Participants: James Marcum & Charles Mills
Series Code: UP
Program Code: UP00015B
|
00:01 Welcome back to the program.
00:02 We're talking about what kills us. 00:04 And our hearts are high on that list. 00:06 As a matter of fact it's number 1 on that list. 00:08 Dr. Marcum is here telling us how we can live 00:10 and things that we can do to minimize the risk. 00:13 And that's what it sounds like. 00:15 We're not talking about guarantees here. 00:17 We're talking about risk management. 00:19 Right, and we talked early about 00:21 the congenital abnormalities. Yes. 00:22 And before we had these treatments 00:25 the congenital patients would pass away. Yeah. 00:27 But we talked in previous programs about heart attacks. 00:30 You know, we talked about the rhythms. 00:32 But there is all-- lot of other things 00:34 that cause hearts to get weak too. 00:36 And we're gonna address these 00:37 and some of the questions we get up. 00:39 Let's go to the heartwiseministries.org website 00:41 and here are some questions that have been sent in. 00:43 Number 1, what exactly does the term, 00:47 heart failure mean? 00:49 Now that sounds like the heart just stops. Is that right? 00:51 The heart's failure means 00:53 that the heart for whatever reason 00:54 doesn't pump blood to the needed organs. 00:57 And the needed organ is the brain. Yes. 00:59 A needed organ is the kidneys. 01:01 So when the heart doesn't pump for whatever reason, 01:04 we call that heart failure. 01:05 It fails to do what it's designed to do. 01:06 Exactly. A symptom of heart failure might be fatigue. 01:10 If the heart doesn't pump blood 01:12 for it sometimes fluid backs up in the lungs. 01:14 You get short of breath, especially, when you lie down. 01:16 Yeah. You can't get rid of the fluid in the body 01:18 so you might swell up in the abdomen or legs. 01:21 Those all might be symptoms of heart failure. Okay. 01:24 So once you make a diagnosis of heart failure 01:26 and we've got- we have x-rays. 01:28 We can look for extra fluids. 01:29 There are some chemicals we can measure in the blood 01:31 that tells us if that person is in heart failure. 01:33 But usually I know if a person is in the heart failure 01:35 because their heart's beating fast. 01:37 Try to keep up with them, they can't breathe well. 01:39 They're swelling up. They'll feel weak and tired. 01:42 You've told me that you can have 01:43 a patient walk into the room 01:45 and you can look at that patient. 01:47 And you can pretty well tell what's going on with the heart. 01:48 Yeah. What are you looking for? You can. 01:50 You know, usually you're looking for them not feeling well. 01:52 Yeah. You know, they're breathing quickly. 01:54 Lot of times a minute. 01:55 You know, they might have pallor 01:57 because they're not getting good blood 01:58 throughout their body. All right. 02:00 So after we determine 02:01 a patient's in heart failure for whatever reason, 02:03 we wanna find out the reason why. 02:05 Why do things happen? 02:07 Unless you understand the reason 02:08 why it's hard to get a good treatment. 02:10 So the next thing we say it could be a rhythm problem. 02:13 And we do that with an E.K.G. 02:15 or monitor or checking the pulse. 02:16 It could be one of these congenital problems. 02:18 Yes. It could be a fast rhythm like atrial fibrillation. 02:21 It might be a slow rhythm. 02:23 So if that's a cause of heart failure, 02:24 we want to correct the rhythm. 02:26 Now sometimes another reason of heart failure 02:28 is the heart pump itself is weak. 02:31 The left ventricle, this big chamber 02:33 that pumps to the entire body is weak. 02:36 Many things can cause that to be weak too. 02:38 The most common is blockages in the arteries. 02:41 We've talked about that in previous programs. 02:43 And the treatment for that would be 02:44 see if we can get more blood out to the heart. 02:47 You can sure tell right here that needs blood. 02:49 I mean look at that--you can see the artery is coming in here. 02:51 There is a big supply coming into the heart all the time. 02:53 So it's very obvious that without that blood supply 02:56 this heart would have a hard time. 02:57 Absolutely, Charles, also heart attacks, 03:00 blockages can make your heart weak. 03:03 The heart gets weak, doesn't pump blood very well. 03:06 Fluid backs up into the body. 03:08 Another cause of heart failure. 03:10 Now sometimes the muscle gets stiff and doesn't relax well. 03:14 The muscle either gets thick 03:16 from pumping against a lot of high blood pressure. 03:18 Sometimes we can have things 03:19 that actually get inside the heart wall. 03:21 We have conditions like sarcoidosis 03:24 where we have different proteins 03:25 that make the heart not expand as well. 03:28 Another condition called amyloidosis or hemochromatosis, 03:31 all these can also make the heart not relax well. 03:35 I mean there is a relaxing phase of the heart. 03:37 So any type of rhythm problem, 03:39 strength of the heart or relaxing condition 03:42 can also precipitate heart failure. 03:44 So your cardiologist, Charles,when you come in, 03:46 he first is gonna decide if you're an heart failure- 03:48 Yeah. Why you're in heart failure 03:50 and then he's gonna come up with the treatment plan. 03:53 Both with modern medicine 03:54 and especially with lifestyle changes. 03:56 Now did we answer her question? I think we did. 03:59 What does heart failure mean? 04:00 It just means that the heart is not doing 04:02 what it's designed to do. Exactly. 04:03 Like brain failure. Let me tell you. 04:05 Brain failure. Brain failure? 04:07 Yes, brain fails when the brain doesn't do 04:08 what it's supposed to do. I have that. Yeah. 04:10 So I was gonna remind you that so 04:11 we could talk more about heart failure 04:13 because we don't want to have brain failure. 04:15 So that's what's- let's go to another question. All right. 04:17 I wanna insert one of my own here because a lot of times 04:21 when I am just, sort of, sitting at the computer 04:23 and everything my heart just flutters. 04:26 Yeah. Is fluttering dangerous? 04:28 Shall I go see you with a fluttering heart? 04:30 If it continues and lots of people 04:32 have skipped heart beats. Yeah. 04:34 Okay, now if it goes for long periods of time 04:36 then you don't get a good blood pressure to your head. 04:38 You get dizzy or you've a- - Just for a few seconds. 04:40 Yeah, if it's just for a few seconds. 04:42 Probably not but if you start having symptoms 04:44 that lasts longer we put a monitor 04:46 on you and I'll check to see 04:47 if you have a funny heart rhythm that might need some treatment. 04:50 But most people if they lower the stress, 04:52 they get enough sleep, drink enough water, 04:54 cut back on their stimulants-- 04:56 you know, these energy drinks are causing 04:58 lots of problems with rhythm now. 04:59 Yeah, people drink all these energy drinks 05:01 and the heart starts going too fast. 05:03 No blood goes to the head. 05:04 They've serious problems. Wow. Okay. 05:06 So-so lots of things can make the heart not work well. 05:09 So I think we answered that question. I think we did. 05:11 All right. No more brain failures. 05:12 Now what is the main stay in the treatment of heart failure? 05:16 What's the number 1 thing to do? Okay, okay. 05:18 Well, we talked about that. First, we wanna to know 05:20 why the heart's weak, okay? 05:22 Once we deal with that and let's say 05:23 there's nothing that we can do to reverse it. 05:25 There's no-a pacer or a device we can put in the heart. 05:28 We can't do bypass. The heart is just weak, let's say. Yeah. 05:31 When the heart is weak 05:33 it turns on this neural hormonal axis. 05:35 The heart says I am weak. 05:36 So a bunch of chemicals get in the body which make it weaker. 05:39 Those are the stress chemicals. 05:41 Adrenaline, cortisol, angiotensin, 05:44 we make all these chemicals 05:45 that make your heart even weaker. 05:46 So what we wanna do is we wanna block those chemicals. 05:49 So our medications that we give people help block 05:52 those chemicals. which damage the heart further. 05:55 Of course, the natural thing we wanna do is get enough rest, 05:59 exercise, make some endorphins. Eat a healthy diet. 06:02 You know, get good oxygen throughout the body. 06:04 The common sense things. 06:06 But in addition to that we can give medicines like 06:09 beta blockers which block adrenaline. 06:11 We can also give angiotensin blockers, 06:15 they call ACE inhibitors, the blocker chemical. 06:18 So we can block the chemicals that make a heart weaker. 06:21 It can actually make the heart a little bit stronger. 06:23 So the dual treatment for this, first find out why it's weak 06:27 and see if there's anything reversible. Yeah. 06:29 And if it's not reversible give medicines 06:31 to block this neural hormonal axis. 06:33 And then, of course, if there's extra fluid in the body, 06:35 we wanna give a diarrhetic 06:37 which take fluid out of the body. 06:40 We wanna teach people how to eat well. 06:41 And avoid extra salt or do anything 06:43 that will make the heart work harder. 06:44 Years ago, Charles, 06:46 when we didn't have all this modern medicine, 06:48 when we didn't have defibrillators 06:49 to shock a weak heart or these medicines 06:52 to keep the heart from getting weaker, 06:53 you know, what we used to do? 06:54 We use to rest the heart. 06:56 If your arm was broken 06:57 you wouldn't quit throwing fast balls, would you? 06:59 We used to bed rest hearts. 07:01 And so resting the heart helps too, 07:03 which brings me back to some of the biblical treatments 07:05 we've been talking about. 07:06 You know, God gave us a time of rest. God gave us night. 07:10 Well, that helps us to block these chemicals 07:12 which make our body weaker. 07:13 So that's a great treatment for everybody 07:16 whether or not they have a weak heart 07:17 is make sure you get enough rest in your life. 07:20 Both the nightly rest and the God of the universe 07:22 didn't have health problems and he rested one day a week. 07:25 So rest is also a treatment. 07:26 It changes the chemistry just like these medicines should. 07:30 So let's go to another question. Absolutely. 07:32 Modern medicine is there to get us through the emergency 07:36 and then immediately, immediately, 07:39 lifestyle, get right on it. 07:40 Okay, here we go. Okay. 07:43 Does everyone with atrial fibrillation 07:46 need a blood thinner? Yeah. 07:47 And that's a question that has to do 07:49 because sometimes atrial fibrillation 07:51 that's where the top part 07:52 goes faster than the bottom part. 07:54 Sometimes it goes so fast 07:56 that the heart loses its efficiency. 07:58 Like quivering. Yes. 07:59 If the top part is quivering 08:00 then you go into heart failure. Yeah. 08:02 So the first thing I say when a person-- 08:03 if the heart failure is from the atrial fibrillation 08:06 we wanna see if we can reverse 08:07 the cause of atrial fibrillation. 08:09 That might be sleep apnea, over active thyroid, 08:11 dehydration or it might be that you just have it. 08:14 Now we can get rid it quickly with a shock. 08:16 I can shock the heart and get it back in rhythm. 08:18 I sometimes-we also can sometimes do a fancy oblations 08:21 that can get rid of the rhythm. 08:23 But sometimes no matter what we still have this rhythm. 08:26 Once we slow it down usually the heart functions pretty good. 08:29 It's that fast speed 08:31 that doesn't allow it to fill up with blood 08:32 that causes heart failure but in this process 08:36 the atrium goes fast it's like a bag of worms. 08:39 And when the blood doesn't move 08:41 through it easily you can get a blood clot. 08:44 And if a blood clot pumps out of the heart 08:46 it could go at the head. 08:47 And that could cause a stroke, an embolic stroke. 08:50 So people that have atrial fibrillation, 08:53 once the heart slowdown, 08:55 they're out of heart failure, every doctor should say, 08:57 listen, is this a person that's a candidate for a blood thinner. 09:01 And one of the blood thinners 09:03 we have out now is called coumadin. 09:04 They've developed a couple of new blood thinners 09:06 that are on the market now. 09:08 One's called pradaxa. One's called xarelto. 09:10 They each have their pros and cons. 09:13 And I know a lot of people 09:14 that I talk to never want to take a blood thinner. 09:17 But then also I don't want them to have a stroke 09:19 because the stroke could debilitate them. 09:21 And if you're in atrial fibrillation 09:23 and you don't take a blood thinner 09:25 the chance of you having a stroke 09:26 is about five percent per year. 09:28 So if you go four years you could have a 20% 09:30 chance of having a stroke off a blood thinner. 09:31 So everything about medicines 09:33 is about the risk versus the benefits. 09:36 So this question, should I take a blood thinner 09:38 at least should be talked about it 09:40 to see if you're an adequate risk for it. 09:42 All right. Let's go to the next question here. 09:44 My friend had a pacemaker. 09:47 What type of patient needs a pacemaker? 09:49 And I understand you've one here to show us. 09:51 Yes, I do, Charles. 09:52 And before we get to that I am gonna tell you 09:55 what type of person needs a pacemaker. 09:57 If your heart's going too slow for whatever reason 10:00 you might benefit from a pacemaker, okay? 10:03 And it might be that your heart's just degenerative. 10:05 It's just getting old, rusty. 10:07 The battery doesn't work well. You need a new battery. 10:10 It might be that you're not getting 10:11 enough blood to the battery. 10:13 It might be that you get an infection. 10:14 It might be that you have other conditions 10:16 that make your heart go slow. 10:18 Well, a pacemaker is usually placed right here 10:21 in this area on the non dominant side. Okay. 10:24 And then we-- The heart is right in here-- 10:26 Right in here, uh-huh. 10:28 It's right in here about the size of the fist. 10:29 Now this is probably an elephant's heart here. 10:31 That would be a very large heart. Big heart. Okay. 10:33 So what we do we put the lead--we implant 10:36 this here under the skin. We put the lead in. 10:38 Now the lead has wires that monitor. 10:40 It has computer chip. 10:41 It would go inside and we would actually 10:43 place this inside the left ventricle-- 10:46 the right ventricle of the heart 10:47 And it now would tell wevery single beat 10:49 that would happen and if it would go slow 10:51 there is a sensor there and the heart would start pacing 10:55 the electrical current that came through this battery. 10:58 This is like a probe then-- Yes. 11:00 It's a like a battery of your car.Okay. 11:03 And then you have this lead 11:04 that would give the electrical shock 11:06 that would make it squeeze. 11:07 Is this embedded right into the muscle of the-- 11:09 Yes and actually there's some little spikes that, 11:11 sort of, anchor it into the ventricle. Okay. 11:14 But eventually it grows into the heart. Okay. 11:16 Pacemaker usually lasts about seven years 11:19 before the battery runs out. 11:21 Now we can check it with monitors on the telephone. 11:24 And then when it runs out we just put a new one in 11:26 and take the lead that's already there 11:28 and hook it back up and boom, 11:29 you're good for another seven leads. 11:30 This is minimally invasive because you make 11:32 a very small insertion there. 11:33 Yes, very, very-- it's a very great thing 11:36 for people that are older. 11:37 That have there hearts going too slow 11:39 just because the battery is wearing out. 11:41 Before we had this people would die prematurely. 11:44 Their heart would go slower and slower and slower. 11:46 And then it would stop. 11:48 But now we've pacemaker therapies 11:49 that can help a weak-- a heart beat better. 11:52 It can also help people not go into heart failure. 11:55 Sometimes it goes so slow, 11:56 the lungs fill up with fluids. So it's a great treatment. 12:00 A great place for modern medicine. Absolutely. 12:02 And here's our final question from heartwiseministries.org. 12:06 What is a left ventricular assist device? 12:09 Well, you know, a left ventricular--sometimes, 12:12 people's hearts are weak. Yeah. 12:13 And we look at all the reversible causes 12:15 and we can't do anything with the rhythm. 12:17 We can't make the heart stronger 12:18 with the medicines we talked about. 12:20 We can't make it relaxed better, okay? 12:23 So if we can't do anything medically to help the heart 12:25 we now can replace the heart 12:27 with the left ventricular assist device. 12:29 This device actually does the pumping for the body. 12:33 And they improve them year after year 12:35 so sometimes this device helps the heart get better 12:39 because the heart rests, because it doesn't have pump 12:41 when the left ventricle assist device is in. 12:44 This sometimes helps a heart, especially, 12:45 if they've had a virus. 12:47 And the heart just needs sometime to get better. 12:49 But also it's a bridge 12:51 and it can stay in it for several years now. 12:53 I mean there is a vice president of the United States. 12:57 A former vice president that had one of these 12:58 left ventricles devices and he walked around 13:01 and he functioned well with it until he got a heart transplant 13:05 which is the definitive treatment 13:07 for a heart that can't get better. 13:08 They can't keep up the supplies. 13:10 So who would get a left ventricular assist device? 13:12 Well, if the heart continues to go into failure, 13:14 you're not doing well, have no energy 13:18 and all the medicines and everything else 13:19 we can't-- cannot reverse it, 13:21 they might get a left ventricular device 13:23 Sometimes it might be an end treatment, okay?Yeah. 13:26 Forever until a person died or sometimes 13:29 it might be a bridge to a transplantation. 13:31 All right. That is amazing. 13:32 We'll take a short break and when we comeback 13:34 lets talk to God about hearts. Stay tuned. 13:40 We've talked today about heart failure. 13:43 Another one of the leading causes 13:44 of death in the entire world. 13:47 This might come from a rhythm abnormality 13:49 that might be congenital. 13:51 It might come from a heart that's weak 13:53 from a variety of causes, blockages in the arteries, 13:56 infections, bad heart valves. 13:59 It might be that the heart doesn't fill up well 14:01 because there's something in the muscle. 14:03 Like a protein called amyloid or sarcoid. 14:07 There are great treatments for the heart 14:08 that we've talked about. 14:10 Blocking the neural hormonal access. 14:12 Lot's of medications in help. 14:14 Lifestyle changes including exercise, 14:17 eating a good diet, resting the heart 14:19 and in the most severe cases 14:21 there are treatments like a left ventricular assist device. 14:24 And even some people get a heart transplantation. 14:27 Well, there's also healing power in this relationship. 14:30 This relationship that we can have with our heavenly Father. 14:33 No matter how bad our heart is 14:36 this relationship can bring us to healing 14:38 at some point in our life. 14:39 And if you're heart is weak God can give you 14:41 the power to make some lifestyle changes. 14:44 So we want to-- if any one is out there 14:46 that has a weak heart we'll be praying for you, 14:48 that God will bring you 14:50 into this healing relationship with him. 14:52 We wanna thank you for joining us and we hope that 14:55 all of your days are good days filled with the heavenly spirit. |
Revised 2014-12-17