Welcome back to the
Ultimate Prescription.
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I'm your host Nick Evenson
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here with Dr. James
Marcum, practicing Cardiologist
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with the
Chattanooga Heart Institute.
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And today, we're
talking about heart valves.
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And, Dr. Marcum,
in the last segment,
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we talked a bit about
trans aortic valve replacement.
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Yeah. And why
you might want that.
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What are some of
the risks involved?
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Yeah, there's always
risk and there's risk
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of having the surgery itself,
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which mainly includes bleeding,
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there's a small risk of
dying from any procedure.
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There's a small
risk of stroke and that,
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but we also talk about
the benefits of not doing it.
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Usually the valve
gets old fairly quickly,
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and then you not
only lose quality of life
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but you die from this.
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Now some people say,
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"No, I don't
want anything done."
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It's ready, it's my time
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and they choose
not to have it done
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and that's fine.
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I know that, you know,
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it's hard to
make these decisions.
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I know that you
have a grandmother
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that watches these programs on.
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I do have grandma if
you're watching, "Hello."
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Okay. If you're watching.
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Okay, but when people
get older things do wear out.
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And that's why it's important
to have a detailed discussion
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about what's
available, the risk and benefits
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and some people say,"
No, this is not for me.
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I don't wanna
take the risk of that.
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I don't wanna
have that. I'm ready.
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I'm ready to meet
Jesus." And that's okay.
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But technology has improved,
it's become a lot safer.
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And some people opt
to have these procedures,
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whether they be a new valve.
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Now valve disease
is a very complex,
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we can't talk about everything.
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Right.
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But the things I
want people to know about
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is if you're short of breath
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or having a
symptom, see your doctor.
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And one of the
things that causes symptoms
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might be the
valve is getting older,
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and we have lots of options
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for valves that are wearing out.
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Now sometimes, you know,
we talked about my patient
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has had the
symptom for a long time.
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We call that chronic disease.
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Now some people
have emergencies.
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The valve just, you
know, has a problem right away.
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We call that
emergent valve problem.
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And if the valve
happens, you know,
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something
happens wrong emergently
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something has to
be done right away.
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So what would cause that?
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A trauma to the valve, you know,
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an infection to the valve,
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a trauma where something
was ripped in the heart
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having a heart attack
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where the blood supply
to the valve wasn't good.
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And the valve
was affected by that
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caused a lot of
leaking something tear.
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So the valve
where its scaffolding
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was becomes disrupted,
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those are
medical emergency route,
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so that we have to
do something right away
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from that that's
called an emergency.
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And then sometimes
we have a slower symptom
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that develops over time.
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That's a chronic situation.
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So my patient
was more of a chronic
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that gradually got worse,
but lots of different options
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on the valves on both
the mitral and the aortic.
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Sometimes the third
valve that we sometimes work on
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is called the tricuspid valve.
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That's the one between
the low pressure chamber
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the right ventricle,
sometimes we have to do stuff
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with that valve as well.
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So lots of different
options on different valves.
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All right, now let's see
if I've got this straight.
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We were just talking
about the trans aortic valve...
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Yeah.
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Which is
controlling the blood flow
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between the left
atrium and ventricle?
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In the left
ventricle in the body.
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In the body. Okay.
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So it pumps out that
valve to the entire body.
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That's the one
that let, you know,
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the heart pumps goes out
the aorta to entire body.
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That's the aortic valve.
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Okay, now let's talk
about the mitral valve,
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the other one in there.
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Yeah. Okay.
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Where's that
controlling blood flow to?
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The mitral valve
control, you know, the lungs,
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fill up the blood with oxygen,
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and it
circulates through the lungs
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and it comes back
to the left atrium,
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and then from the left atrium
it moves to the left ventricle,
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and the left ventricle
then pumps it out to the body.
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Okay. So this is that valve.
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So when there's a
problem with the mitral valve,
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what kind of options are there?
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Well, you know, first of
all, how would we find out that
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we had a problem,
again, shortness of breath,
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sometimes the
heart, the flow can back up
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and the heart can
start fibrillating,
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that might be a clue.
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Sometimes people can
get fatigued and tired,
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but the one I see
most is shortness of breath
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when I do things.
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And that's a clue that
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the mitral valve
might be involved.
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So what would I do?
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I would get my stethoscope
out and I would listen
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and there's things that
they teach us in medical school
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and residency where we
can tell characteristics
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of which valve
is malfunctioning.
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Okay.
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So I would listen
to that valve and say,
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"Wow, that valve sounds like
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it's got a holosystolic murmur."
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That's the way they describe it.
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And I said, "Well, I
need more information."
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So I would do a test,
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an echocardiogram where
we can look at the valve.
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We can look at
it from just putting
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some ultrasound on it.
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Sometimes we can swallow a
probe and look behind that.
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That's called a
transesophageal echocardiogram.
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Sometimes we can get
clues about the valves
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through angiography
and looking at that.
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We now have MRIs and, you know,
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different types of
scans that can look at
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how the valve is
opening and closing.
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And once we found
out that it was leaking,
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then we try to figure out
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why it's leaking, you
know, is it an infection?
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Is it from a
lack of blood supply?
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Is it because
it's just wearing out?
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Is it something congenital?
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So once we
figured out the cause,
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then we could figure out
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what would be the
options for treatment.
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Sometimes the
valve leaks a little bit,
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and we just keep an eye on it.
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Sure, yeah.
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Okay, but
sometimes it leaks a lot.
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And if we don't do
something about it,
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it's gonna
cause further problems
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down the road.
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So sometimes we choose
to treat it right away.
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One of the new develops
in cardiology now, you know,
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for years we
could, sometimes a surgeon
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can open you up
and repair the valve.
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Sometimes you can
replace either a metal valve in
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or put a bioprosthetic valve,
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that's been sort
of the gold standard,
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but over the last two
years, for leaky heart valves
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and for certain
valve conditions,
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we have a procedure that
we don't cut anyone open.
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It's called a mitral valve clip.
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And this is
brand new technology.
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All right, well,
let's take a look at that.
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And you can describe
what's going on here for us?
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Yeah.
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Well, here is a heart,
and that's the mitral valve,
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and see that blue,
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that's the valve
leaking a whole lot.
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So the blood
instead of going forward
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and out the aorta,
which is to your right,
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it's going
backwards and it's leaking.
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And that is what causes
someone to be short of breath.
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Well, we have this procedure,
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where we actually clip
the two valves together.
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And there's an
example of clicking it.
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So now we have two orifices,
and it will cause a lot less
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of this regurgitation leaking.
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So see how much
before and now after
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we notice a lot
less leakage backwards,
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and that's a sort
of a non-invasive way
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we can use to help the blood
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from the mitral valve
from leaking backward.
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Do all patients
candidate for this?
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No, not all,
only specific patients
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would benefit from this,
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but that's what
all the testing can do
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to look at these valves.
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So we can do a lot
of different things
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to help the valves.
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Yeah, so I
imagine the mitral clip,
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maybe has less risk
than actually opening up.
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Yeah, yeah.
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Less risk of
infection, quicker recoveries.
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What are some of
the other benefit?
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Well, the
benefits, main benefits
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is you don't have to
have open-heart surgery.
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Yeah. But it's
not for everybody.
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And again, there
are risks from this.
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And really, you know,
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there's always a
risk of bleeding,
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there's still a
risk of infection,
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there's still a small
risk of stroke and damage,
00:07:14.63\00:07:17.03
but this is for a new technology
00:07:17.07\00:07:19.70
for a special class of patients
that have a leaky heart valve.
00:07:19.73\00:07:23.61
And that valve is
called mitral regurgitation.
00:07:23.64\00:07:25.67
But the big point today
I want for our listeners
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is to know that if
you're short of breath,
00:07:27.88\00:07:30.05
see your doctor.
00:07:30.08\00:07:31.41
There are lots of
things that we can do,
00:07:31.45\00:07:32.98
lots of different
things we can offer.
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Modern medicine has its place
in helping these valves out.
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So are there
medications that are associated
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with these procedures
that patients might have
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to take for a shorter
time or a prolonged time after?
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No, it's according
to their underlying
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whether the heart's strong,
00:07:47.53\00:07:48.86
whether it's weak,
whether the fluids backing up,
00:07:48.90\00:07:51.27
you know, sometimes the fluids
backing up they need diuretics.
00:07:51.30\00:07:54.04
Sometimes they need
00:07:54.07\00:07:55.40
different types
of blood thinners.
00:07:55.44\00:07:56.91
Sometimes their
blood pressure's high.
00:07:56.94\00:07:58.51
They need medicines
to strengthen the heart.
00:07:58.54\00:08:00.68
So yes, there
are some medications
00:08:00.71\00:08:02.48
that's used to help sort
of slow down the aging process
00:08:02.51\00:08:06.28
to help the
heart not work as hard
00:08:06.31\00:08:08.65
to help blood
clots not developing,
00:08:08.68\00:08:10.55
blood doesn't move as well.
00:08:10.59\00:08:12.42
So yeah, there's medications
00:08:12.45\00:08:13.79
but each
individual is so unique, Nick,
00:08:13.82\00:08:16.29
there's not a
sort of a standard mix,
00:08:16.32\00:08:18.59
but we look at the
patient, see what medicines
00:08:18.63\00:08:20.90
we can do to help the
quality of life the best.
00:08:20.93\00:08:23.67
So we talked a little
bit about modern medicine,
00:08:23.70\00:08:26.20
how it benefits,
00:08:26.23\00:08:27.57
valves that are
that don't open well,
00:08:27.60\00:08:29.54
valves that leak,
00:08:29.57\00:08:30.91
but there's other
heart conditions as well.
00:08:30.94\00:08:32.67
That's right. That's right.
00:08:32.71\00:08:34.04
And during this
series of programs,
00:08:34.08\00:08:35.64
if you keep watching
the Ultimate Prescription,
00:08:35.68\00:08:37.05
we'll share more
of those with you.
00:08:37.08\00:08:38.61
But I wanna move on to
our biblical prescription
00:08:38.65\00:08:41.05
for the day.
00:08:41.08\00:08:42.42
We've got a great app
that shares these with folks,
00:08:42.45\00:08:45.49
but I want you to go ahead
00:08:45.52\00:08:46.86
and give us one
right now if you would.
00:08:46.89\00:08:48.22
Yeah.
00:08:48.26\00:08:49.59
On the biblical prescription
for today is Daniel 1:20.
00:08:49.62\00:08:53.43
"And in all matters of wisdom,"
they were talking about Daniel
00:08:53.46\00:08:56.67
and his friends,
"and understanding that
00:08:56.70\00:08:58.80
the king enquired of them,
00:08:58.83\00:09:00.34
he found them
ten times better than
00:09:00.37\00:09:03.04
all the
magicians and astrologers
00:09:03.07\00:09:04.84
that were in all his realm."
00:09:04.87\00:09:06.84
That's very interesting.
00:09:06.88\00:09:08.31
And if you think about Daniel,
00:09:08.34\00:09:10.05
here is a gentleman
that's moved from his country,
00:09:10.08\00:09:13.38
away from his mom and dad,
00:09:13.42\00:09:15.05
living in a foreign
culture, everything's different.
00:09:15.08\00:09:17.89
Everything's different.
And yet he says, no...
00:09:17.92\00:09:21.42
This story
talks about, you know,
00:09:21.46\00:09:22.96
when he ask them to
bring him pulse and water.
00:09:22.99\00:09:27.16
Yeah. Basically, a healthy diet.
00:09:27.20\00:09:29.66
But it was more
than a healthy diet.
00:09:29.70\00:09:31.57
It was about worship as well
00:09:31.60\00:09:33.40
'cause he was gonna stay true
00:09:33.44\00:09:34.77
to the things he
was taught as a child.
00:09:34.80\00:09:36.57
Remember that text, "In
all things acknowledge Him,
00:09:36.60\00:09:39.17
and He will direct the paths."
00:09:39.21\00:09:40.54
So they're acknowledging God
00:09:40.58\00:09:41.94
to remembering the
way they were raised.
00:09:41.98\00:09:44.45
That's why I brought up kids,
you know, we all have kids,
00:09:44.48\00:09:46.21
we all wanna
teach them these ways.
00:09:46.25\00:09:47.92
So when they grow up,
they're not gonna forget him.
00:09:47.95\00:09:50.22
So he even in a foreign country,
00:09:50.25\00:09:52.85
he stuck with what he was taught
00:09:52.89\00:09:54.22
by mom and dad.
00:09:54.26\00:09:55.62
He stuck with his
beliefs, a healthy diet,
00:09:55.66\00:09:58.26
in worship and in a
short period of time
00:09:58.29\00:10:00.80
he was how much?
00:10:00.83\00:10:02.16
Ten times better than
00:10:02.20\00:10:04.17
all the
magicians and astrologers.
00:10:04.20\00:10:06.00
God blessed
Daniel for his worship,
00:10:06.03\00:10:08.67
for his staying close
00:10:08.70\00:10:10.04
to biblical
prescriptions in nutrition.
00:10:10.07\00:10:11.97
He was blessed
with a better body.
00:10:12.01\00:10:13.98
God made him a special person.
He was in charge of everything.
00:10:14.01\00:10:19.31
Yeah, I think, when we
think about the story of Daniel,
00:10:19.35\00:10:21.35
it's easy to just
think about the nutrition.
00:10:21.38\00:10:23.02
Well, plants are better for you,
00:10:23.05\00:10:24.42
obviously, but 10 times
better, that's more than...
00:10:24.45\00:10:27.19
Oh, yeah.
00:10:27.22\00:10:28.56
Just nutrition that's
definitely worshiping God
00:10:28.59\00:10:30.43
working in his life to
do something supernatural.
00:10:30.46\00:10:32.99
Yeah. Yeah. And he did.
00:10:33.03\00:10:34.36
And this is a
very powerful study
00:10:34.40\00:10:35.90
that we talked about
how worship and staying true
00:10:35.93\00:10:38.43
to God's Word in
all aspects of life,
00:10:38.47\00:10:41.37
you know, and
how it's a blessing
00:10:41.40\00:10:43.30
and, you know, some
sometimes God blesses us
00:10:43.34\00:10:45.27
more than others.
00:10:45.31\00:10:46.64
But Daniel was the second
in command of two kingdoms,
00:10:46.68\00:10:51.31
you know, of the
world at that time.
00:10:51.35\00:10:53.72
And he was a smart
guy, and he also worshiped
00:10:53.75\00:10:57.02
remember later on in
the study, no matter what,
00:10:57.05\00:10:59.72
he was gonna worship and
sometimes at great peril,
00:10:59.75\00:11:02.69
he stuck with that
plan of worship, you know,
00:11:02.72\00:11:05.89
and that made a big
difference in his life.
00:11:05.93\00:11:07.93
God blessed him as he followed
God's plan for his life.
00:11:07.96\00:11:11.37
So I think that's good.
00:11:11.40\00:11:13.54
Very interesting and
how biblical prescriptions
00:11:13.57\00:11:16.71
are something
that we can depend on
00:11:16.74\00:11:18.71
throughout life.
00:11:18.74\00:11:20.11
You know, I'm very curious,
00:11:20.14\00:11:21.48
we talked about
valves, you know,
00:11:21.51\00:11:22.98
and things are
gonna change in valves.
00:11:23.01\00:11:24.75
If God doesn't take us home,
00:11:24.78\00:11:26.41
what's gonna be 10
or 20 years from now?
00:11:26.45\00:11:28.85
We didn't have mitral clips.
00:11:28.88\00:11:30.79
We didn't have trans
aortic valve replacements
00:11:30.82\00:11:32.82
just 10 years ago.
00:11:32.85\00:11:34.29
Technology is growing
faster now than ever before.
00:11:34.32\00:11:37.56
Yeah.
00:11:37.59\00:11:38.93
Not only medical technology,
but now we're learning
00:11:38.96\00:11:40.80
even about lifestyle technology.
00:11:40.83\00:11:42.50
We're finding out
00:11:42.53\00:11:43.87
how our gut
influences our health,
00:11:43.90\00:11:45.50
how our brain, our
stress, our rest patterns,
00:11:45.53\00:11:48.50
everything that comes
into our brain affects us.
00:11:48.54\00:11:51.17
That's right. That's right.
00:11:51.21\00:11:52.67
Well, Dr. Marcum,
thanks for sharing
00:11:52.71\00:11:54.04
that biblical prescription.
00:11:54.08\00:11:55.41
And, viewers, if you
would like to learn more
00:11:55.44\00:11:56.78
and employ more biblical
prescriptions in your life,
00:11:56.81\00:11:59.18
go to HeartWiseMinistries.org.
00:11:59.21\00:12:01.92
You can leave a
prayer request there,
00:12:01.95\00:12:03.82
you can find lots
of health information,
00:12:03.85\00:12:06.02
articles,
videos, radio podcasts.
00:12:06.05\00:12:08.52
But also you can find
our Biblical Prescriptions
00:12:08.56\00:12:10.09
for Life app there.
00:12:10.13\00:12:11.46
And it's a free
download on iOS or Android,
00:12:11.49\00:12:14.26
and it will
share 10-minute worship
00:12:14.30\00:12:17.73
with you every day,
00:12:17.77\00:12:19.10
a worship
routine that you can do
00:12:19.13\00:12:20.70
to better employ
these biblical principles
00:12:20.74\00:12:22.97
and these
prescriptions in your life.
00:12:23.00\00:12:25.51
Dr. Marcum, thank you very much
00:12:25.54\00:12:26.91
for sharing with
us on today's program.
00:12:26.94\00:12:28.64
And we look forward
to more at another time.
00:12:28.68\00:12:31.45
Viewers, Dr. Marcum
will close the program
00:12:31.48\00:12:32.88
with prayer in just a moment.
00:12:32.91\00:12:34.25
As we end our program today,
00:12:38.82\00:12:40.69
I'd like to invite
you to join me in prayer.
00:12:40.72\00:12:44.59
Father God, we wanna
thank You for the technology
00:12:44.63\00:12:47.53
that You have to
give to us to help us
00:12:47.56\00:12:50.00
to feel better and
serve You better and,
00:12:50.03\00:12:52.30
but more than that,
Father, we want to continue
00:12:52.33\00:12:54.77
to worship with You
and help us have the power
00:12:54.80\00:12:57.51
to make the
changes in our lives.
00:12:57.54\00:12:59.11
And to continue
to spread the gospel
00:12:59.14\00:13:01.71
wherever we might go by serving
00:13:01.74\00:13:03.35
and loving others is our prayer.
00:13:03.38\00:13:05.01
Amen.
00:13:05.05\00:13:07.02
If you might have more questions
00:13:07.05\00:13:08.48
about valvular heart disease,
00:13:08.52\00:13:10.22
I want to encourage
you to go to our website,
00:13:10.25\00:13:12.32
that's HeartWiseMinistries.org.
00:13:12.35\00:13:15.36