By Ryan Unverzagt

Welcome back to another edition of From the Trainer! Did you know that February not only recognizes Black History, but also marks heart awareness month? Most of us don’t think twice about our hearts unless you’ve had any chest pain, palpitations, heart attack, or cardiac arrest that will definitely catch your attention. This column will provide some insight on the precious organ that can “take a lickin’ and keep on tickin’”. As a cardiovascular sonographer, I have seen all forms of heart and vascular disease first hand. I get an up close and personal ultrasound view of the heart in action (good or bad). This article contains some interesting facts about the heart, but let’s start with the basics……

Heart Anatomy:

A normally formed heart has 4 chambers with 4 valves. There are 2 chambers located on the top called the atrium and 2 chambers on the bottom called the ventricles. The heart is also divided into right and left sides. The right side receives deoxygenated blood from the body and pumps it to the lungs. The left side receives oxygenated blood from the lungs and pumps it out to the body. The right side has two valves (tricuspid and pulmonic) and the left side has two valves (mitral and aortic). Valves are located inside the heart and are designed to allow blood to flow one-way, either to the next chamber (atria to ventricles via the mitral and tricuspid valves) or to the pulmonary artery and aorta (ventricles to the lungs or body via the pulmonic and aortic valves). There is a network of arteries that supply the heart muscle with oxygenated blood called the coronary arteries. These are small arteries that wrap around the outside of the heart. Each heart usually has the same major configuration, but the smaller branches are as unique as fingerprints. The heart also has coronary veins that drain “used blood” from the heart muscle back into the heart.

Heart Attack (Myocardial Infarction or MI) vs. Cardiac Arrest- What is the difference?

A heart attack happens when there is a lack of blood flow to the heart muscle itself, depriving it from oxygen. This happens when there is a sudden blockage in the coronary arteries. In non-fatal heart attacks, the heart continues to beat even with a blockage or multiple blockages in the coronary arteries. In contrast, a cardiac arrest happens when there is a major rhythm issue that prevents the heart from beating effectively. If sustained and not treated immediately with an AED (shock), the person will lose consciousness and ultimately die. Fortunately, what happened to NFL player Damar Hamlin was treated very quickly on the field. He went into cardiac arrest after receiving a hit directly to his chest. This phenomenon is called commotio cordis and happens when there is blunt force to the chest wall at the exact same time of the up slope of the T-wave on the EKG. This is very rare because of the timing of the trauma has to be at the same time the ventricles are starting to re polarize. This is more common in adolescence population because the chest wall is thinner than in an adult’s.

Bad news:

• Cardiovascular (CV) disease is the #1 cause of death for men and women in the United States.
• It is estimated that one person dies every 33 seconds from CV disease.
• Someone has a heart attack every 40 seconds in the US.
• Every year, about 805,000 people in the US have a heart attack. Of these, 605,000 are a 1^st heart attack

Good news:

• The heart is the strongest muscle in the body!
• On average, the heart pumps about 2,000 gallons of blood per day.
• The heart beats about 115,000 times in 24 hours.
• Hearts have specialized cells that originate and conduct the electrical impulses which control heart beats. The sinoartrial (SA) node is located within the upper part of the right atrium and is considered the heart’s natural pacemaker.
• Hearts perform the essential task of keeping us alive via our autonomic nervous system.

Other interesting facts:

• Heart muscle is called myocardium. It has a unique appearance when compared to skeletal muscle and is designed to contract in a very quick, strong, and rhythmical way.
• Heart cells eventually stop dividing which means that primary heart cancer is extremely rare. The heart can have tumors that are generally located inside the chambers. The good news is that most of these are benign in nature and can be surgically removed.
• The heart squeezes blood out by torsion or a twisting pattern. The upper part of the ventricles (heart’s lower chambers) rotate clockwise and the apex (very bottom part) rotate counter-clockwise while the chamber shortens longitudinally (up & down).
• Sitting is an independent risk factor for heart disease. You may be lucky enough to not have high blood pressure, diabetes, hyperlipidemia, don’t smoke, and yet just sitting can increase your risk for heart disease. This means that even regular exercisers should decrease their sitting time throughout the day, so keep moving!
• Broken heart syndrome is a real medical diagnosis. This is also called stress or Takosubo cardiomyopathy. This condition mimics symptoms of a heart attack which include chest pain or heaviness, shortness of breath, or even fainting. This usually occurs when a person experiences severe emotional or physical stress such as a sudden illness, accident, or loss of a loved one. More than 90% of reported cases are in women ages 58-75. Good news about broken heart syndrome is that most people’s hearts recover within a month or two.

The thought of having a heart attack is scary enough, but imagine not knowing the symptoms. The obvious one is chest pain. But symptoms can be different very between men and women. Below is not an all-inclusive list, but just an overview of the major ones. If you notice that yourself, someone you know, or even a stranger having these symptoms, call 911 immediately!

Heart Attack symptoms:

            Male                                                                                                   Female                                                                     

• Chest pain, pressure, or tightness             Jaw, neck, back, or shoulder pain
• Sudden shortness of breath                                                 Nausea and/or vomiting
• Dizziness                                                 Unusual fatigue
• Chest pain that radiates to the arm or jaw             Heartburn/Indigestion
• Sweating after chest discomfort             Palpitations (unusual heart beats)

These are just a few of the differences, but both genders can share these symptoms. Again, call 911 immediately and start CPR (with the use of an AED, if available) when needed. A person having a heart attack can develop a dangerous arrhythmia that can lead to a cardiac arrest.

I hope this gave you a new appreciation and understanding of our most vital organ. I will discuss resting heart rates, target heart rates for exercising efficiently, and other ways to monitor exercise intensity in next month’s column.

About the Author: Unverzagt holds a Bachelor of Science degree in Wellness Management from Black Hills State University. He is a certified Strength & Conditioning Specialist and a Registered Diagnostic Cardiac Sonographer.