Understanding Your Heart Condition

HeartHouseIcon300X200Among our friends and neighbors, it is not uncommon to hear that someone has “heart trouble” or a “heart condition.” But why? They might share that they have congestive heart failure or hypertension or that they need a pacemaker. For patients and the people who love them, figuring out what is going on can be difficult.

In this case, it is helpful to turn to a metaphor. The heart is surprisingly like a house. We all live in houses. Some of us spend a great deal of time repairing them. Because we have so much familiarity with houses, envisioning the heart as a house is a good way to explain many heart conditions.

Like houses, hearts have rooms and doors. The heart has four rooms: the right atrium, left atrium, the right ventricle, and the left ventricle. It has four doors, the valves. Two of the valves connect the atria with the ventricles, one valve connects the left ventricle out through the body (via the aorta), and the fourth valve connects the right ventricle to the lungs. The anatomy is quite simple when we think of it in this way.

Just like a house, the heart is made up of three main systems: plumbing, electrical, and carpentry. The most common heart conditions can be traced to a problem with one of these three systems.

Plumbing. The heart receives critical oxygen through arteries. Arteries are like the pipes and plumbing of the house. If there is a blockage—no different than a hair clog—in the coronary arteries, it causes a heart attack. The heart cannot get the oxygen it needs to work.

Symptoms can come on suddenly or over time and vary in severity. If you have chest pain, which can be in any region of the upper body, both right and left sided, and shortness of breath, contact your doctor, call 9-1-1 or go immediately to the Emergency Department. Lack of oxygen to the heart—over as little as a few minutes—can cause damage to the heart.

Electrical. Most people’s hearts beat involuntarily at regular intervals. Adult hearts usually beat between 60 and 100 times per minute. This beating is a result of electrical impulses. Someone with trouble in the electrical system of their heart might find that their heart beat in unexpected ways.

A problem with the rate or rhythm of the heartbeat is called arrhythmia. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. Atrial fibrillation is the most common type of arrhythmia. If a heart is beating too slowly, without having impact from medications, it may cause a person to feel poorly. In some circumstances, a pacemaker may be indicated. A pacemaker is a metaphorical upgrade to the electrical system.

Carpentry. If you have a problem with the walls or doors of your heart, we would consider it carpentry. One of the most common heart problems in this category is leaking valves. Using the house metaphor, you can imagine that the doors of your heart are not closing properly. (Who hasn’t had a door that wouldn’t open or shut?) When the problem gets serious enough, patients may need to have their valves, or “doors,” repaired or replaced.

Like problems we find in our houses, heart problems can be caused by several factors, including congenital (something you were born with), biological (the effect of a bacterial or viral pest), or chemical (like chemotherapy). The same problems in a house problems might be imagined as weathered wood.

For both houses and people, the most common cause of problems is behavior. If you live in your house for a long time without cleaning and conducting general maintenance, your house will slowly break down. For hearts, general maintenance is eating a healthy diet and getting enough exercise.

Living a sedentary lifestyle and eating foods high in sugar, fat, and LDL (the bad) cholesterol cause arteries to harden and become clogged. Just as you have your furnace maintained and your gutters cleaned at home, be sure to get a regular checkup. Talk to your healthcare provider today to learn about your blood pressure, cholesterol, blood sugar, and body mass index. Each of these numbers will help you and your provider assess your risk and determine what you may need to do differently to ensure your heart health.

Jennifer Thuermer, DNP, ACNP, AACC, is a provider in the Cardiology practice at Southwestern Vermont Medical Center in Bennington, VT. “Health Matters” is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care.