WEBVTT 1 00:00:00.160 --> 00:00:05.080 Virgin Media broadband is smooth. How smooth you ask, Well, 2 00:00:05.240 --> 00:00:06.719 Imagine you're a big old war. 3 00:00:06.679 --> 00:00:11.160 Russ and rather than lumbering around a glacier avoiding polar bears, 4 00:00:11.400 --> 00:00:16.440 you're on a lake, driving a speedboat three thousand kilos 5 00:00:16.480 --> 00:00:20.640 of mollusk, munching magnificence, feeling the wind in your whiskers 6 00:00:20.679 --> 00:00:25.000 and the sun on your big blubbery face. That's the 7 00:00:25.120 --> 00:00:27.879 kind of smoothness you feel. With ninety nine point nine 8 00:00:27.960 --> 00:00:35.240 percent broadband reliability available nationwide Virgin Media, it's playtime subject 9 00:00:35.240 --> 00:00:36.280 to location availability. 10 00:00:36.320 --> 00:00:39.000 Teasin, he's apply for broadland reliability see Virgin Media dot 11 00:00:39.000 --> 00:00:40.039 I E Forward slash proof. 12 00:00:40.759 --> 00:00:43.159 Oh hey, it's the woman on the swamp tour who 13 00:00:43.200 --> 00:00:46.439 won't stop screaming. Yeeha, Ali Ward, and we are here 14 00:00:47.119 --> 00:00:51.240 with your heart in your ears. Cardiology, let's consider this 15 00:00:51.280 --> 00:00:53.159 episode of one on one. It's a very basic intro 16 00:00:53.320 --> 00:00:55.560 to a really huge discipline. And this is a guest 17 00:00:55.600 --> 00:00:57.600 I have waited months and months and months to interview. 18 00:00:57.880 --> 00:01:00.119 It all started. I got a note from a list 19 00:01:00.439 --> 00:01:02.920 named Matthew Evan Taylor who said, not only was this 20 00:01:03.000 --> 00:01:07.680 person a top cardiologist in the country, but he also 21 00:01:07.760 --> 00:01:11.760 has a great radio voice and also was his dad. 22 00:01:11.959 --> 00:01:15.599 I did a little research and quickly realized no other 23 00:01:15.719 --> 00:01:20.159 cardiologist would do me and this guest. We chatted months 24 00:01:20.200 --> 00:01:23.439 back over the phone, and he wanted to time the 25 00:01:23.519 --> 00:01:27.280 episode so that it hit in February to encompass both 26 00:01:27.280 --> 00:01:31.040 American Heart Month and Black History Month. But he's super busy. 27 00:01:31.280 --> 00:01:33.480 He had a conference to go to November, and then 28 00:01:33.519 --> 00:01:36.200 he was going to the Super Bowl in February. Turns 29 00:01:36.239 --> 00:01:38.799 out he didn't just have a conference to go to. 30 00:01:39.120 --> 00:01:42.680 He was being awarded the Clinical Research Prize at the 31 00:01:42.719 --> 00:01:46.920 American Heart Association's Scientific Sessions in twenty twenty four. Owned 32 00:01:46.959 --> 00:01:49.560 the Super Bowl tickets, you know. He was there as 33 00:01:49.599 --> 00:01:53.799 the director of Player Engagement and Education and a co 34 00:01:53.879 --> 00:01:57.280 investigator into the Football Player's Health Study at Harvard University. 35 00:01:57.439 --> 00:02:00.079 He was at workin He is a professor and a 36 00:02:00.120 --> 00:02:04.640 director at the Cardiovascular Research Institute at the Moorhouse School 37 00:02:04.680 --> 00:02:08.159 of Medicine in Atlanta. He did his undergrad at Princeton, 38 00:02:08.479 --> 00:02:11.919 his doctorate from Harvard Medical School, and has been named 39 00:02:11.960 --> 00:02:17.159 the American Heart Association's Physician of the Year. This man's schedule, 40 00:02:17.719 --> 00:02:20.520 like some of our arteries, is packed wall to wall 41 00:02:20.840 --> 00:02:24.719 with huge responsibilities, but he is gracious and generous and 42 00:02:24.759 --> 00:02:27.120 we were able to nab him for about an hour 43 00:02:27.280 --> 00:02:29.960 this past Saturday morning. I was terrified to take up 44 00:02:29.960 --> 00:02:31.680 too much of his time because I already loved him 45 00:02:31.680 --> 00:02:34.520 so much. And we turned this episode around in just 46 00:02:34.639 --> 00:02:37.599 a few days. He showed up on video and a 47 00:02:37.639 --> 00:02:41.159 shirt and tie, all smiles. He let me ask him 48 00:02:41.159 --> 00:02:43.439 so many questions. But first, before we get into it, 49 00:02:43.439 --> 00:02:45.919 thanking about on the patrons who submitted their questions before 50 00:02:45.960 --> 00:02:48.800 we recorded. Thanks to all the folks in ologies merch 51 00:02:48.800 --> 00:02:52.360 from ologiesmerch dot com. Thanking about on the listeners leaving 52 00:02:52.400 --> 00:02:55.000 reviews which helped the show so much, such as this 53 00:02:55.080 --> 00:02:57.879 recent review from Amy and Arlington, who wrote, you learn 54 00:02:57.960 --> 00:03:00.840 new stuff each time, you come away amazed by all 55 00:03:00.840 --> 00:03:03.319 the smart and good people in the world, something we 56 00:03:03.360 --> 00:03:06.560 all need nowadays. Thank you, Amy and Arlington and everyone 57 00:03:06.560 --> 00:03:09.479 who has ever left a review. I have read them all. Okay, 58 00:03:09.680 --> 00:03:12.120 let's get to the heart of the matter. Cardiology comes 59 00:03:12.199 --> 00:03:15.960 from the Greek for heart easy, and we covered as 60 00:03:16.039 --> 00:03:17.800 much as we could in the time that we had. 61 00:03:17.840 --> 00:03:20.159 So Yeah, consider this a one oh one, A primer. 62 00:03:20.520 --> 00:03:26.240 Get pumped for valves, tubes, beats, electrical shocks, Gray's anatomy glossaries, 63 00:03:26.400 --> 00:03:29.680 heavy metal hearts, The effects of long term stress on 64 00:03:29.719 --> 00:03:33.199 the heart, What those blood pressure numbers mean, how to 65 00:03:33.240 --> 00:03:36.719 read an EKG, what to do with an emergency cardiac 66 00:03:36.759 --> 00:03:39.840 disease symptoms, what your heart wants you to eat, how 67 00:03:39.879 --> 00:03:42.879 to decipher your cholesterol numbers, and why you would want 68 00:03:42.919 --> 00:03:47.039 to trust me it's fun, The worst heart art out there, 69 00:03:47.080 --> 00:03:52.800 and why a wedding ring goes on that finger with researcher, Professor, physician, 70 00:03:53.360 --> 00:03:58.159 Heart Hero and your new favorite cardiologist, doctor Herman Taylor. 71 00:04:17.160 --> 00:04:19.240 This one is going to come up on Tuesday, so 72 00:04:19.279 --> 00:04:20.639 this is going to be a quick turnaround. 73 00:04:20.839 --> 00:04:23.600 Yeah, okay, all right, Yeah, let's get to it. 74 00:04:23.680 --> 00:04:30.240 Okay, he him, Yes, okay, Herman Taylor. Now you're a cardiologist. 75 00:04:30.319 --> 00:04:32.199 How long have you been a cardiologist? 76 00:04:33.360 --> 00:04:37.199 I've been a cardiologist really since nineteen ninety, which now 77 00:04:37.240 --> 00:04:40.600 I guess is what thirty five years? Is that? Right? 78 00:04:40.759 --> 00:04:41.000 Yeah? 79 00:04:41.079 --> 00:04:42.879 Yes, quite a long time. 80 00:04:43.560 --> 00:04:47.759 Now, what was it that drove you into cardiology when 81 00:04:47.800 --> 00:04:49.399 you were in med school, when you were on this 82 00:04:49.480 --> 00:04:52.079 path to becoming a doctor. When did that passion start 83 00:04:52.120 --> 00:04:52.319 for you? 84 00:04:53.199 --> 00:04:57.879 Well, let's see, originally I was I guess just very 85 00:04:57.879 --> 00:05:00.519 interested in science. The thing that got me going actually 86 00:05:01.199 --> 00:05:03.439 was believe it or not, And this dates me a bit. 87 00:05:03.519 --> 00:05:07.759 The Space program got me first interested in science in general, 88 00:05:08.319 --> 00:05:11.560 and I gravitated through a period where I wanted to 89 00:05:11.600 --> 00:05:15.120 be an oceanographer. You may not be familiar with the 90 00:05:15.199 --> 00:05:16.639 undersea world of Jacquesustau. 91 00:05:17.680 --> 00:05:20.759 We would like to know more about this serpent who 92 00:05:20.879 --> 00:05:23.560 ages ago it turned from land to the ocean of 93 00:05:23.600 --> 00:05:26.800 his origin to prey on the tiny bottom dwen hours. 94 00:05:27.240 --> 00:05:30.040 But if you go back in the archives, I'm sure 95 00:05:30.040 --> 00:05:32.680 you could find that I found that really inspirational. But 96 00:05:32.720 --> 00:05:34.879 as time went by, I got more interested in physics, 97 00:05:34.879 --> 00:05:41.160 as it turns out, which led me actually to cardiovascular physiology. 98 00:05:41.519 --> 00:05:43.319 The way it was taught back then, there was a 99 00:05:43.399 --> 00:05:47.560 heavy emphasis on himodynamics and flows and fluids as sort 100 00:05:47.560 --> 00:05:49.439 of one of the primary things you had to master 101 00:05:49.519 --> 00:05:51.240 if you wanted to understand what was going on with 102 00:05:51.240 --> 00:05:54.199 the circulation with the heart. In college, while I was 103 00:05:54.199 --> 00:05:56.240 still vacillating a little bit about what I was going 104 00:05:56.319 --> 00:05:59.439 to do after college, I had the opportunity to go 105 00:05:59.480 --> 00:06:04.560 to Cornelli University's School of Medicine for a research fellowship, 106 00:06:05.000 --> 00:06:08.879 and part of that experience was teaching cardiovascular physiology, and 107 00:06:08.920 --> 00:06:11.720 that's sort of where things everything came together for me 108 00:06:11.759 --> 00:06:14.399 in terms of my interest in the heart and the circulation. 109 00:06:15.199 --> 00:06:19.439 And that combined with sort of seeing through the opportunity 110 00:06:19.439 --> 00:06:23.639 of this summer research fellowship, seeing clinical scenarios that showed 111 00:06:23.720 --> 00:06:29.160 that marginalized populations had a particularly bad time with cardiovascular disease. 112 00:06:29.240 --> 00:06:33.040 All that sort of piqued my interest, got my passions 113 00:06:33.079 --> 00:06:38.240 going and pointed in the direction of cardiology. After spending 114 00:06:38.279 --> 00:06:44.319 some time on a faculty in Birmingham, my hometown, teaching cardiology, 115 00:06:44.480 --> 00:06:49.600 seeing patients, etc. And really having a wonderful experience being 116 00:06:49.639 --> 00:06:55.000 in my hometown treating people who were maybe colleagues and 117 00:06:55.120 --> 00:06:59.240 friends and coworkers of my parents and friends, and I 118 00:06:59.279 --> 00:07:04.360 got inspired by the idea of studying a large population 119 00:07:04.439 --> 00:07:08.680 of African Americans looking specifically at cardiovascar risk. There had 120 00:07:08.800 --> 00:07:12.560 been a study and still actually still is, a study 121 00:07:12.920 --> 00:07:16.319 called the Framingham Heart Study, which looked at a long 122 00:07:16.519 --> 00:07:20.360 term took a long term view of cardiovascular health and 123 00:07:20.399 --> 00:07:23.920 a population in the Northeast that happened to be almost 124 00:07:24.079 --> 00:07:28.759 entirely white. In fact, even more specifically, mostly it was 125 00:07:28.879 --> 00:07:33.279 either Italian Irish or Irish Italian in terms of its heritage. 126 00:07:33.439 --> 00:07:36.040 So this study, founded just after World War Two, focused 127 00:07:36.079 --> 00:07:39.120 on the long term heart health of over five thousand 128 00:07:39.199 --> 00:07:42.480 residents of Framington, Massachusetts, and it's ongoing. It's in its 129 00:07:42.480 --> 00:07:47.160 third generation of volunteer subjects and among many discoveries chronicled 130 00:07:47.160 --> 00:07:51.000 in thousands of published papers were findings about cigarette smoke 131 00:07:51.079 --> 00:07:56.600 and heart disease, psychosocial factors, and genetic or inherited risk factors. 132 00:07:56.959 --> 00:08:01.720 That study has been tremendous in its contrabans, but there 133 00:08:01.759 --> 00:08:04.480 was a major omission. You know, that's a very small 134 00:08:04.639 --> 00:08:07.639 slice of the human family when you talk about people 135 00:08:07.639 --> 00:08:12.399 whose heritage is traced principally to Western Europe. Mankind, womankind 136 00:08:12.519 --> 00:08:15.639 is much broader than that, and there were some special 137 00:08:15.759 --> 00:08:19.519 challenges in the black population that weren't adequately being met. 138 00:08:19.720 --> 00:08:25.279 So the world of research was really looking for a 139 00:08:25.360 --> 00:08:28.759 way to fill that gap, and we came together with 140 00:08:28.879 --> 00:08:30.879 the idea of the Jackson Heart Study to do that. 141 00:08:31.240 --> 00:08:35.720 So it was a particularly fun time of my career. 142 00:08:36.039 --> 00:08:38.639 And the Jackson Heart Study, started twenty five years ago, 143 00:08:38.840 --> 00:08:42.399 looked at the cardiac health of again over five thousand participants. 144 00:08:42.480 --> 00:08:45.919 But this time in Jackson, Mississippi. And another reason why 145 00:08:45.960 --> 00:08:48.559 we waited until February for this episode at doctor Taylor's 146 00:08:48.559 --> 00:08:51.360 suggestion for a Black History Month is that Black history 147 00:08:51.399 --> 00:08:55.639 factors into what care patients receive. And one twenty twenty 148 00:08:55.639 --> 00:08:58.159 study laying out a lot of info was published in 149 00:08:58.200 --> 00:09:02.320 the Journal of Hypertension titled discrimination and Hypertension risk among 150 00:09:02.320 --> 00:09:06.000 African Americans. In the Jackson Heart Study, you mentioned that 151 00:09:06.080 --> 00:09:09.159 there are certain circumstances that put heart health at risk. More, 152 00:09:09.279 --> 00:09:12.440 what is genetic versus? What is lifestyle? What is access 153 00:09:12.559 --> 00:09:18.840 to medical care? What factors are really affecting any person? 154 00:09:19.720 --> 00:09:23.679 Well, there's so many, and it's a combination, a convergence 155 00:09:24.039 --> 00:09:28.039 of a lot of different dimensions. Let's say, so the 156 00:09:28.080 --> 00:09:32.559 genetic certainly, you know, family history and things that run 157 00:09:32.559 --> 00:09:36.000 in families are important. There are some very specific things 158 00:09:36.080 --> 00:09:42.200 like abnormalities and cholesterol metabolism, tendencies towards high blood pressure. 159 00:09:42.799 --> 00:09:46.000 Those things can run in families. But so can things 160 00:09:46.120 --> 00:09:50.000 like eating habits which are not genetic in any serious way. 161 00:09:50.639 --> 00:09:53.399 If there is a family tradition of eating a quote 162 00:09:53.480 --> 00:09:57.440 Southern diet or what people might consider a soul food diet, 163 00:09:57.600 --> 00:10:00.519 or some other diet that has a propund difference of 164 00:10:00.679 --> 00:10:06.799 certain types of foods, seasoning that carries certain electrolyzed that 165 00:10:07.320 --> 00:10:12.039 might not be good taken in overabundance, a tendency to 166 00:10:12.120 --> 00:10:15.360 fry foods which causes chemical changes in foods that may 167 00:10:15.399 --> 00:10:17.840 not be ideal, et cetera. 168 00:10:18.440 --> 00:10:22.600 So cardiac disease may involve a straight up DNA predisposition 169 00:10:22.759 --> 00:10:28.000 like familial hypercholesterolmia, which is cosmetis genetic link on how 170 00:10:28.039 --> 00:10:32.240 your body recycles LDL or bad cholesterol, and it might 171 00:10:32.240 --> 00:10:35.000 require meds no matter how you change your habits. And 172 00:10:35.120 --> 00:10:38.480 of course, heart health is affected by geographic and lifestyle 173 00:10:38.519 --> 00:10:41.679 factors like how walkable your neighborhood is, or diet in 174 00:10:41.720 --> 00:10:44.120 your culture. And actually, if you want a great Black 175 00:10:44.200 --> 00:10:47.720 History Month episode on cuisine, doctor Psyche Williams Forsen is 176 00:10:47.759 --> 00:10:50.519 a food historian who we interviewed for a Black American 177 00:10:50.559 --> 00:10:53.960 Magnrology episode. But yeah, some heart conditions are just wired 178 00:10:53.960 --> 00:10:54.720 into yourselves. 179 00:10:55.559 --> 00:10:57.559 Those types of things can run in families. Then you 180 00:10:57.720 --> 00:11:04.480 have cultural and societal exposures that may be quite material 181 00:11:04.559 --> 00:11:08.200 in terms of whether a person develops high blood pressure, diabetes, 182 00:11:08.240 --> 00:11:12.399 et cetera, or heart disease, itself, and these can relate 183 00:11:12.720 --> 00:11:17.399 to things that induce stress in the population, whether it's 184 00:11:17.919 --> 00:11:22.840 the stress of city life or the stress of you know, 185 00:11:22.919 --> 00:11:28.559 let's let's call it discriminatory practices, or limited access to care, 186 00:11:29.519 --> 00:11:33.840 or limited access to good food. Those things too, can 187 00:11:34.279 --> 00:11:39.559 all come together to create an ecosystem that's very unfavorable 188 00:11:40.080 --> 00:11:43.440 for your heart. And some people face those things day 189 00:11:43.440 --> 00:11:46.000 in and day out, and they accumulate over time and 190 00:11:46.080 --> 00:11:49.360 can lead to some fairly serious sequella. 191 00:11:49.519 --> 00:11:53.240 Yeah, I didn't know what that work meant. Sequella, Yes, sequella, Okay, 192 00:11:53.320 --> 00:11:53.840 I got it. 193 00:11:54.120 --> 00:11:59.840 Maybe I should pick another word. Things that happen in contant, 194 00:12:00.159 --> 00:12:04.399 So that's or, you know, in sequence, I guess, but you. 195 00:12:04.360 --> 00:12:06.480 Know, I'm not sure. I don't take you as someone 196 00:12:06.519 --> 00:12:10.000 who spends a lot of time scrolling on social media, 197 00:12:10.039 --> 00:12:12.080 because you've got a lot of important things to do. 198 00:12:12.399 --> 00:12:14.799 But there was this viral video that went around of 199 00:12:14.919 --> 00:12:15.480 this heart. 200 00:12:15.720 --> 00:12:18.360 So it is a one piece. 201 00:12:19.879 --> 00:12:24.360 Piece, so it was a model of a heart that 202 00:12:24.399 --> 00:12:28.279 they were teaching in anatomy and it almost was spiral 203 00:12:28.879 --> 00:12:33.759 the muscle. They almost stretched it out like unrolling a 204 00:12:33.840 --> 00:12:37.000 map or something. Is that how a heart is constructed? 205 00:12:37.720 --> 00:12:40.799 Wow? Well, I haven't seen the video, okay, but what 206 00:12:41.000 --> 00:12:44.679 is true is that the heart in the embryo, the 207 00:12:44.720 --> 00:12:49.399 heart starts out as a straight tube right of cells, 208 00:12:49.919 --> 00:12:55.879 and as gestation goes forward, that tube begins to fold up, 209 00:12:56.240 --> 00:13:01.000 twist on itself, and fuse. And what you wind up 210 00:13:01.039 --> 00:13:06.279 having is this four chambered marvel of a muscle. Muscle 211 00:13:06.480 --> 00:13:09.799 is maybe too simple a description of what it is, 212 00:13:10.519 --> 00:13:15.159 because it has electrical properties, it has contractile properties, and 213 00:13:15.279 --> 00:13:18.639 even a sort of a mind of its own. I mean, 214 00:13:18.679 --> 00:13:21.759 it can beat on outside of your body, powered by 215 00:13:21.759 --> 00:13:26.039 its own spontaneous electrical impulses. They've left to its totally 216 00:13:26.080 --> 00:13:28.679 through its own devices, as long as it had oxygen 217 00:13:28.840 --> 00:13:29.639 and nutrients. 218 00:13:29.879 --> 00:13:33.240 So when you see people in medical dramas, hopefully not 219 00:13:33.279 --> 00:13:35.759 in real life unless you're a healthcare worker, in which case, 220 00:13:36.000 --> 00:13:38.600 thank you so much, they may be using what's called 221 00:13:38.600 --> 00:13:42.399 an AED and this is an automated external defibrillator, and 222 00:13:42.440 --> 00:13:45.480 it's called automatic because it detects and then it analyzes 223 00:13:45.480 --> 00:13:48.399 the patient's heart rhythm and then it delivers an electrical 224 00:13:48.480 --> 00:13:53.320 shock to reset the cardiac arrhythmia, which a rhythmic so 225 00:13:53.399 --> 00:13:56.519 it's out of sync heart beats. So if a person 226 00:13:56.600 --> 00:14:00.000 has a cardiac arrest and they have no pulse, no heart, 227 00:14:00.159 --> 00:14:03.600 they're not breathing. The protocol is typically to administer CPR 228 00:14:03.840 --> 00:14:05.480 if you know how to do it, and then if 229 00:14:05.480 --> 00:14:09.039 there's an AED nearby, use that next. And I cannot 230 00:14:09.039 --> 00:14:11.120 stress enough that first aid training is going to do 231 00:14:11.159 --> 00:14:14.000 a better job than me. I'm my podcast host and 232 00:14:14.080 --> 00:14:17.120 I'm just search engining how to save a life. And 233 00:14:17.159 --> 00:14:19.639 then I'm trying to tell you in like seventeen seconds now, 234 00:14:19.879 --> 00:14:23.080 if a heart can beat with electrical charge and oxygen. 235 00:14:23.120 --> 00:14:24.840 Is that what happens in heart transplants? 236 00:14:25.039 --> 00:14:25.399 I don't know. 237 00:14:25.440 --> 00:14:28.080 I've never had one. But our guest, doctor Tom Bulk 238 00:14:28.120 --> 00:14:30.919 in the Mycology episode, did have a heart transplant, and 239 00:14:30.960 --> 00:14:33.360 we discussed it in his episode, which we'll link for you, 240 00:14:34.440 --> 00:14:37.960 during which he pointed me toward this felted box on 241 00:14:38.039 --> 00:14:40.919 his desk. It looked like a Kleenex box, but it 242 00:14:40.960 --> 00:14:45.240 contained a fluid filled plastic bag with the heart he 243 00:14:45.360 --> 00:14:49.200 was born with. It was sliced up like thick roast beef. Now, 244 00:14:49.200 --> 00:14:52.919 how do those transplants work well? In brief, a donor 245 00:14:53.000 --> 00:14:56.120 heart is removed, usually from a patient who has experienced 246 00:14:56.159 --> 00:14:59.879 brain death. But is a live via intubation, and one 247 00:15:00.240 --> 00:15:03.679 that support is withdrawn and the patient passes. The heart 248 00:15:03.720 --> 00:15:06.720 is removed and it's taken on ice to wherever the 249 00:15:06.759 --> 00:15:09.759 recipient is hopefully close by. They only have a couple 250 00:15:09.759 --> 00:15:13.519 hours on ice. Now, the recipient is prepped and while 251 00:15:13.600 --> 00:15:19.279 the surgeons replace their heart, a cardiopulmonary bypass machine circulates 252 00:15:19.320 --> 00:15:23.279 and oxygenates their blood while the recipient's heart is getting 253 00:15:23.360 --> 00:15:27.840 taken out. Now, typically the donor heart would be transplanted, 254 00:15:28.360 --> 00:15:34.120 not beating, and then restarted, but thrillingly, weirdly and surreally. 255 00:15:34.159 --> 00:15:37.000 As described in this twenty to twenty three paper first 256 00:15:37.120 --> 00:15:40.559 inhuman beating heart transplant, doctor Joseph Wu and his team 257 00:15:40.600 --> 00:15:43.759 at Stanford were able to restart a donor heart, keep 258 00:15:43.799 --> 00:15:47.600 it warm with blood and beating as it was being 259 00:15:47.679 --> 00:15:51.440 implanted into its new recipient. Trust me, we could do 260 00:15:51.480 --> 00:15:54.799 a thirteen episode series just on this topic. But those 261 00:15:54.799 --> 00:15:58.279 are some basics, back to even basic or basics. How 262 00:15:58.320 --> 00:16:01.840 did you build your heart in the first place? How'd 263 00:16:01.879 --> 00:16:02.360 you do it? 264 00:16:03.200 --> 00:16:06.639 So? Yeah, it starts out as a two. It twists 265 00:16:06.639 --> 00:16:09.840 and bols and fuses in just the right way, and 266 00:16:09.879 --> 00:16:13.480 you get again this four chamber structure that we know 267 00:16:13.519 --> 00:16:14.399 as the heart. 268 00:16:14.799 --> 00:16:17.759 What are those four chambers doing? If you had to 269 00:16:17.799 --> 00:16:20.600 break it down to someone who is obviously not a cardiologist, 270 00:16:21.600 --> 00:16:26.080 the ventricles, the chambers, what's doing what? 271 00:16:26.919 --> 00:16:31.480 Okay, so there are four chambers. There's a left heart, 272 00:16:31.519 --> 00:16:34.159 if you will, in a right heart. Each side of 273 00:16:34.200 --> 00:16:38.360 the heart, let's go with that terminology has sort of 274 00:16:38.600 --> 00:16:40.519 an atrium, just like the atrium to a building. The 275 00:16:40.559 --> 00:16:44.679 four you end up building, and that atrium is the 276 00:16:44.679 --> 00:16:49.039 first chamber, and it receives blood and then loads the 277 00:16:49.320 --> 00:16:53.159 sort of more business in the stronger, more thickly muscle 278 00:16:53.320 --> 00:16:57.399 chamber called the ventricle. The right atrium takes all of 279 00:16:57.399 --> 00:17:00.879 the venus blood. All the blood has been say used, 280 00:17:00.960 --> 00:17:03.519 let's call it. It's been out to the body, has 281 00:17:03.600 --> 00:17:06.880 dropped off its nutrients and its oxygen, has participated in 282 00:17:07.000 --> 00:17:10.119 cholesterol transport, has taken immune cells to where they need 283 00:17:10.160 --> 00:17:14.079 to go, and all the various functions of blood that 284 00:17:14.319 --> 00:17:17.039 comes back with a lot of the oxygen and nutrients 285 00:17:17.039 --> 00:17:21.720 depleted for another round to pick up essentially more oxygen 286 00:17:22.440 --> 00:17:25.599 by being pumped through the lung. So there's a special 287 00:17:25.680 --> 00:17:29.519 part of the heart that's devoted entirely to making sure 288 00:17:29.680 --> 00:17:33.920 that fresh blood with a fresh supply of oxygen is 289 00:17:33.920 --> 00:17:38.400 supplied to the body. The first stop after first coming 290 00:17:38.440 --> 00:17:42.480 into that right atrium going through a valve which is 291 00:17:42.519 --> 00:17:45.759 a one way door. Now that valve is called the 292 00:17:45.799 --> 00:17:49.200 tricuspid valve for those who want detail. But coming through 293 00:17:49.200 --> 00:17:54.759 that valve, leaving the atrium, it goes into the right ventricle. 294 00:17:54.640 --> 00:17:58.400 Which is downstairs from the right entry or atrium. 295 00:17:59.000 --> 00:18:02.079 That strong ventrals then pumps it up to the lungs 296 00:18:02.960 --> 00:18:08.039 where it goes through this amazing network of blood vessels 297 00:18:08.319 --> 00:18:11.039 and down to where the blood vessels are so thin 298 00:18:11.119 --> 00:18:14.440 they come right up next to the little sacs that 299 00:18:14.519 --> 00:18:19.559 have air oxygen alvil and they're so close that the 300 00:18:19.599 --> 00:18:23.880 oxygen can just diffuse across into the blood. And then 301 00:18:24.119 --> 00:18:27.759 after the blood gets refreshed from people like to talk 302 00:18:27.799 --> 00:18:31.440 about blue blood and bright red blood, it turns much 303 00:18:31.480 --> 00:18:34.359 more closer than this bright red type of blood. 304 00:18:34.920 --> 00:18:38.200 So once again the spent blood enters the right atrium 305 00:18:38.400 --> 00:18:41.240 via the vena cava as venus blood heads to the 306 00:18:41.319 --> 00:18:44.400 ventricle and then to the lungs via the pulmonary arteries 307 00:18:44.440 --> 00:18:46.880 where it fills up on oxygen, and then it heads 308 00:18:46.920 --> 00:18:51.279 back to the heart's left atrium via the pulmonary veins. Okay, 309 00:18:51.319 --> 00:18:54.440 so you got fresh blood back to the heart for distribution. 310 00:18:55.160 --> 00:18:58.599 All of that then drains from the lungs into now 311 00:18:59.200 --> 00:19:03.880 the left atrium, okay, which is the first chamber after 312 00:19:03.920 --> 00:19:09.720 the blood has been refreshed. Once there, that atrium squeezes 313 00:19:10.480 --> 00:19:14.599 and pushes loads the true business end of the heart, 314 00:19:14.680 --> 00:19:17.559 the left ventricle. This is the most powerful part of 315 00:19:17.559 --> 00:19:21.079 the heart. This is the thickest muscle in the heart. 316 00:19:21.599 --> 00:19:26.240 Why because it has to then generate enough pressure to 317 00:19:26.319 --> 00:19:32.640 push blood through the body to every cubic millimeter or 318 00:19:32.680 --> 00:19:36.920 even smaller portion of tissue throughout the heart and every 319 00:19:37.039 --> 00:19:43.319 organ to again supply oxygen and nutrients, and then allow 320 00:19:43.519 --> 00:19:46.680 after it all is used, for the whole thing to 321 00:19:46.720 --> 00:19:49.400 circle back again to the heart. The heart does this 322 00:19:49.519 --> 00:19:54.079 through it's estimated thousands of miles if you could, if 323 00:19:54.119 --> 00:19:57.880 you could stretch all of these vessels out into end, 324 00:19:58.519 --> 00:20:02.759 they'd be several thousand for an individual person, which is 325 00:20:02.839 --> 00:20:03.839 kind of hard to conceive. 326 00:20:04.079 --> 00:20:04.960 Several thousand. 327 00:20:05.400 --> 00:20:09.440 Well, when you consider that the blood vessels go from 328 00:20:09.799 --> 00:20:16.319 the big obvious vessels down to tiny microscopic capillaries that 329 00:20:16.680 --> 00:20:22.480 allow again, the diffusion of nutrients and oxygen into every 330 00:20:22.480 --> 00:20:25.240 part of tissues and organs throughout the body. You can 331 00:20:25.319 --> 00:20:29.039 imagine that. Yeah, if it was possible that it would 332 00:20:29.680 --> 00:20:33.079 make for a very very long highway of blood vessels. 333 00:20:33.400 --> 00:20:36.759 Okay, So the atrium is on top, the ventricles are 334 00:20:36.759 --> 00:20:40.000 on the bottom, and the left side is tasked with 335 00:20:40.359 --> 00:20:44.400 shooting blood out to your whole body like an Olympic 336 00:20:44.519 --> 00:20:47.599 shot putter, but just throwing buckets of blood as far 337 00:20:47.640 --> 00:20:50.720 as it can. And that beefy left side is why 338 00:20:50.759 --> 00:20:53.759 our heart is kind of left leaning in our chest. Now, 339 00:20:54.000 --> 00:20:57.000 as for a wedding ring on the left ring finger, 340 00:20:57.200 --> 00:21:00.839 what's the deal with that so called vina and which 341 00:21:00.960 --> 00:21:04.160 is the blood plumbing that leads from the heart straight 342 00:21:04.200 --> 00:21:09.680 to that one wedding ring finger digit? Friends, it's flim flam. 343 00:21:10.119 --> 00:21:12.119 All the veins and the arteries go back and forth 344 00:21:12.160 --> 00:21:15.039 to the heart and wedding rings. Over time, they've been 345 00:21:15.079 --> 00:21:18.160 worn on either hand. Some were even worn on the 346 00:21:18.279 --> 00:21:22.039 thumb when the fashion was like blingier and bulkier one 347 00:21:22.079 --> 00:21:24.480 hundreds of years ago. So no, you do not have 348 00:21:24.640 --> 00:21:26.960 a vein or an artery that goes straight from your 349 00:21:27.000 --> 00:21:29.559 heart to your wedding ring. It's cute though. Now if 350 00:21:29.599 --> 00:21:31.839 you're like, I must know more about this history, you 351 00:21:31.880 --> 00:21:34.839 can see the nineteen seventeen book. Well, I'm going to 352 00:21:34.880 --> 00:21:38.920 take a breath here. It's titled Rings for the Finger 353 00:21:39.039 --> 00:21:42.000 from the Earliest known times to the present, with full 354 00:21:42.000 --> 00:21:46.880 descriptions of the origin, early making materials, the archaeology, history 355 00:21:47.039 --> 00:21:51.519 for affection, for love, for engagement, for wedding, commemorative morning, 356 00:21:51.960 --> 00:21:55.440 et cetera. That's the whole title. I find that et 357 00:21:55.519 --> 00:21:58.039 cetera at the end to be like the funniest thing 358 00:21:58.400 --> 00:22:00.440 I've ever read, because it's the longest title of the book, 359 00:22:00.920 --> 00:22:03.839 maybe in the universe. Anyway, onward, I need you to 360 00:22:03.920 --> 00:22:07.480 know also that atrium, you know how it means entry 361 00:22:07.519 --> 00:22:11.920 hall for the heart. Ventricle derives from the Latin for 362 00:22:12.359 --> 00:22:15.079 little belly, So that's a little belly of your heart. 363 00:22:15.559 --> 00:22:18.039 More on guts in your hearts later in the episode. Now, 364 00:22:18.240 --> 00:22:21.400 remember how in the recent surgical Anchiology episode with doctor 365 00:22:21.400 --> 00:22:25.079 s Sheila Blumberg about veins and arteries, we learned that 366 00:22:25.240 --> 00:22:27.880 venous blood is on its return trip to the heart. 367 00:22:27.960 --> 00:22:31.720 It's darker in color, it's low in oxygen from delivering 368 00:22:31.759 --> 00:22:35.160 it all over your body. While arterial blood it's fresh 369 00:22:35.160 --> 00:22:38.119 from the lungs, it's brighter, and it's fueled up with 370 00:22:38.240 --> 00:22:40.640 O two on the way to your body. If you 371 00:22:40.680 --> 00:22:44.519 don't remember that, that's okay, because I just told you so. Obviously, 372 00:22:45.160 --> 00:22:48.799 the speed and pressure that that fluid is pumping through 373 00:22:48.880 --> 00:22:52.000 your body is important when it comes to blood pressure. 374 00:22:52.680 --> 00:22:54.640 When it comes to heart health too, we always hear, like, 375 00:22:54.680 --> 00:22:57.480 my blood pressure, it's good or bad. What does blood 376 00:22:57.480 --> 00:22:59.119 pressure have to do with your heart health? 377 00:23:00.160 --> 00:23:03.359 Well, it has so much to do with it. One, 378 00:23:03.839 --> 00:23:08.200 the pressure you need to keep blood actually flowing to 379 00:23:08.400 --> 00:23:11.960 the heart itself. Just like every other tissue in the body, 380 00:23:12.039 --> 00:23:17.720 the blood has arteries that feed itself, that pump blood 381 00:23:17.880 --> 00:23:20.119 through to the heart muscle or that what's called the 382 00:23:20.200 --> 00:23:21.119 mio cardium. 383 00:23:21.279 --> 00:23:25.759 Okay, so a quick terminology breakdown here. Myo muscle card 384 00:23:26.279 --> 00:23:31.319 heart eum means the tissue and idis means inflammation. So 385 00:23:31.559 --> 00:23:37.279 myocardium is the muscle tissue of the heart, and myocarditis 386 00:23:37.759 --> 00:23:41.720 is inflammation of the muscle tissue of the heart. But yeah, 387 00:23:41.759 --> 00:23:45.440 the myocardium, the heart muscle is the pump and in 388 00:23:45.519 --> 00:23:49.039 fluid dynamics or chemo dynamics, you need to keep things moving. 389 00:23:49.039 --> 00:23:52.519 Maybe in order to do that, there's a certain head 390 00:23:52.519 --> 00:23:55.440 of pressure that's needed in the heart, but it can't 391 00:23:55.440 --> 00:23:59.960 be too much. If it's too much, then what can happen, 392 00:24:00.079 --> 00:24:02.759 and is those arteries that are so vital to the 393 00:24:02.759 --> 00:24:06.839 heart survival become damaged the lining inside of them called 394 00:24:06.880 --> 00:24:12.279 the endothelium. That then lining that allows for the exchange 395 00:24:12.319 --> 00:24:16.039 of oxygen and nutrients and so forth, is so very important. 396 00:24:16.039 --> 00:24:20.640 If it becomes damaged and starts to dysfunction, that allows 397 00:24:20.640 --> 00:24:25.359 all sorts of badness, like cholesterol accumulation, the formation of 398 00:24:25.400 --> 00:24:28.960 what we call fatty streaks, which are just it's like 399 00:24:29.440 --> 00:24:32.559 a giant oil slick on a road where you have 400 00:24:32.759 --> 00:24:37.640 cholesterol gathering breaking through the barrier that should be intact. 401 00:24:38.279 --> 00:24:42.359