therefore, you can see that this is clearly very important advancement in medicine, as it has the potential to save many lifes, by being the first fully automatic and non-damaging pump.
In conclusion, I believe that heart problems, due to their frequency and high death rate, are an extremely important part of medicine and the medical community. They make up a huge number of surgery patients due to different treatments that can be used, especially the open-heart surgery that can often be used. Advancements in the area of Cardiovascular treatment is something that should, in my opinion, be of a priority as it will be an increasingly big problem over the years.
Cheers guys for taking the time to read this and i hope you can see what a huge problem this is and appreciate the complicated science behind it.