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The heart is a hollow muscular organ the size of a fist. It lies in the center of the chest, slightly to the left and under the sternum or breastbone.
The heart’s function is to pump blood containing oxygen and nutrients to all parts of the body. The heart is divided into four chambers (two atriums and two ventricles). The right side of the heart receives "used" blood from the body and pumps it to the lungs, where it picks up oxygen. The oxygen-rich blood then returns to the left side of the heart and is pumped through the aorta to all parts of the body.
There are four valves in the heart. These are located between the upper and lower chambers of the heart and in the major blood vessels of the heart. The valves keep blood pumping in one direction.
At rest, a heart beats an average of 60–100 times a minute. Each beat or contraction is caused by an electrical stimulus triggered by specialized cells called the SA node. The electrical impulse from the SA node travels through a series of fibers located throughout the heart chamber and causes a contraction of the heart muscle.
Coronary angioplasty (PTCA) and stent insertion is a method used to open a blockage in a coronary artery from inside the artery. Like an angiogram, a long tube or catheter is threaded through to the heart from the artery in the groin or arm. The catheter used has a special balloon at the tip. The balloon catheter is threaded down the coronary artery containing the blockage. The balloon is inflated at the blockage and compresses the plaque of cholesterol, thereby opening a new channel for blood flow. Where possible, an expandable metal tube (stent) is implanted in the blockage, using the balloon catheter. The stent acts like a scaffold in the blockage and provides a better opening in the artery.
Open Heart Surgery is done when normal circulation is changed by coronary artery disease, heart valve disease, or other heart problems. Common heart surgeries are:
Coronary artery surgery is done to bypass each narrowed artery with a healthy vein or artery from your body. A leg vein (usually the saphenous vein) or an artery from your chest (internal mammary artery) and from your arm (radial artery) or Gastroepiploic artery can be used for the bypass graft. Your doctor will decide on what type of graft to use depending on the number and location of your blockages. The bypass increases blood flow to the heart muscle to relieve angina and improve heart function.
The valves can be abnormal or damaged by birth defects, infection (rheumatic fever or scarlet fever) and degeneration from aging. When scarring or thickening occurs, this makes the valves harder to open (stenosis) or unable to close completely (insufficiency). A damaged heart valve may be repaired but more often it must be replaced with a mechanical or tissue valve.
The atrial septum is the wall that divides the upper chambers (atria) of the heart. An atrial septal defect (ASD) is an opening in this wall "hole in the heart" that fails to close during fetal development. The surgery is designed to repair this hole so that blood will follow the normal pathway through the heart chambers.
A complete physical examination can help determine if you have or may develop heart disease. Your medical history is also important. Questions about smoking history, alcohol intake and exercise habits, will be asked. Information about your health history as well as a history of your family's health will also be important.
ECG is short for Electrocardiogram, which measures the heart's electrical beating pattern. Electrodes are placed on the chest wall to pick up the electrical impulses, which are then printed on a graphed paper. A similar pattern is seen in normal functioning hearts. A change in this pattern may indicate that an area of the heart is injured or damaged. This is a very simple procedure and can be easily performed in any doctor’s office.
A stress test is similar to a resting ECG test in that a series of leads are attached to your chest. However, the recording is made while exercising, such as walking on a treadmill or riding a stationary bicycle. This exercise intensifies the demands on your heart by increasing your heart rate and blood pressure. This test is used to evaluate the heart's response to physical stress, including: electrical abnormalities, the amount of blood flowing to the heart muscle, and the heart muscle's response to exercise.
Cardiac enzymes are substances normally stored in heart muscle cells. When the heart is damaged, enzymes are released into the bloodstream. These blood tests show an increase in the level of enzymes when you have had a heart attack.
An echocardiogram uses high frequency sound waves to take moving pictures of your heart. Your doctor studies the pictures to measure and determine the function and structure of your heart.
A radionuclide scan is a test in which a radio-active substance (Radionuclide) is injected into your blood stream and travels to your heart. A special camera projects a picture of your heart on screen, showing any malfunction of your heart.
A heart catheterization is an X-ray test performed by a doctor. A thin, flexible tube is passed through the blood vessel in your groin and follows the artery to your heart. A special dye is injected through the tube. The location of any narrowing or blockages can be seen on an X- Ray screen.
バムルンラード病院の心臓専門医であり、同循環器科センターの経営陣の一人でもあるDr. Achirawin Jirakamolchaisiriが、患者さんへの「心から」のヘルスケアのご提供がいかに重要であるか、そのビジョンを語っています。