The heart is a strong muscle located in the middle of the chest, slightly to the left, and is protected by the sternum and ribs.
The heart works like a pump, allowing blood to circulate through the body. The heart beats about 100,000 beats a day.
Blood, pumped by the heart, supplies the body’s cells and tissues with oxygen and nutrients and carries away waste (harmful) substances.
On the inside, the heart has four cavities:
- right atrium (atrium)
- right ventricle
- left atrium
- left ventricle
The heart’s right side receives blood that comes from the body after supplying the tissues with nutrients and oxygen. This blood is “pumped” into the lungs, supplied with fresh oxygen. The blood then returns to the left side of the heart, from where it goes to the body, through the great main artery (aorta), and is distributed through the smaller arteries to all parts of the body.
The heart has 4 valves that ensure that the blood passes through the heart in one direction.
- tricuspid valve
- mitral valve
- pulmonary (pulmonary) valve
- aortic valve
The tricuspid and mitral valves control blood flow through the heart, while the pulmonary and aortic valves control blood flow from the heart.
Coronary arteries
Like any muscle, the heart needs oxygen and nutrients. The heart muscle receives blood with oxygen and nutrients through the coronary arteries, which are the first two branches of the aorta.
The two main coronary arteries (left and right) are located mostly in the anterior half of the heart:
- The left coronary artery begins with a wider, shorter part, which we also call the left coronary artery’s main stem. It is then divided into two larger arteries: the anterior left descending branch, which provides branches for the septum between the ventricles and most of the anterior wall and apex, and the bypass or circumflex artery, which feeds the posterior side of the left ventricle.
- The right coronary artery feeds the right side of the heart and has branches that extend to the back of the heart.
The coronary arteries divide into smaller branches so that each part of the heart muscle receives oxygen and nutrients.
Coronary heart disease
Coronary arteries may become narrowed due to the accumulation of fatty layers on the arteries’ walls (atherosclerosis). As a result, less blood flows through the arteries. If 75% of the coronary artery is narrowed, the heart muscle may not get enough blood and oxygen. In case the heart muscle does not receive enough blood and oxygen, more warning signs usually appear.
Warning signs:
- In the area of the chest, arms, neck, back, or jaw, you may feel the following:
- pain (angina)
- tension
- pressure
- burning, heat, or cramps
- You could also have a feeling of shortness of breath
- These “warning signs” or symptoms may occur when the heart is working harder than usual (e.g., during exercise) or after eating. You may also have symptoms at rest.
- If you notice any of the above symptoms, stop what you are currently doing, sit down, and follow the instructions:
- Take your nitro-glycerin (NTG) tablet or spray as you are told
- If you still feel pain after 5 minutes, take another NTG tablet/spray
- If you still feel pain after the next 5 minutes, take the third NTG tablet/spray
- If the pain has not subsided even 5 minutes after taking the third NTG tablet/spray, you may have a heart attack. If this happens, have someone take you to the nearest ambulance station. If you are alone, do not drive. Call 94, ask for help, and then sit or lie down and rest.
Remember: Symptoms of a heart attack are similar to angina but are generally more intense and long-lasting. In any case, if you notice these symptoms more often, consult a cardiologist or surgeon.
Risk factors for coronary artery disease
Certain factors are known to increase your chances of coronary artery disease.
Risk factors for coronary artery disease are:
- smoking
- high blood pressure
- high blood cholesterol
- diabetes
- disease in the family
- obesity (obesity over 20% overweight)
- lack of physical activity
- stress
Why are risk factors important?
It has been shown that changing or modifying risk factors can affect your health, as it can help reduce the risk of developing heart disease or slow the development of the disease.
What can I do?
You have the most important role in preserving your health! Here are some suggestions on how you can help yourself. Because you know you have heart disease, you may have already changed or modified some of your risk factors.
|
If |
Then |
|
Smoke |
Quit smoking |
|
You eat a lot of fatty foods. |
Reduce the amount of fat in your diet |
|
You have high blood pressure. |
Control your blood pressure |
|
You exercise little or not at all. |
Walk briskly (15-30 min.) 3-4 times a week. |
|
You are overweight |
Achieve a favorable body weight, according to your height and age |
Coronary artery bypass graft surgery (ACB) (Coronary Bypass)
- ACB surgery improves blood flow to the heart muscle, reduces (alleviates) symptoms, and improves heart function. Using a portion of the leg vein (saphenous vein) and/or the thoracic-thoracic artery (internal thoracic-thoracic artery), the surgeon bridges the narrowing or blockage in the coronary arteries.
The number of bridges you will have depends on the number of damaged arteries and the size and quality of the arteries behind the narrowing site. - When part of the leg vein is used, one end is sutured to the aorta and the other to the coronary artery below the blockage (blockage).
- When the internal thoracic artery is used, one end is attached to the aorta’s left branch, while the other is sutured to the coronary artery below the blockage.
- Oxygen-enriched blood can then pass through the transplanted portion to the heart muscle area behind the site of narrowing or blockage.
Note: narrowed or clogged arteries are not removed.
Heart valve disease
- Normal heart valves are thin, smooth structures that direct blood through the heart cavities and prevent them from returning.
- Over time, damage or thickening of the heart valve can occur. Due to these changes, the valves are harder to open (stenosis) or do not close completely (insufficiency). Heart valves may be altered or damaged:
- due to a congenital anomaly
- due to infections
- cause of rheumatic fevers or scarlet fever
- Aortic and mitral valves are most commonly damaged. These valves control the blood through the main ventricle (left ventricle).
- When the valves do not open and close as they should, less blood passes, or it returns. As a result, the heart works harder to pump blood into the body. If the heart is unable to do so, heart failure occurs.
- After heart failure, the heart cannot pump blood as it should, and blood is not drained from the heart. Blood lags in the lungs and other parts of the body. As a result, you may be short of breath, swollen legs, feet, dry cough, or extreme fatigue. If the heart valves do not work properly, an enlargement of the heart can occur over time.
- Abnormal valves can also cause irregular heartbeat or blood clots forming in the heart.
- When medications no longer help with heart failure or do not improve pumping the heart, surgery is often needed to repair or replace the valve.
Heart valve surgery
- When possible, your own valve is repaired. Otherwise, you must replace it. Some people feel better immediately after surgery due to the relief of symptoms. However, most people need several months to begin to feel the positive effects of heart surgery. The heart needs some time to recover from the strenuous work before surgery. For this reason, your doctor may ask you to continue taking some medications and adhere to a certain diet.
- When a heart valve needs to be replaced, a mechanical or biological valve is used.
- Whether you have a biological or mechanical valve, there is a risk of infection. If you undergo dental, urological, or unclean surgical procedures after implanting an artificial valve, you will need to be given antibiotics as a precaution.
- Before each of the above procedures, tell your doctor (dentist, surgeon, etc.) that you have an artificial valve.
Other types of heart surgery
Coronary artery bypass grafting and valve surgery are the most common types of heart surgery. Below are some more types of heart surgeries you might have, related to heart problems.
Repair of atrial or ventricular septal defect
Some patients may need surgical closure of the opening.
The septum separates the atrium’s ventricles (atrial septal defect – ASD) or the ventricle (ventricular septal defect – VSD). VSD can occur as a result of damage caused by a heart attack. Some people may be born with ASD or VSD, which requires surgery in adulthood.
Aortic aneurysm surgery
The aorta can be the site of various diseases. The aorta may dilate or its inner layers may rupture to form an aneurysm (“bulge”), requiring surgical replacement with commercially available material.
Ventricular aneurysm surgery
Heart attacks (heart attacks) cause damage to the ventricle, which weakens the muscles of the wall and can cause protrusions on the walls of the ventricle (aneurysm). The aneurysm reduces the efficiency of the heart as a pump. This requires surgical removal of the aneurysm.
Myectomy – in HCM
The septum between the ventricles may increase. Excess tissue that blocks blood flow from the heart is removed
Myxoma removal
Sometimes the heart can be the seat of tumor tissue growth (myxoma) which can interfere with the functioning of the heart. This growth can be surgically removed.
Bental’s operation
This procedure involves replacing both the aortic valve and the ascending portion of the aorta.
Congenital heart defects
Some patients experience old age with a birth defect. These are less common situations, which require surgical therapy, which should be explained to you in more detail by the surgeon.
Combined operations
Some heart patients due to atherosclerosis have narrowing of the large carotid arteries. If the surgeon decides that narrowing of the jugular veins could compromise the results of heart surgery, the jugular veins are operated on before or during heart surgery.
Risks and complications of heart surgery
The decision to have heart surgery often involves weighing the benefits against the risks. The risks associated with different heart surgeries vary from one operation to another and depend on various factors, such as:
- patient age
- recent heart attack
- other health problems (e.g., kidney disease)
- condition of the heart muscle
- the number of heart valves that need to be repaired or replaced.
Your surgeon will explain the risks of surgery to you and compare the risks of surgery to the risks if you do not have surgery.
Heart surgery is a major operation that can lead to minor or major complications.
Your anesthesiologist will introduce you to the possible and expected risks and difficulties in the perioperative period.
Complications may include:
- bleeding
- irregular heartbeat
- wound infection
- breathing problems
- heart attack, stroke, or death
- heart rhythm problems that may result in the need for a permanent pacemaker.
Your surgeon will explain each of the possible complications.
Natural remedies to regulate heart problems
If used as a tea or food supplement, the so-called hot spices (ginger, cinnamon, cloves, and cayenne pepper) contribute to blood vessels’ health because they stimulate circulation, dilate blood vessels that supply blood to the extremities.
In the treatment of heart and blood vessel diseases, medicinal herbs are also used: hawthorn, bear’s onion, nettle, lemon balm, garlic, white mistletoe, prosciutto, flax, bitter gourd, etc.
Hawthorn is one of the most valuable natural remedies that strengthen the heart muscle, which regulates blood pressure and calms the heart muscle’s inflammatory processes. It is also effective in angina pectoris and atherosclerosis.
To regulate blood pressure, the following are used: garlic, bear onion, restavić, and olive oil.
Drink against angina pectoris and atherosclerosis
– 10 fresh primrose stalks (aboveground only),
– liter quality wine,
– 2 tablespoons of wine vinegar
– 300 g of honey.
Tea against inflammation of the heart sac
Mix 30g of called flowers, mountain ash, hawthorn, and 10g of rosemary. Two tablespoons of this tea mixture, pour 400 ml of cold water, cover, and leave to stand for 10-12 hours (overnight). Heat to boiling, cook for 2-3 minutes. Cool, strain, and drink 3 tablespoons three times a day.
