Welcome back to the program.
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We're talking
about what kills us.
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And our hearts
are high on that list.
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As a matter of fact
it's number 1 on that list.
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Dr. Marcum is here
telling us how we can live
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and things that we can
do to minimize the risk.
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And that's what it sounds like.
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We're not talking
about guarantees here.
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We're talking
about risk management.
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Right, and we talked early about
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the congenital
abnormalities. Yes.
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And before we
had these treatments
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the congenital
patients would pass away. Yeah.
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But we talked in previous
programs about heart attacks.
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You know, we
talked about the rhythms.
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But there is all--
lot of other things
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that cause
hearts to get weak too.
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And we're gonna address these
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and some of the
questions we get up.
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Let's go to the
heartwiseministries.org website
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and here are some questions
that have been sent in.
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Number 1, what
exactly does the term,
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heart failure mean?
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Now that sounds like the
heart just stops. Is that right?
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The heart's failure means
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that the heart
for whatever reason
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doesn't pump blood
to the needed organs.
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And the needed
organ is the brain. Yes.
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A needed organ is the kidneys.
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So when the heart doesn't
pump for whatever reason,
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we call that heart failure.
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It fails to do what
it's designed to do.
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Exactly. A symptom of
heart failure might be fatigue.
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If the heart doesn't pump blood
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for it sometimes
fluid backs up in the lungs.
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You get short of breath,
especially, when you lie down.
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Yeah. You can't get rid
of the fluid in the body
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so you might swell up
in the abdomen or legs.
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Those all might be
symptoms of heart failure. Okay.
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So once you make a
diagnosis of heart failure
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and we've got- we have x-rays.
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We can look for extra fluids.
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There are some chemicals
we can measure in the blood
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that tells us if that
person is in heart failure.
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But usually I know if a
person is in the heart failure
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because their
heart's beating fast.
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Try to keep up with
them, they can't breathe well.
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They're swelling up.
They'll feel weak and tired.
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You've told me that you can have
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a patient walk into the room
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and you can
look at that patient.
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And you can pretty well tell
what's going on with the heart.
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Yeah. What are you
looking for? You can.
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You know, usually you're looking
for them not feeling well.
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Yeah. You know,
they're breathing quickly.
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Lot of times a minute.
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You know, they might have pallor
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because they're
not getting good blood
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throughout
their body. All right.
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So after we determine
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a patient's in heart
failure for whatever reason,
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we wanna find
out the reason why.
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Why do things happen?
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Unless you understand the reason
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why it's hard to
get a good treatment.
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So the next thing we say
it could be a rhythm problem.
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And we do that with an E.K.G.
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or monitor or
checking the pulse.
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It could be one of
these congenital problems.
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Yes. It could be a fast
rhythm like atrial fibrillation.
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It might be a slow rhythm.
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So if that's a
cause of heart failure,
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we want to correct the rhythm.
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Now sometimes another
reason of heart failure
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is the heart
pump itself is weak.
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The left
ventricle, this big chamber
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that pumps to the
entire body is weak.
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Many things can
cause that to be weak too.
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The most common is
blockages in the arteries.
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We've talked about
that in previous programs.
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And the
treatment for that would be
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see if we can get more
blood out to the heart.
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You can sure tell
right here that needs blood.
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I mean look at that--you can see
the artery is coming in here.
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There is a big supply coming
into the heart all the time.
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So it's very obvious
that without that blood supply
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this heart would
have a hard time.
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Absolutely,
Charles, also heart attacks,
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blockages can
make your heart weak.
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The heart gets weak,
doesn't pump blood very well.
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Fluid backs up into the body.
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Another cause of heart failure.
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Now sometimes the muscle gets
stiff and doesn't relax well.
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The muscle either gets thick
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from pumping against a
lot of high blood pressure.
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Sometimes we can have things
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that actually get
inside the heart wall.
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We have
conditions like sarcoidosis
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where we have different proteins
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that make the
heart not expand as well.
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Another condition called
amyloidosis or hemochromatosis,
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all these can also make
the heart not relax well.
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I mean there is a
relaxing phase of the heart.
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So any type of rhythm problem,
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strength of the
heart or relaxing condition
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can also
precipitate heart failure.
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So your cardiologist,
Charles,when you come in,
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he first is gonna decide
if you're an heart failure-
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Yeah. Why
you're in heart failure
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and then he's gonna come
up with the treatment plan.
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Both with modern medicine
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and especially
with lifestyle changes.
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Now did we answer her
question? I think we did.
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What does heart failure mean?
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It just means that
the heart is not doing
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what it's
designed to do. Exactly.
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Like brain
failure. Let me tell you.
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Brain failure. Brain failure?
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Yes, brain fails
when the brain doesn't do
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what it's supposed to
do. I have that. Yeah.
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So I was gonna
remind you that so
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we could talk more
about heart failure
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because we don't want
to have brain failure.
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So that's what's- let's go
to another question. All right.
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I wanna insert one of my
own here because a lot of times
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when I am just, sort
of, sitting at the computer
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and everything my
heart just flutters.
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Yeah. Is fluttering dangerous?
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Shall I go see you
with a fluttering heart?
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If it continues
and lots of people
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have skipped heart beats. Yeah.
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Okay, now if it goes
for long periods of time
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then you don't get a good
blood pressure to your head.
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You get dizzy or you've
a- - Just for a few seconds.
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Yeah, if it's
just for a few seconds.
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Probably not but if
you start having symptoms
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that lasts
longer we put a monitor
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on you and I'll check to see
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if you have a funny heart rhythm
that might need some treatment.
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But most people if
they lower the stress,
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they get enough
sleep, drink enough water,
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cut back on their stimulants--
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you know, these
energy drinks are causing
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lots of
problems with rhythm now.
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Yeah, people drink
all these energy drinks
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and the heart
starts going too fast.
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No blood goes to the head.
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They've serious
problems. Wow. Okay.
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So-so lots of things can
make the heart not work well.
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So I think we answered
that question. I think we did.
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All right. No
more brain failures.
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Now what is the main stay in
the treatment of heart failure?
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What's the number 1
thing to do? Okay, okay.
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Well, we talked about
that. First, we wanna to know
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why the heart's weak, okay?
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Once we deal with
that and let's say
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there's nothing that
we can do to reverse it.
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There's no-a pacer or a
device we can put in the heart.
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We can't do bypass. The heart
is just weak, let's say. Yeah.
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When the heart is weak
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it turns on this
neural hormonal axis.
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The heart says I am weak.
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So a bunch of chemicals get in
the body which make it weaker.
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Those are the stress chemicals.
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Adrenaline,
cortisol, angiotensin,
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we make all these chemicals
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that make your
heart even weaker.
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So what we wanna do is we
wanna block those chemicals.
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So our medications that
we give people help block
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those chemicals. which
damage the heart further.
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Of course, the natural thing
we wanna do is get enough rest,
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exercise, make some
endorphins. Eat a healthy diet.
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You know, get good
oxygen throughout the body.
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The common sense things.
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But in addition to that
we can give medicines like
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beta blockers
which block adrenaline.
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We can also give
angiotensin blockers,
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they call ACE inhibitors,
the blocker chemical.
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So we can block the chemicals
that make a heart weaker.
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It can actually make the
heart a little bit stronger.
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So the dual treatment for this,
first find out why it's weak
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and see if there's
anything reversible. Yeah.
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And if it's not
reversible give medicines
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to block this
neural hormonal axis.
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And then, of course, if
there's extra fluid in the body,
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we wanna give a diarrhetic
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which take
fluid out of the body.
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We wanna teach
people how to eat well.
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And avoid extra
salt or do anything
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that will make
the heart work harder.
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Years ago, Charles,
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when we didn't have
all this modern medicine,
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when we didn't
have defibrillators
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to shock a weak
heart or these medicines
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to keep the heart
from getting weaker,
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you know, what we used to do?
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We use to rest the heart.
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If your arm was broken
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you wouldn't quit
throwing fast balls, would you?
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We used to bed rest hearts.
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And so resting
the heart helps too,
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which brings me back to
some of the biblical treatments
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we've been talking about.
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You know, God gave us a
time of rest. God gave us night.
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Well, that helps us
to block these chemicals
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which make our body weaker.
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So that's a great
treatment for everybody
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whether or not
they have a weak heart
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is make sure you get
enough rest in your life.
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Both the nightly rest
and the God of the universe
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didn't have health problems
and he rested one day a week.
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So rest is also a treatment.
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It changes the chemistry just
like these medicines should.
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So let's go to
another question. Absolutely.
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Modern medicine is there to
get us through the emergency
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and then
immediately, immediately,
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lifestyle, get right on it.
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Okay, here we go. Okay.
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Does everyone with
atrial fibrillation
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need a blood thinner? Yeah.
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And that's a
question that has to do
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because sometimes
atrial fibrillation
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that's where the top part
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goes faster
than the bottom part.
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Sometimes it goes so fast
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that the heart
loses its efficiency.
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Like quivering. Yes.
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If the top part is quivering
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then you go into
heart failure. Yeah.
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So the first thing
I say when a person--
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if the heart failure is
from the atrial fibrillation
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we wanna see if we can reverse
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the cause of
atrial fibrillation.
00:08:07.50\00:08:09.01
That might be sleep
apnea, over active thyroid,
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dehydration or it might
be that you just have it.
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Now we can get rid
it quickly with a shock.
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I can shock the heart
and get it back in rhythm.
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I sometimes-we also can
sometimes do a fancy oblations
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that can get rid of the rhythm.
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But sometimes no matter
what we still have this rhythm.
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Once we slow it down usually
the heart functions pretty good.
00:08:26.30\00:08:29.73
It's that fast speed
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that doesn't allow
it to fill up with blood
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that causes heart
failure but in this process
00:08:32.94\00:08:36.26
the atrium goes fast
it's like a bag of worms.
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And when the blood doesn't move
00:08:39.37\00:08:41.33
through it easily
you can get a blood clot.
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And if a blood clot
pumps out of the heart
00:08:44.41\00:08:46.14
it could go at the head.
00:08:46.17\00:08:47.54
And that could cause a
stroke, an embolic stroke.
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So people that have
atrial fibrillation,
00:08:50.48\00:08:53.81
once the heart slowdown,
00:08:53.84\00:08:55.21
they're out of heart failure,
every doctor should say,
00:08:55.24\00:08:57.48
listen, is this a person that's
a candidate for a blood thinner.
00:08:57.69\00:09:01.76
And one of the blood thinners
00:09:01.79\00:09:03.16
we have out now
is called coumadin.
00:09:03.19\00:09:04.90
They've developed a
couple of new blood thinners
00:09:04.93\00:09:06.82
that are on the market now.
00:09:06.85\00:09:08.22
One's called
pradaxa. One's called xarelto.
00:09:08.25\00:09:10.76
They each have
their pros and cons.
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And I know a lot of people
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that I talk to never
want to take a blood thinner.
00:09:14.47\00:09:17.59
But then also I don't
want them to have a stroke
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because the stroke
could debilitate them.
00:09:19.83\00:09:21.90
And if you're in
atrial fibrillation
00:09:21.93\00:09:23.65
and you don't
take a blood thinner
00:09:23.68\00:09:25.05
the chance of
you having a stroke
00:09:25.08\00:09:26.45
is about five percent per year.
00:09:26.48\00:09:28.09
So if you go four
years you could have a 20%
00:09:28.12\00:09:30.14
chance of having a
stroke off a blood thinner.
00:09:30.17\00:09:31.83
So everything about medicines
00:09:31.86\00:09:33.63
is about the risk
versus the benefits.
00:09:33.66\00:09:36.07
So this question,
should I take a blood thinner
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at least should
be talked about it
00:09:38.89\00:09:40.59
to see if you're an
adequate risk for it.
00:09:40.62\00:09:42.72
All right. Let's go to
the next question here.
00:09:42.75\00:09:44.52
My friend had a pacemaker.
00:09:44.55\00:09:46.98
What type of
patient needs a pacemaker?
00:09:47.01\00:09:49.93
And I understand
you've one here to show us.
00:09:49.96\00:09:51.33
Yes, I do, Charles.
00:09:51.36\00:09:52.73
And before we get to
that I am gonna tell you
00:09:52.76\00:09:55.27
what type of
person needs a pacemaker.
00:09:55.30\00:09:57.58
If your heart's going
too slow for whatever reason
00:09:57.61\00:10:00.84
you might benefit
from a pacemaker, okay?
00:10:00.87\00:10:03.18
And it might be that your
heart's just degenerative.
00:10:03.21\00:10:05.51
It's just getting old, rusty.
00:10:05.54\00:10:07.34
The battery doesn't work
well. You need a new battery.
00:10:07.37\00:10:10.01
It might be that
you're not getting
00:10:10.04\00:10:11.41
enough blood to the battery.
00:10:11.44\00:10:12.99
It might be that
you get an infection.
00:10:13.02\00:10:14.87
It might be that you
have other conditions
00:10:14.90\00:10:16.72
that make your heart go slow.
00:10:16.75\00:10:18.36
Well, a pacemaker is
usually placed right here
00:10:18.39\00:10:21.86
in this area on the
non dominant side. Okay.
00:10:21.89\00:10:24.58
And then we-- The
heart is right in here--
00:10:24.61\00:10:26.80
Right in here, uh-huh.
00:10:26.83\00:10:28.20
It's right in here
about the size of the fist.
00:10:28.23\00:10:29.60
Now this is probably
an elephant's heart here.
00:10:29.63\00:10:31.20
That would be a very
large heart. Big heart. Okay.
00:10:31.23\00:10:33.39
So what we do we
put the lead--we implant
00:10:33.42\00:10:36.18
this here under the
skin. We put the lead in.
00:10:36.21\00:10:38.11
Now the lead has
wires that monitor.
00:10:38.14\00:10:40.02
It has computer chip.
00:10:40.05\00:10:41.42
It would go inside
and we would actually
00:10:41.45\00:10:43.74
place this inside
the left ventricle--
00:10:43.77\00:10:46.28
the right ventricle of the heart
00:10:46.31\00:10:47.78
And it now would
tell wevery single beat
00:10:47.81\00:10:49.87
that would happen
and if it would go slow
00:10:49.90\00:10:51.84
there is a sensor there and
the heart would start pacing
00:10:51.87\00:10:55.18
the electrical current
that came through this battery.
00:10:55.21\00:10:58.08
This is like a probe then-- Yes.
00:10:58.11\00:11:00.09
It's a like a
battery of your car.Okay.
00:11:00.12\00:11:03.48
And then you have this lead
00:11:03.51\00:11:04.88
that would give
the electrical shock
00:11:04.91\00:11:06.28
that would make it squeeze.
00:11:06.31\00:11:07.68
Is this embedded right
into the muscle of the--
00:11:07.71\00:11:09.34
Yes and actually
there's some little spikes that,
00:11:09.37\00:11:11.58
sort of, anchor it
into the ventricle. Okay.
00:11:11.61\00:11:13.97
But eventually it
grows into the heart. Okay.
00:11:14.00\00:11:16.57
Pacemaker usually
lasts about seven years
00:11:16.60\00:11:19.52
before the battery runs out.
00:11:19.55\00:11:21.28
Now we can check it with
monitors on the telephone.
00:11:21.31\00:11:24.38
And then when it runs
out we just put a new one in
00:11:24.41\00:11:26.62
and take the lead
that's already there
00:11:26.65\00:11:28.02
and hook it back up and boom,
00:11:28.05\00:11:29.42
you're good for
another seven leads.
00:11:29.45\00:11:30.82
This is minimally
invasive because you make
00:11:30.85\00:11:32.22
a very small insertion there.
00:11:32.25\00:11:33.62
Yes, very, very--
it's a very great thing
00:11:33.65\00:11:36.01
for people that are older.
00:11:36.04\00:11:37.65
That have there
hearts going too slow
00:11:37.68\00:11:39.54
just because the
battery is wearing out.
00:11:39.57\00:11:41.78
Before we had this
people would die prematurely.
00:11:41.81\00:11:44.49
Their heart would go
slower and slower and slower.
00:11:44.52\00:11:46.86
And then it would stop.
00:11:46.89\00:11:48.26
But now we've
pacemaker therapies
00:11:48.29\00:11:49.79
that can help a
weak-- a heart beat better.
00:11:49.82\00:11:52.48
It can also help people
not go into heart failure.
00:11:52.51\00:11:55.46
Sometimes it goes so slow,
00:11:55.49\00:11:56.86
the lungs fill up with fluids.
So it's a great treatment.
00:11:56.89\00:12:00.25
A great place for
modern medicine. Absolutely.
00:12:00.28\00:12:02.92
And here's our final question
from heartwiseministries.org.
00:12:02.95\00:12:06.40
What is a left
ventricular assist device?
00:12:06.43\00:12:09.73
Well, you know, a left
ventricular--sometimes,
00:12:09.76\00:12:12.00
people's hearts are weak. Yeah.
00:12:12.03\00:12:13.58
And we look at all
the reversible causes
00:12:13.61\00:12:15.70
and we can't do
anything with the rhythm.
00:12:15.73\00:12:17.24
We can't make the heart stronger
00:12:17.27\00:12:18.64
with the
medicines we talked about.
00:12:18.67\00:12:20.70
We can't make it
relaxed better, okay?
00:12:20.73\00:12:23.09
So if we can't do anything
medically to help the heart
00:12:23.12\00:12:25.80
we now can replace the heart
00:12:25.83\00:12:27.77
with the left
ventricular assist device.
00:12:27.80\00:12:29.80
This device actually
does the pumping for the body.
00:12:29.83\00:12:33.36
And they improve
them year after year
00:12:33.39\00:12:35.70
so sometimes this device
helps the heart get better
00:12:35.73\00:12:39.00
because the heart rests,
because it doesn't have pump
00:12:39.03\00:12:41.56
when the left
ventricle assist device is in.
00:12:41.59\00:12:44.02
This sometimes
helps a heart, especially,
00:12:44.05\00:12:45.91
if they've had a virus.
00:12:45.94\00:12:47.31
And the heart just
needs sometime to get better.
00:12:47.34\00:12:49.21
But also it's a bridge
00:12:49.24\00:12:51.06
and it can stay in it
for several years now.
00:12:51.09\00:12:53.80
I mean there is a vice
president of the United States.
00:12:53.83\00:12:57.09
A former vice
president that had one of these
00:12:57.12\00:12:58.92
left ventricles
devices and he walked around
00:12:58.95\00:13:01.49
and he functioned well with it
until he got a heart transplant
00:13:01.52\00:13:05.26
which is the
definitive treatment
00:13:05.29\00:13:07.03
for a heart that
can't get better.
00:13:07.06\00:13:08.43
They can't keep up the supplies.
00:13:08.46\00:13:10.02
So who would get a left
ventricular assist device?
00:13:10.05\00:13:12.20
Well, if the heart
continues to go into failure,
00:13:12.23\00:13:14.88
you're not doing
well, have no energy
00:13:14.91\00:13:17.97
and all the
medicines and everything else
00:13:18.00\00:13:19.66
we can't-- cannot reverse it,
00:13:19.69\00:13:21.15
they might get a
left ventricular device
00:13:21.18\00:13:23.43
Sometimes it might be an
end treatment, okay?Yeah.
00:13:23.46\00:13:26.53
Forever until a
person died or sometimes
00:13:26.56\00:13:29.04
it might be a bridge
to a transplantation.
00:13:29.07\00:13:30.99
All right. That is amazing.
00:13:31.02\00:13:32.76
We'll take a short
break and when we comeback
00:13:32.79\00:13:34.56
lets talk to God
about hearts. Stay tuned.
00:13:34.59\00:13:37.45
We've talked today
about heart failure.
00:13:40.87\00:13:43.26
Another one of
the leading causes
00:13:43.29\00:13:44.77
of death in the entire world.
00:13:44.80\00:13:47.43
This might come
from a rhythm abnormality
00:13:47.46\00:13:49.44
that might be congenital.
00:13:49.47\00:13:51.43
It might come from
a heart that's weak
00:13:51.46\00:13:53.12
from a variety of causes,
blockages in the arteries,
00:13:53.15\00:13:56.11
infections, bad heart valves.
00:13:56.14\00:13:59.41
It might be that the
heart doesn't fill up well
00:13:59.44\00:14:01.42
because there's
something in the muscle.
00:14:01.45\00:14:03.57
Like a protein
called amyloid or sarcoid.
00:14:03.60\00:14:07.30
There are great
treatments for the heart
00:14:07.33\00:14:08.81
that we've talked about.
00:14:08.84\00:14:10.21
Blocking the
neural hormonal access.
00:14:10.24\00:14:12.33
Lot's of medications in help.
00:14:12.36\00:14:13.98
Lifestyle changes
including exercise,
00:14:14.01\00:14:17.14
eating a good
diet, resting the heart
00:14:17.17\00:14:19.77
and in the most severe cases
00:14:19.80\00:14:21.21
there are treatments like a
left ventricular assist device.
00:14:21.24\00:14:24.39
And even some people
get a heart transplantation.
00:14:24.42\00:14:27.55
Well, there's also healing
power in this relationship.
00:14:27.58\00:14:30.90
This relationship that we can
have with our heavenly Father.
00:14:30.93\00:14:33.95
No matter how bad our heart is
00:14:33.98\00:14:36.09
this relationship
can bring us to healing
00:14:36.12\00:14:38.19
at some point in our life.
00:14:38.22\00:14:39.77
And if you're heart
is weak God can give you
00:14:39.80\00:14:41.42
the power to make
some lifestyle changes.
00:14:41.45\00:14:44.33
So we want to-- if
any one is out there
00:14:44.36\00:14:46.31
that has a weak heart
we'll be praying for you,
00:14:46.34\00:14:48.81
that God will bring you
00:14:48.84\00:14:50.23
into this healing
relationship with him.
00:14:50.26\00:14:52.75
We wanna thank you for
joining us and we hope that
00:14:52.78\00:14:55.01
all of your days are good days
filled with the heavenly spirit.
00:14:55.04\00:14:58.77