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The Heart



1. The Heart

Your heart works as a pump that pushes blood to the organs, tissues, and cells of your body. Blood delivers oxygen and nutrients to every cell and removes the waste products made by those cells. Blood is carried from your heart to the rest of your body through a complex network of arteries, arterioles, and capillaries. Blood is returned to your heart through venules and veins.

The heart weighs between 7 and 15 ounces and is a little larger than the size of your fist. By the end of a long life, a person's heart may have beat (expanded and contracted) more than 3.5 billion times. In fact, each day, the average heart beats 100,000 times, pumping about 2,000 gallons of blood.

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Your heart has 4 chambers. The upper chambers are called the left and right atria, and the lower chambers are called the left and right ventricles. A wall of muscle called the septum separates the left and right atria and the left and right ventricles. The left ventricle is the largest and strongest chamber in your heart. Its half-inch thick chamber walls have enough force to push blood into your body.


2. How does the heart receive notice to beat?

The heart has its own electrical system, like a battery. This special electrical conduction system tells it to beat (contract) in a regular, coordinated and effective way. The electrical impulse starts in the right atrium. The impulse spreads throughout the atria, causing them to contract. Next, the impulse moves to the ventricles. As the impulse travels down the fibers, the ventricles contract. The cycle then repeats itself. Your heart rate may still change depending on physical demands, stress, or hormonal factors. At night the heart will beat slowly, and during exercise it will beat faster.
 



ARRHYTHMIA



3.What is an arrhythmia?

The regular cycle of atria contractions, followed by ventricular contractions, pumps blood effectively out of the heart. Problems may occur anywhere in the electrical system and interfere with effective pumping of blood. The heart may beat too fast (tachycardia), too slow (bradycardia), or irregularly. These abnormal beats are known as arrhythmias. The arrhythmia may come from either the top or the bottom chambers. During an arrhythmia a patient may notice different sensations: he may feel nothing, the heart pounding or fluttering, a heaviness in the chest, shortness of breath. However, when the arrhythmia is so severe that the heart is not able to pump the blood efficiently, the patient may experience a fainting spell and even die. This can happen if the heart beats too slow or too rapidly.

4. What is the treatment for an arrhythmia?

Special studies of the heart's electrical system may be needed to find the type of arrhythmia. Treatment for arrhythmias is based on their type and any difficulties they cause. Treatment may include medication, cardiac catheterization, placement of a pacemaker, or even surgery.

5. How do I know if I have an arrhythmia?

There are different tests, but the doctor will probably start by asking a few questions, listening to your heart and doing an electrocardiogram.

6. Can I inherit an arrhythmia from my parents?

There are some arrhythmias that may be inherited, like long QT, Brugada syndrome and atrial fibrillation. This means that if your parents have the arrhythmia you have a higher chance of also having it.



BRUGADA SYNDROME


7. What is Brugada syndrome?

This is an inherited arrhythmia that causes the bottom chambers of the heart (the ventricles) to beat so fast that they can prevent the blood from circulating efficiently in the body. When this situation occurs (called ventricular fibrillation), the individual will faint and may die in a few minutes if the heart is not reset. While this is a disease that usually affects people in their 30's, it has actually been described at all ages. So it is important to screen everybody in a family. Not everybody who has the disease will have arrhythmias. However, we can not know yet who will be OK and who will have problems. If you have had fainting spells related to Brugada syndrome, our experience indicates that you are at very high risk of having them again.

8. How common is Brugada syndrome?

It is very difficult to know because it was only described 10 years ago. It is found all over the world and in some countries in Asia is the most common cause of death in young people after car accidents.

9. Is there any medication for Brugada syndrome?

Not yet. Brugada syndrome was discovered 10 years ago, and there is no medication to prevent the black outs yet.

10. Is there anything that resets the heart when it beats too fast?

Yes, there is a special pacemaker, called defibrillator, that when used in patients that have Brugada syndrome and black outs, jump-starts the heart every time it malfunctions. All the patients who have a defibrillator are doing well.

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11. If one of my parents or siblings has Brugada syndrome what do I need to do?

Brugada syndrome may be inherited, that means passed from parents to children. So it is important that you follow some important steps:

  • Contact your physician who will probably perform a physical exam and an electrocardiogram. Brugada syndrome can be seen in few occasions right away in the electrocardiogram, but sometimes, to see it, it requires the infusion of a medication.
  • If the electrocardiogram shows Brugada syndrome or if you had some signs that your heart malfunctions, like loss of consciousness, fainting, passing out, your physician may advise you to undergo an EP test. This is a test that checks your heart's electrical activity and whether there is any malfunction.
  • Because Brugada syndrome is inherited, the physician may request that you give a blood sample to perform genetic analysis in you and your family.

    Talking to your physician is the first thing to do and he will advise you

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