Cardiovascular diseases claim about 1.7 crore lives every year worldwide; with more than 80% of
the fatalities in low as well as middle-income countries, as per the numbers presented by the World
Health Organization (WHO). Due to insufficient diagnostic facilities, inaccurate interpretation,
lack of knowledge, and non-availability of relevant expertise; there is a high fatality rate
(number of deaths) in low and middle-income countries. This makes it important to understand
mysteries of the heart and Diagnostic Test used for its assessments.
"Heartbeat" is a measure of our life and death. The rate of this heartbeat indicates the status
of one's health. Various medical parameters utilize the heartbeat-related data for evaluations.
There's a reason why all our poems, philosophy, and songs revolve around the heart and heartbeat.
Scientific understanding of the human body also confirms this notion. We now know that this
heartbeat is a coordinated activity between the heart and lungs that assures proper
functioning of rest of the body.
When one speaks about the heart and lungs, the connecting link between the two, the lifeline
of the body, the role of "blood" cannot be ruled out. Superficially, it appears like the blood
matches the rhythm of the heart while flowing in our veins and capillaries. That's the reason
we can feel the heartbeat at far-off sites from the heart. But investigating closely provides
us details about the vital functioning of the heart, blood, and lungs.
Heart and Blood-The Supply Chain of the body
Heart, in very simple words, is the most important muscle in the human body which
continuously and tirelessly plays the vital role of a circulating pump. It is responsible
for the supply of life-saving oxygen to all the organs of the body. In humans, the heart
is a four chambered organ. The upper two
chambers are called auricles and the two lower chambers are called ventricles. The auricles
are connected to their respective side ventricles through valves-tricuspid and bicuspid valves.
These valves are like windows that open and close to ensure unidirectional blood flow. Similar
valves also connect the ventricles to the lungs and organs. The pulmonary valve is present at the
juncture of the pulmonary artery and right ventricle, while the aortic valve is present at the
juncture of the aorta and left ventricle. The opening and closing of these valves generate
the lub-dub sound of the heartbeat.
Blood is like that obedient subordinate which by itself acts as the circulating medium to execute
the circulation all over the body. This entire play led by the heart and blood is called the
circulatory system. To execute the function efficiently blood flows in specialized tracks called
blood vessels. Blood vessels participating in the blood circulation are of two categories - Arteries
and Veins, The arteries carry blood away from the heart, while the veins carry it back to the heart.
The system of blood vessels resembles a tree: The "trunk" - the main artery called the aorta
branches into large arteries, which lead to smaller and smaller vessels. The smallest arteries end
in a network of tiny vessels known as the capillary network. These tiny vessels spread over the
surface of organs facilitating the efficient exchange of oxygen with carbon dioxide. Similarly, the
other category of capillaries merges into smaller vein vessels,
finally into the main vein called Vena Cava. For veins and arteries connecting the
heart and lungs, the role reverses, the same will be discussed in detail in the next section.
This complex circulatory system in the human body is basically of two types Pulmonary circulation
and Systemic circulation. The key players in pulmonary circulation are pulmonary vein and pulmonary
artery. The pulmonary vein carries oxygenated blood from lungs to the heart. The heart receives this
oxygenated blood through its left auricle which is then pumped to the rest of the organs of the body
through the left ventricle and aorta while flowing in the arteries. The cells and tissues of different
organs undergoing active
respiration receive oxygen from the oxygenated blood in exchange for carbon dioxide which is
carried back to the heart through veins. This CO,-laden blood then is pumped by the heart to the
lungs via the right auricle/ventricle and pulmonary artery. Lungs help in expelling out
this Co, and breathing in oxygen. The cycle continues with every breath of a person. Hemoglobin
in the blood binds to oxygen and carbon dioxide facilitating their exchange during these cycles.
Before we move on to read more about the heart and its anatomical importance; let's have a
quick check on what is your risk score to be vulnerable to heart diseases.
Understanding Your Heart Risk Score
Studies have uncovered that there is no specific reason for putting you in the high-risk zone
of heart diseases. However, certain modifications in your modern lifestyle help in keeping your
hard-working heart safe and healthy. A few habits that increase your heart ailment risk include:
Poor dietary habits
Smoking and/or tobacco indulgence
High blood pressure
Obesity
Chronic diabetes
Stress
Depression
Certain other risk factors that cannot be modified are noted as:
Age
Advanced or later stage of menopause
Genetic prevalence
Why to Avoid Heart Disorders?
The heart is one of the key organs that keep you going! This muscular key handles two systems
simultaneously; the cardiopulmonary system and the circulatory system.
Circulatory System
The cardiopulmonary system comprises your heart, blood vessels, trachea, bronchi, and lungs;
wherein the oxygen-poor blood enters into the capillaries of the lungs from the right atrium of
the heart for purification. From the lungs, oxygen-rich blood is again sent back to the heart.
The circulatory system comprises a vast network of arteries, veins, and capillaries whereas
arteries carry the oxygen-rich blood to different tissues as well as cells of the body and veins
carry the oxygen-poor blood back to the heart.
A normal human adult heart pumps around 7,570 liters of blood each day that travels a total
distance of 96,560 kilometers within 20 seconds. Any hindrance in the oxygenated blood flow
has been correlated with the gradual sinking of multiple vital organs like brain, kidneys, liver,
etc. Imagine the power of its pumping capacity; you still think that it is not important to take
care of your heart-
Reasons for Prevailing Uncertainties in Fighting Heart Issues
The steady rise in heart issues has triggered alarming signals amongst the scientific
community to develop accurate diagnostic and appropriate management regimens.
Some key barriers that are crucial to understand are:
- Lack of confidence and clinical expertise in interpreting diagnostic findings from
tests; such as an Echocardiogram, Chest X-ray, Electrocardiogram, etc.
- Availability as well as timely use of advanced imaging systems is difficult in low
and middle income countries.
- Unpredictable disease progression is considered as one of the important challenges in
fighting heart issues by experts.
- The availability of medications like beta-blockers,
ACE inhibitors, diuretics; and reluctance in initiating the medications on time.
- Lack of proper management in paramedical setups.
Common Diagnostic Tests to Assess Heart Function
Electrocardiogram (ECG):
The test is commonly suggested to assess normal/abnormal heart rhythm. Depending
upon your medical history, the doctor may prescribe an ECG, while you are exercising;
known as a stress test.
Holter Monitoring Test:
This is an advanced portable system working on the same principle of ECG; and is
suggested to study the rhythmic challenges of heart that cannot be easily determined
by ECG.
Echocardiogram: This test is generally suggested to understand structural
abnormalities of the heart. It uses ultrasonic sound waves to display how your heart is beating
and pumping oxygenated blood to different organs of the body.
Cardiac Computerized Tomography:
The analysis is suggested for a deeper understanding of structural abnormalities, leading to
obstruction in heart pumping.
Cardiovascular Health Care -Heart of the Heart Care
The heart being such a vital organ needs extra care, unfortunately, the statistics show a different
picture indicating poor heart health of the population, particularly in India. It is worrisome that
heart ailments comprise one-fifth of the causes of death in India and experts predict it to turn into
onethird in the coming days. The major cause of heart ailment-related death is heart attack or stroke.
Atherosclerosis, i.e. formation of plaques within the arteries and capillaries carrying oxygen to the
heart lead to a heart attack if the plaque generated clot travels to vital organs. It can lead to a stroke
when the clot blocks blood flow to the brain. There are few congenital heart diseases but most of
these are the ones that a person develops with age due to poor lifestyle and healthcare. Regular
health check-ups, healthy diet, cholesterol, blood pressure, blood sugar control, incorporation of
physical exercise in daily schedule, and maintenance of healthy weight can help in achieving ideal
cardiovascular health.
Impact of COVID-19
The current COVID-19 pandemic has compelled clinicians and scientists all over the world
to solve the puzzling correlation between COVID-19 infection and its short-term as well as
long-term impacts on the body. A recent study has come up with an interesting theory that
strongly supports the evidence of cardiac inflammation, structural or functional changes in
the heart having detrimental impacts on different other organs of the body due to poor
circulation.
Conclusion
With rising incidences of heart disorders, the medical community is more inclined towards a
deeper and clear understanding of structural as well as functional abnormalities of the heart.
This will lead them to successfully apply advanced technology for better clinical outcomes.