A Heartfelt Analogy

The heart is an amazing organ that can have various issues. Over the 22 years practicing as a Cardiology Nurse Practitioner, I have found a relatively straight-forward way to describe an individual’s diagnosis by using my “Heart as a House” analogy.

I literally start each conversation as, “Think of your heart as a house.” I describe the house as having four rooms: two smaller rooms upstairs and two large rooms downstairs. They represent the four chambers of the heart: two atria and two ventricles. Then, I describe the house’s four doors. Two doors connect the rooms upstairs to the rooms down stairs. A third door leads to a filtration area (the lungs), and the fourth door leads to outside the house (to the body). These four doors are the valves.

I review with the individual whether or not their doors function properly. Do they open all the way? Do they close tightly? Are the hinges intact? Is the door stenosed or abnormally narrowed? Problems with the structure of the valve relate to valves leaking.

I review wall structure and function. Is it weak? We talk about the pumping mechanism of the house. Sometimes I will describe a sump pump trying to get water out of a basement. Is it working correctly?

Then, I review the plumbing and the electrical systems of the house. The plumbing refers to the arteries on the outside of the heart, which allow the muscle to work properly. Using the description of plumbing allows an individual to visualize. When your sink pipes get “clogged,” sometimes there is residue stuck to the inside of the pipes that narrows them. They may need cleaning, rather than a sudden temporary clog that needs an urgent fix. This is an example of plaque buildup in the arteries. Some is from years of build up over time, while other times it’s a plaque rupture that clots and causes sudden onset of heart attack.

The electrical system in the house refers to a variety of possible arrhythmias of the heart. Examples include atrial fibrillation, an irregularly irregular rhythm that has no rhyme or reason. Often patients need a blood thinner to prevent stroke. Tachy-brady syndrome, refers to the combination of fast and slow heart rates. If persistent, the patient may require a pacemaker. There are more dangerous electrical problems that involve the bottom part of the heart and that may require further electrical intervention, such as automatic implantable defibrillator. The electrical issues within the heart may require further evaluation from a specialist in Cardiology called an Electrophysiologist.

It is important to remind ourselves that maintenance of our health is as important as the maintenance of our homes. The maintenance includes keeping our cholesterol in check, exercising, managing our weight, making healthy dietary choices, limiting alcohol intake, and quitting smoking.

Jennifer Thuermer, DNP, is a cardiology nurse practitioner at SVMC Cardiology, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care, in Bennington.