The following
program presents principles
00:00:01.98\00:00:02.95
designed to promote good health
00:00:02.96\00:00:03.93
and is not intended
to take the place of
00:00:04.18\00:00:05.95
personalized professional care.
00:00:05.96\00:00:07.73
The opinions and ideas expressed
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are those of the speaker.
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Viewers are
encouraged to draw their own
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conclusions about the
information presented.
00:00:13.64\00:00:15.94
Praise God for I am fearfully
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and wonderfully
made. This is a glorious
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text found in the
Psalms that just brightens
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my spirit. I wanna
thank each one of you
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for joining us on
Wonderfully Made today.
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Thank you for taking
the time out of your busy
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schedules wherever
you might be throughout
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the world to
learn about your bodies,
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the body is
actually are gifts from God
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and how we take
care of it is very,
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very important
because if I gave you a good
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Cadillac you certainly
take good care of that.
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Today's topic is gonna be on
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valvular heart
disease. And I wanna welcome
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Mr. Daniel Miller
here today to join us,
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he is a
businessman from Chattanooga
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who is also a
heart consumer and Dan,
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what are you doing
on a healthcare center?
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A business coming, what's your,
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you know what
interest do you have in the
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valvular heart
disease? Well, that's a good
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question at my age,
soon or later everyone
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starts wondering
and asking themselves
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how do you want your
quality of life to be
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as you get older.
And that's, that's one of
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the reasons why I'm here.
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Well, have you notice
that as your body ages
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and I'm not saying you're old,
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but as the body ages you
notice more abnormalities
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or things that
don't feel quite as right.
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Yeah. What are the
some of the first things
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you notice? Just
getting out of bed though,
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okay. You know as
when we're younger
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we don't realize the
effects on our bodies that
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we have as we live
our lives and as when
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we're younger
obviously we're harder
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on our systems,
one of the effects that
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I have are more
joint pains you have more
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shortness of breath,
you have different things
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like that, that do
make you kind of wonder
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about how you're doing it.
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Well, one of the
things that I tell my patients
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is you know you
only get one body
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and the body is a
machine and you know mostly
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I don't know how you
are but, but most men
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especially men
seem to be more guilty
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than women. Most
men take better care
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of their cars, your right,
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then they do their
bodies. I mean when was the
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last time you had a physical?
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Put you on the spot here.
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That's been about
3 months, 3 months.
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Well, that's better than most,
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I have some people
mainly men they will come,
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they will come when
something breaks down.
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But I want to talk
to our audience around
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the world it is
very important to get
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health maintenance
as well. Now, do you,
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you know we talked a
little bit about being
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a steward, a lot of
people don't see their
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bodies as gifts and
their stewards in responsible
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for taking care
of this gift, right.
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Do you think as you
get older you see yourself
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more as a steward of
a gift that's been given
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and why do we abuse it
so much when we're younger,
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why do we, it seems
we take it for granted
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or just mature.
Well, as either steward two
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or three
different things as you're,
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when you're younger
for one you feel like
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you're invincible.
You know, you're out
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jumping off from
cliffs, you know diving
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into lakes. You
know go parachuting
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and you don't
think about the parachute
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not opening, yeah. As
you get older you start
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thinking about these things more
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and I would assume
that that's probably
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some of the reasons for that.
00:03:49.29\00:03:52.05
Well, I want our
audience today to keep that
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in mind that our
bodies are a gift from God,
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right, and it's one
of the greatest gift
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you know we have
the gift of time,
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the gift of our bodies,
the gift of our resources
00:04:01.20\00:04:05.41
and jobs and I'm
glad you're interested
00:04:05.42\00:04:07.89
about your body and
I'm glad you joined us
00:04:07.90\00:04:09.50
here today Dan.
Well, what we've been doing
00:04:09.51\00:04:12.08
is we collect questions
in the Heartwise Ministers
00:04:12.09\00:04:15.64
from all over the
world about people that are
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interested in their
hearts and want to know more
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and the next thing
we do is we try to group
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these on a specific
subject and today's subject
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we're gonna answer
questions from all over
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in regard to
valvular heart disease, right.
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So with that introduction
let's get on with some
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questions here, okay.
Our first question Jim
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is from Calvin in Mississippi.
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He writes, the
doctor told me I have a
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leaky heart valve,
what does this mean?
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Okay, a leaky heart
valve in your heart between
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the chambers of
your heart you have
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little fiber
structures that open and close.
00:04:54.51\00:04:57.14
And there is one that
comes in from the right
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side of the heart
that's called a tricuspid valve
00:04:59.94\00:05:02.60
because it has
three leaflets that open
00:05:02.61\00:05:04.78
and close then the
blood goes into the lungs
00:05:04.79\00:05:07.60
through another valve
called the pulmonic valve
00:05:08.02\00:05:10.86
then it gets
oxygen inside the lung
00:05:11.32\00:05:13.23
then it comes back to
the left side of the heart
00:05:13.24\00:05:15.28
and goes through
another valve called
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the mitral valve,
then it goes into the big
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pumping chamber
called the left ventricle
00:05:19.34\00:05:21.28
then its pumped out
through another valve
00:05:21.29\00:05:23.24
called the Aortic
valve. All of these valves open
00:05:23.72\00:05:27.23
and shut. Now the
reason the valves open
00:05:27.24\00:05:29.87
and shut is we don't
want blood to go backwards,
00:05:29.88\00:05:32.64
we want it to be
moving forward with oxygen,
00:05:33.10\00:05:34.89
right. If it was all
moving backwards we wouldn't
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accomplish very
much. The blood that moves
00:05:37.25\00:05:39.96
backwards this is
not a good situation
00:05:40.28\00:05:42.60
and when it moves
backwards sometimes
00:05:42.61\00:05:44.53
we say you have a
leaky heart valve,
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another name for that
is called regurgitation,
00:05:47.49\00:05:50.66
right. If you have a
leaky heart valve Dan,
00:05:51.46\00:05:53.99
if you had a leaky valve that,
00:05:54.00\00:05:55.54
let's say you have
faucet leaks what would be
00:05:55.55\00:05:58.36
the first thing you
would do for a faucet
00:05:58.75\00:06:00.69
that leaks,
making, making noises.
00:06:00.70\00:06:02.29
You know things are
going in the wrong direction.
00:06:02.30\00:06:04.93
Well, the first thing we
do probably would be called
00:06:05.83\00:06:07.91
a plumber,
that's what I would do,
00:06:07.92\00:06:09.35
is call a plumber,
I'm not good at that.
00:06:09.36\00:06:10.38
Well, I'm glad
you bought that up.
00:06:10.39\00:06:11.68
Okay, call a
plumber and the second thing
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I think would be to
have him replace the valve.
00:06:14.34\00:06:17.41
Exactly, and
sometimes when the leak gets
00:06:17.74\00:06:20.25
so bad that it
bothers us so much we have
00:06:20.26\00:06:22.54
to replace a valve and you know
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we don't just jump into that,
00:06:24.56\00:06:25.78
I mean it's something
we consider very closely
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and that's some of
the things we're gonna
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talk about. Let's
bring up our first graphic
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today on leaky heart valve.
00:06:32.86\00:06:35.76
Here's our you know,
we talk about a leaky
00:06:35.77\00:06:37.93
heart valve, what
can cause a heart valve
00:06:37.94\00:06:40.62
to leak or the
blood move backwards
00:06:40.63\00:06:43.19
in the wrong
direction. Well, one of them is
00:06:43.20\00:06:45.94
called high blood
pressure and the way
00:06:45.95\00:06:48.67
high blood pressure
does is it stretches
00:06:48.75\00:06:50.76
things out in the
heart and sometimes
00:06:50.77\00:06:52.23
it actually
stretches the valve to where
00:06:52.24\00:06:54.54
it closes and that closing point
00:06:54.55\00:06:56.26
is called coaptation.
If it closes this point
00:06:56.27\00:06:59.43
sometimes the
blood can leak backwards,
00:06:59.44\00:07:01.54
also sometimes you
can have infections on
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your heart valve and
of course this damages
00:07:04.47\00:07:06.33
it from the
infections another thing is that
00:07:06.34\00:07:08.66
valves need the
blood supply and oxygen
00:07:08.67\00:07:11.09
to open and close, so
if you don't get a good
00:07:11.10\00:07:12.68
blood supply of oxygen from a
00:07:12.69\00:07:14.33
coronary heart disease,
the valve can also leak.
00:07:14.34\00:07:16.78
Another condition that
can cause it is actually
00:07:17.37\00:07:19.45
when your heart gets
weak, when your heart
00:07:19.46\00:07:21.60
gets weak the
valve can't close like
00:07:21.61\00:07:23.76
it normally would,
'cause it's pulled apart
00:07:23.77\00:07:25.33
because the heart tries to adapt
00:07:25.34\00:07:26.74
and then the
valve leaks anymore.
00:07:27.07\00:07:28.46
So that's some
of the causes of a
00:07:28.87\00:07:31.22
leaky heart valve.
Now, back to Calvin
00:07:31.23\00:07:33.37
and I hope that
explain what the leaky heart
00:07:33.88\00:07:36.39
valve means.
Unfortunately Calvin
00:07:36.40\00:07:38.55
most people have
leaky heart valves to a
00:07:38.56\00:07:41.87
certain degree
and that's not a major
00:07:41.88\00:07:44.26
problem just
having a little leak.
00:07:44.27\00:07:45.62
Let me ask you
this, what kind of tests
00:07:45.94\00:07:48.08
are conducted to?
Excellent question,
00:07:48.52\00:07:51.59
well the most,
the most basic test
00:07:51.60\00:07:53.69
is a stethoscope, okay
and I'm sure you've seen
00:07:53.70\00:07:56.72
it when you go to doctors,
00:07:56.73\00:07:57.73
you can actually
hear the blood flow going
00:07:57.74\00:08:00.82
in the wrong
direction, it sounds
00:08:00.83\00:08:03.12
as a swishing
sound, you might hear,
00:08:03.13\00:08:04.79
normally the valves
open and close when you hear
00:08:06.98\00:08:08.66
a swishing sound
sometimes that can be a
00:08:08.67\00:08:11.02
sign that the heart
valve is not leaking
00:08:11.03\00:08:12.95
or not working well,
right, because that's what
00:08:12.96\00:08:14.86
actually what
cardiologists listen to,
00:08:14.87\00:08:16.58
the opening and
closing of the valve that's
00:08:16.59\00:08:18.40
the lub-dub that
you hear in the heart.
00:08:18.41\00:08:20.22
Another thing that we wanted,
00:08:22.20\00:08:23.72
that we look at heart
valves with is a fancy
00:08:23.73\00:08:25.82
machine called an echocardiogram
00:08:25.83\00:08:27.78
where we make
sound wave twitches
00:08:28.16\00:08:29.91
and we can bounce
them off the heart valves,
00:08:29.92\00:08:32.28
right, and we can
create a visualization
00:08:32.29\00:08:34.67
of the valve
opening and closing,
00:08:34.68\00:08:36.40
we also have fancy
maneuvers and equations
00:08:36.71\00:08:39.06
where we can
quantitate how much blood
00:08:39.07\00:08:42.30
is leaking back or
forward so this might
00:08:42.31\00:08:43.87
give us a clue on to
whether the valve leaks,
00:08:43.88\00:08:46.50
so that's how we find
out, but usually a patient
00:08:46.51\00:08:48.30
comes to us if its
bad they have a symptom,
00:08:48.31\00:08:50.72
right. Let me ask
you this does stress
00:08:51.02\00:08:53.76
add to that? It could
if it raises your blood
00:08:53.77\00:08:56.48
pressure cause of it,
it usually stress itself
00:08:56.49\00:08:58.54
won't damage the
valve primarily but it might
00:08:58.55\00:09:01.69
do it secondarily,
right. Okay, you're right.
00:09:01.70\00:09:04.56
And then a person
would have a symptom
00:09:04.57\00:09:06.03
and the most
common symptom I see when
00:09:06.04\00:09:07.94
the heart valves
are leakage is shortness
00:09:07.95\00:09:09.74
of breath, people
can't breathe very well.
00:09:09.75\00:09:12.58
Okay, let's go what's
the next question here?
00:09:12.91\00:09:14.81
Okay, question number 2, is from
00:09:15.46\00:09:17.87
Margaret in
Connecticut and she writes,
00:09:17.88\00:09:21.68
I had a heart valve
surgery and I have to
00:09:21.69\00:09:25.48
take Coumadin. Okay,
however I have a friend
00:09:25.49\00:09:29.51
who also had a valve
replaced, who doesn't
00:09:29.52\00:09:32.41
take Coumadin. We
were recently at a women's
00:09:32.42\00:09:36.11
meeting and got into
a big discussion about
00:09:36.12\00:09:38.56
whether she should be
taking Coumadin or not,
00:09:38.57\00:09:41.02
I'm usually right
about health care issues,
00:09:42.41\00:09:44.65
my friends wanted
me to ask you to settle
00:09:45.32\00:09:47.46
the debate. Well,
now there you can either
00:09:47.47\00:09:50.34
solidify that
friendship or, okay well they're
00:09:51.83\00:09:54.86
having a big discussion
I hope that big discussion
00:09:54.87\00:09:57.13
was not an
argument Margaret about
00:09:57.14\00:09:59.60
who should be
taking Coumadin or not,
00:09:59.61\00:10:01.18
I hope that you know
both people could be right.
00:10:01.74\00:10:05.15
How do you like that for
middle of the road answer.
00:10:05.16\00:10:07.28
I think both
people could be right,
00:10:08.05\00:10:09.78
let me explain a
little bit when you have a
00:10:09.79\00:10:13.43
heart valve that's been
replaced we have different
00:10:13.44\00:10:15.57
types of heart
valves that go in there
00:10:15.58\00:10:17.58
and the decision is
made based on numerous
00:10:17.59\00:10:19.78
factors well one type
of valve is stainless steel
00:10:19.79\00:10:22.29
we call that a
metallic heart valve, right.
00:10:22.63\00:10:24.71
That's not normal for a
person to have a metallic
00:10:25.20\00:10:27.76
heart valve, so that
type of patients sometimes
00:10:27.77\00:10:29.86
can get clots on the
valves, that patient,
00:10:29.87\00:10:32.38
if a clot go on the
valve that would not be good
00:10:32.39\00:10:35.10
'cause it can be pumped up
00:10:35.11\00:10:36.14
and it can cause
an occlusion of a
00:10:36.15\00:10:37.90
blood vessel. Those
type of patients would
00:10:37.91\00:10:40.59
definitely need to
be placed on Coumadin.
00:10:40.60\00:10:42.67
Now, in other
instances we decide to put a
00:10:43.40\00:10:47.55
tissue valve or a
valve or a tissue from,
00:10:47.56\00:10:50.16
sometimes we get
them from a pig, right.
00:10:50.44\00:10:52.14
Sometimes we can
get it from a cow,
00:10:52.45\00:10:53.90
sometimes we get it
from the outside lining
00:10:54.51\00:10:56.99
of a heart of cadaver, right.
00:10:57.00\00:10:59.50
And those tissue
valves can sometimes
00:10:59.51\00:11:01.62
be put into the
heart valve position.
00:11:01.63\00:11:03.96
Some people
cannot take Coumadin.
00:11:04.98\00:11:06.48
Woman of childbearing
years you have to be very
00:11:07.20\00:11:09.50
careful with
Coumadin, because Coumadin
00:11:09.51\00:11:11.39
can damage the baby
if you were to become
00:11:11.40\00:11:13.82
pregnant, right. So
those people would be
00:11:13.83\00:11:15.78
you know we got to
really consider whether
00:11:15.79\00:11:17.50
we put on Coumadin and
some patients bleed a lot,
00:11:17.51\00:11:20.48
right and in that
situation Dan we would want
00:11:21.83\00:11:24.72
to keep people
away from Coumadin which
00:11:25.21\00:11:27.32
could make them bleed more.
00:11:27.33\00:11:28.65
I am thinking about
that situation some people
00:11:29.32\00:11:31.32
have diseases of the bone marrow
00:11:31.33\00:11:33.29
where the bone
marrow doesn't make
00:11:33.67\00:11:34.92
red blood cells and
they are more probably
00:11:34.93\00:11:37.20
just a simple car
you know an accident
00:11:37.21\00:11:39.81
I don't want to say
simple if you cut yourself
00:11:39.82\00:11:42.03
and you're anemic and
you have lots of bleeding
00:11:42.04\00:11:44.70
that would put you at
a very high risk of being
00:11:44.71\00:11:47.05
on Coumadin and
in those situations
00:11:47.06\00:11:49.54
we might decide to
put in a valve that's not
00:11:50.10\00:11:54.19
metallic either
one of these pig valves
00:11:54.20\00:11:56.46
or a cow valve,
cow valve or even a
00:11:56.47\00:11:59.08
pericardial valve.
And let's put up our
00:11:59.09\00:12:01.20
second graphic here
talking about Coumadin
00:12:01.21\00:12:04.79
a little bit, our
second graphic is and
00:12:04.80\00:12:07.14
who needs Coumadin.
Now I think that's the part
00:12:07.15\00:12:09.25
of Margaret's question here.
00:12:09.26\00:12:10.75
These patients definitely
with metallic valves need
00:12:11.71\00:12:14.86
to be placed on
Coumadin to prevent the risk
00:12:14.87\00:12:17.98
of blood
clotting, another group that
00:12:17.99\00:12:19.31
needs it is a group
that has atrial fibrillation,
00:12:19.32\00:12:21.68
that's where the top
part of the heart beats
00:12:21.69\00:12:23.96
asynchronous with the bottom.
00:12:24.45\00:12:25.72
In this situation
regardless of what type
00:12:26.09\00:12:28.01
of valve you have
you're gonna need on to be
00:12:28.02\00:12:29.95
on Coumadin anyway if you can.
00:12:29.96\00:12:31.32
So in these type of
patients we say well
00:12:31.81\00:12:33.94
let's go ahead a
put a metallic valve.
00:12:33.95\00:12:35.27
Then the third
situation is any other situation
00:12:35.28\00:12:38.22
where you have a
blood clots in your body,
00:12:38.23\00:12:39.89
right. Sometimes
blood clots gets in the legs
00:12:39.90\00:12:42.54
and they then go to
the lungs those type
00:12:42.55\00:12:44.02
of situations were need
to be on Coumadin as well.
00:12:44.03\00:12:46.33
A situation where a
blood clot gets in the
00:12:47.56\00:12:49.27
lung is called a
pulmonary embolism.
00:12:49.28\00:12:51.18
I don't know if you
remember that reporter
00:12:51.96\00:12:54.05
that was in
overseas a few months ago,
00:12:54.06\00:12:57.18
that he was in Iraq and
I think he was in a tank
00:12:58.33\00:13:00.94
and he couldn't move
his legs and we couldn't
00:13:00.95\00:13:03.74
move his legs he got
a blood clot there that
00:13:03.75\00:13:06.03
blood clot dislodged, so
inactivity brought in on.
00:13:06.04\00:13:09.13
Exactly and then being the same
00:13:09.14\00:13:10.64
and it went all
the way into his lungs
00:13:10.65\00:13:12.49
and he had a pulmonary embolism
00:13:12.76\00:13:14.20
and that was a
fatal event for him.
00:13:14.21\00:13:15.73
So does exercise then prevent.
00:13:16.40\00:13:18.95
Yes, this kind of situation,
00:13:19.83\00:13:21.21
I mean that's why in a
airplane if you're going
00:13:21.22\00:13:23.00
on a long trip you
know they say you should
00:13:23.01\00:13:24.70
get up and move your legs every,
00:13:24.71\00:13:26.29
every so many hours if
you're in a long car trip,
00:13:26.30\00:13:29.11
in fact if we sit
down here too much we might
00:13:29.12\00:13:31.21
want to stand up so
we don't have a chance
00:13:31.22\00:13:33.64
of having our
venous system get a clot,
00:13:33.65\00:13:36.16
but if you did have
a clot on that system
00:13:36.50\00:13:39.49
and it did go to your
lungs and it wasn't fatal
00:13:39.50\00:13:41.73
you would, that
would be another candidate
00:13:41.74\00:13:43.78
that would be, need
to be on Coumadin, right.
00:13:43.79\00:13:45.83
Margaret, I hope we
answered your question
00:13:46.29\00:13:48.36
here today, I hope
it didn't cause you too
00:13:48.37\00:13:50.92
much problems
with your friend but
00:13:50.93\00:13:53.82
in your situation
it's possible that
00:13:53.83\00:13:55.73
you're both right.
Now, how is that for a
00:13:55.74\00:13:57.53
diplomatic
answer to that question?
00:13:57.54\00:13:59.03
Okay, Jim here's our,
here's our third question,
00:13:59.91\00:14:02.43
this question comes
from Rasmus in Norway.
00:14:03.08\00:14:05.55
How does an
infection get on a heart valve?
00:14:06.81\00:14:09.47
Rasmus, that is a
very insightful question.
00:14:10.72\00:14:14.08
A lot of people don't
even realize that infections
00:14:14.52\00:14:17.00
can get on heart
valves, one of the more common
00:14:17.01\00:14:20.85
ways that an
infection gets on a heart valve
00:14:20.86\00:14:22.81
is through some
type of germ that invades
00:14:22.82\00:14:25.89
the blood
system. The most common,
00:14:25.90\00:14:28.56
one of the most common
dirty places where germs
00:14:28.57\00:14:31.08
live is our
mouths and frequently
00:14:31.09\00:14:34.14
and not frequently
but sometimes we have an
00:14:34.47\00:14:36.64
infection or a tooth gets pulled
00:14:36.65\00:14:38.87
or we have some mouth procedure
00:14:38.88\00:14:40.76
or a dental procedure
and a bug that's in our
00:14:40.77\00:14:43.86
mouth gains access
to our bloodstream,
00:14:43.87\00:14:46.32
that bug gets in the
bloodstream and floats
00:14:46.87\00:14:49.38
around in the
bloodstream. Sometimes even in a
00:14:49.39\00:14:51.97
perfectly normal
heart valve that bacteria
00:14:51.98\00:14:55.26
can get on that heart
valves and it just sticks
00:14:55.27\00:14:57.85
there and guess what
bacteria love to eat?
00:14:57.86\00:14:59.98
Blood, right, it's
just they love that blood,
00:15:00.82\00:15:03.20
it's just like a
constant food source to them
00:15:03.21\00:15:05.07
so they grow and
they set up shop there
00:15:05.08\00:15:07.11
and before you
know they have a family
00:15:07.12\00:15:08.63
there and they keep
in and all of a sudden
00:15:08.64\00:15:10.46
they start munching on
that valve and it destroys
00:15:10.47\00:15:12.86
the valve. But also
people are prone to get
00:15:12.87\00:15:15.99
heart infections
that if you have valves
00:15:16.00\00:15:19.02
that are abnormal
to begin with, right.
00:15:19.03\00:15:20.99
If you're born with
a congenial abnormality
00:15:21.41\00:15:23.73
of the valve or the
valve is not right then
00:15:23.74\00:15:26.30
it sees the bacteria
and they're more prone
00:15:26.31\00:15:28.28
to stick on these
valves and it causes
00:15:28.29\00:15:30.07
an infection. So,
that's one of the ways
00:15:30.08\00:15:32.59
an infection
gets on a heart valve
00:15:33.54\00:15:34.96
and the another one
is through the skin.
00:15:35.43\00:15:37.08
And sometimes in
hospitals we see people
00:15:37.94\00:15:39.96
that have IVs,
that's when a vice that goes
00:15:39.97\00:15:42.93
into a vein if that
gets an infection or dirty
00:15:42.94\00:15:45.67
or its been in a long
time, that's another way
00:15:45.68\00:15:48.27
that bacteria from
the skin gain access
00:15:48.28\00:15:51.09
through the bloodstream
and that same process
00:15:51.10\00:15:53.35
can occur, right. Now
they're different types
00:15:53.36\00:15:56.45
of infections? Oh!
Yeah. There's different,
00:15:56.46\00:15:58.20
most of the serious
infections on the heart
00:15:58.60\00:16:00.89
tend to be
bacteria infections, right.
00:16:00.90\00:16:03.41
And one of the most
serious ones one called
00:16:03.42\00:16:05.57
staph and
another is called strep,
00:16:05.58\00:16:08.19
these are types of bacteria,
00:16:08.20\00:16:09.69
and there's numerous
bacterias that can gain
00:16:09.74\00:16:11.35
access through the bloodstream,
00:16:11.36\00:16:12.49
but any pathogen or
abnormal bug that gets
00:16:12.79\00:16:16.94
in the blood would
be a fungus, bacteria,
00:16:16.95\00:16:19.82
some viruses,
anything that gains access
00:16:19.83\00:16:22.51
that can start
living on these valves can
00:16:22.94\00:16:25.33
potentially get on it
and destroy your heart valve.
00:16:25.34\00:16:27.86
So basically what
you've been saying is that
00:16:28.30\00:16:30.27
bad oral hygiene can
affect it or bring it on.
00:16:30.28\00:16:34.26
Let me ask you this,
how about body piercings?
00:16:35.66\00:16:38.06
Oh! That is an
excellent thing to bring up Dan,
00:16:38.07\00:16:40.91
more and more
people now are getting
00:16:40.92\00:16:42.99
body piercings.
They're getting pierced
00:16:43.00\00:16:45.87
in the nose, in the
ears, in the belly button,
00:16:45.88\00:16:48.10
but the one I saw
this is not too long ago
00:16:48.44\00:16:50.89
I saw a piercing in the
tongue and that piercing
00:16:50.90\00:16:54.55
was right in the
middle of the tongue
00:16:54.56\00:16:55.84
and the person
would eat lots of food.
00:16:55.85\00:16:57.75
Now, this was
someone in their 20's,
00:16:57.76\00:16:59.80
right and that tend to
be, and it got infected
00:16:59.81\00:17:02.45
and I don't know
whether it was from food
00:17:02.83\00:17:04.16
or because of the
hygiene or it might be
00:17:04.17\00:17:05.99
the person that
pierced it wasn't sterile.
00:17:06.00\00:17:07.79
That got infected,
a bacteria had access
00:17:08.23\00:17:11.79
to the bloodstream
the next thing that
00:17:11.80\00:17:14.10
happened was they
deposit it on a heart valve
00:17:14.11\00:17:16.67
and this is a took
time and four, five months
00:17:17.03\00:17:19.48
later and this patient
was fatigued and tired,
00:17:19.49\00:17:21.89
they came in, we
heard a rip-roaring heart
00:17:22.32\00:17:24.74
murmur because the
valve couldn't close
00:17:24.75\00:17:27.12
anymore because
it had a big old hole
00:17:27.13\00:17:28.75
where those
bacteria just munched away.
00:17:28.76\00:17:30.68
Right. Big leakage,
we did an echocardiogram
00:17:30.69\00:17:33.38
and we could see
the growing bacteria
00:17:33.39\00:17:35.32
on the valve and at
that point it was in a place
00:17:35.33\00:17:38.49
we couldn't treat
it with antibiotics,
00:17:38.50\00:17:40.42
that's what we
do if it was small,
00:17:40.43\00:17:41.72
it was leaking so bad that,
00:17:41.73\00:17:43.46
that in this 24-year-old
we had to place a metallic
00:17:43.47\00:17:46.82
heart valve,
right. And guess what else
00:17:46.83\00:17:48.81
I asked her to do?
Besides put her face
00:17:48.82\00:17:51.20
in the valve, take
her piercing out, exactly,
00:17:51.21\00:17:53.50
correct and that
was the hardest thing
00:17:53.51\00:17:55.20
I think for her is
because these piercing
00:17:55.21\00:17:56.57
are so popular, but
these piercing do have
00:17:56.58\00:17:59.07
there consequences
especially if they're,
00:17:59.08\00:18:01.51
if they could
cause an infection that
00:18:01.52\00:18:03.06
could gain access
to the bloodstream.
00:18:03.07\00:18:05.40
Would you put
tattooing in that same column?
00:18:05.75\00:18:08.12
I would put
anything that is done,
00:18:08.13\00:18:10.10
that is unsterile
right, insterile where you know
00:18:11.23\00:18:13.73
we have to, we have
access of bugs to gain
00:18:13.74\00:18:16.39
access to the blood system and
00:18:16.40\00:18:18.23
there are certain
people that are at much
00:18:18.24\00:18:19.66
greater risk and
we know that people
00:18:19.67\00:18:21.31
that are diabetic,
you know people that
00:18:21.32\00:18:23.36
have immune systems
that are weak, right.
00:18:23.37\00:18:25.35
Now, some people can
get a bacteria in the blood
00:18:25.36\00:18:27.10
and just throw it
off. We know that people
00:18:27.11\00:18:29.07
would bad heart valves
to begin with that risk.
00:18:29.08\00:18:31.83
And these are
people and we know that
00:18:32.24\00:18:33.70
people that have HIV
infection are at higher
00:18:33.71\00:18:36.33
risk of getting
these affects because
00:18:36.34\00:18:37.39
their immune
systems are damaged, right.
00:18:37.40\00:18:39.11
So, is there any
one certain age group
00:18:39.45\00:18:42.05
where it occurs more?
No, it can well it can
00:18:42.06\00:18:45.03
happen in any age
group, but the ones
00:18:45.04\00:18:47.37
I see it most in are
usually the middle age
00:18:47.38\00:18:49.65
people and it
usually happens from some
00:18:49.66\00:18:51.48
infection on the
blood. You know when I saw
00:18:51.87\00:18:54.65
not too long ago, is a
person had an infection
00:18:54.66\00:18:57.75
on the leg that never healed.
00:18:57.76\00:18:59.22
And they didn't
go to the doctor,
00:18:59.58\00:19:00.99
they didn't get antibiotics
00:19:01.00\00:19:02.01
and it got worse
and worse and worse
00:19:02.02\00:19:03.67
and soon that
the infection got on
00:19:03.68\00:19:05.71
the blood. Does
all infections end up
00:19:05.72\00:19:08.62
in the blood on
the heart valves,
00:19:08.63\00:19:09.95
no it doesn't. And
actually it's sort of rare
00:19:09.96\00:19:13.06
that this would
happen but if it does
00:19:13.07\00:19:14.80
it's devastating,
correct. So, I hope that
00:19:14.81\00:19:17.62
and you think that
answers your question?
00:19:18.03\00:19:20.34
But, let's see we've
discussed the different
00:19:20.35\00:19:23.85
types of infections,
we've discussed the different
00:19:23.86\00:19:25.89
ways that you can
get those infections,
00:19:25.90\00:19:28.61
what are some of the
different treatments?
00:19:29.10\00:19:31.85
Okay. That's, that's
good to talk about that,
00:19:31.86\00:19:34.88
if the infection is
so bad that the valve
00:19:34.89\00:19:37.08
is destroyed, and
the patents having severe
00:19:37.09\00:19:39.77
symptoms, there is
nothing to do but replace
00:19:39.78\00:19:42.79
the valve. And
we've talked about the
00:19:42.80\00:19:44.48
different valves
the metal valves,
00:19:44.49\00:19:46.04
the pig valves,
depending on the situation
00:19:46.05\00:19:48.57
the bleeding
problems. Sometimes infection
00:19:48.58\00:19:51.68
is not so bad, it
catches it early on,
00:19:51.69\00:19:53.34
the symptoms are minimal.
And in those cases we can
00:19:53.35\00:19:56.39
treat them with long
term IV antibiotics, right,
00:19:56.40\00:20:00.15
to help to kill the bacteria.
00:20:00.16\00:20:01.76
But, usually even
though you put them on long
00:20:02.36\00:20:04.61
term antibiotics,
usually the bacteria damages
00:20:04.62\00:20:07.74
the valve to some extent.
00:20:07.75\00:20:09.11
Because it's lived
there for a while, right.
00:20:09.75\00:20:11.45
But, in some instances
we can get six or eight
00:20:11.46\00:20:13.63
weeks of IV antibiotics.
Specific to that bacteria
00:20:13.64\00:20:17.53
or whatever it is
and we can knock it out
00:20:17.54\00:20:19.39
that way, right.
Alright, let's go on to
00:20:19.40\00:20:24.07
question number
4, this comes from
00:20:24.41\00:20:28.11
Frances in Orlando, Florida.
00:20:28.12\00:20:29.72
And she says
that her heart valve
00:20:30.98\00:20:34.48
does not open well.
And now getting short
00:20:34.49\00:20:38.63
of breath and might
need a new heart valve.
00:20:38.64\00:20:41.35
I live alone on a fixed income,
00:20:42.66\00:20:45.08
I have no family nearby,
00:20:45.68\00:20:47.59
can you give me any advice?
00:20:50.27\00:20:51.70
Well Frances from your
question I'm not exactly
00:20:52.81\00:20:55.35
sure what exactly
what's going on here.
00:20:55.36\00:20:59.92
If you might need
a new heart valve,
00:21:01.36\00:21:02.89
if you're an elderly
person the most common heart
00:21:03.43\00:21:05.83
valve that needs
to be replaced is the
00:21:05.84\00:21:07.77
Aortic valve. And
some people just through
00:21:07.78\00:21:10.60
the process of
aging, that valve,
00:21:10.61\00:21:13.03
the aortic valve,
that's the one that leads out
00:21:13.04\00:21:14.79
of the heart
just gets calcified,
00:21:14.80\00:21:16.75
so it doesn't open.
I think if it Dan like
00:21:16.76\00:21:19.59
rusting, you know you just rust,
00:21:19.60\00:21:21.71
doesn't open good, an
old house, an old house.
00:21:22.39\00:21:25.23
Now we're not
saying Frances that
00:21:26.40\00:21:27.58
you're in a old
house, but the valve,
00:21:27.59\00:21:29.03
no not at all. The
valve might not be opening
00:21:29.04\00:21:31.04
like it should,
correct. If this is the case
00:21:31.05\00:21:33.17
you have to decide
whether this, you know
00:21:33.98\00:21:36.22
whether your quality
of life would want a new
00:21:36.23\00:21:38.44
valve replacement.
And a valve replacement
00:21:38.45\00:21:42.69
now we're doing it
very common and what I told
00:21:42.70\00:21:45.84
my elderly people
according to how old
00:21:45.85\00:21:47.63
they are, and I'll
give you an example
00:21:47.64\00:21:48.89
I had someone come in
the other day that was 87.
00:21:48.90\00:21:50.95
And she had this
Aortic Stenosis and she says,
00:21:51.77\00:21:54.47
I've lived my
life, I'm right with God.
00:21:54.48\00:21:57.91
I prefer just live out
my life and she was having
00:21:59.22\00:22:03.07
symptoms you know,
right you know short
00:22:03.08\00:22:04.99
of breath was the
most common one we see,
00:22:05.00\00:22:06.84
she choose that
and everything you know
00:22:07.60\00:22:10.00
that was a good decision for her
00:22:10.01\00:22:11.45
and she didn't have
any problems with that.
00:22:11.90\00:22:14.45
Other people say no I
have a lot to accomplish,
00:22:15.21\00:22:18.03
I'm very active, I
don't have a lot of other
00:22:18.04\00:22:19.90
medical problems and
I've replaced heart valves
00:22:19.91\00:22:22.61
in people up to
90 years older times,
00:22:22.62\00:22:25.11
we show them to the
surgeons and they've had
00:22:25.12\00:22:27.08
good outcomes. However the older
00:22:27.09\00:22:29.23
we get the more
chances of us having a
00:22:29.56\00:22:32.43
surgical complication.
And recovering from any
00:22:32.44\00:22:35.97
heart surgery is
difficult, so without
00:22:36.28\00:22:38.95
a family nearby
you know that could be
00:22:38.96\00:22:41.63
a little bit tough,
living alone so this is a.
00:22:41.64\00:22:44.68
The reason why more friends
00:22:44.69\00:22:46.18
and people that you know.
00:22:46.19\00:22:48.36
You know I've would Frances,
00:22:48.63\00:22:50.08
I would just give
this a lot of thought
00:22:50.09\00:22:51.61
and talk to your
family and a lot of prayer,
00:22:51.62\00:22:53.40
right. Prayer in this situation.
00:22:53.41\00:22:54.95
Alright, number 5 is
from Ashley in California.
00:22:57.71\00:23:01.52
And she writes,
I'm 22 years old,
00:23:02.63\00:23:04.98
and have been told I
have mitral valve prolapse,
00:23:05.28\00:23:08.51
okay. I like high
intensity aerobic classes,
00:23:08.52\00:23:12.54
will this slow me down?
00:23:13.78\00:23:14.75
Ashley, it should
not slow you down at all.
00:23:17.47\00:23:19.20
Mitral valve
prolapse is a condition that
00:23:19.84\00:23:22.50
we have diagnosed
commonly and that's simply
00:23:22.51\00:23:26.11
where the valve, the
mitral valve doesn't shut
00:23:26.12\00:23:29.19
where it should, it shuts
a little bit further back.
00:23:29.20\00:23:31.66
And in some cases
the valve doesn't leak,
00:23:32.46\00:23:35.38
and in some patients
its leaks a little bit.
00:23:35.39\00:23:37.18
Some times this
valve can be thickened
00:23:37.19\00:23:39.48
and we give that
term called myxomatous.
00:23:39.83\00:23:42.38
And if that valve is
myxomatous it tends to
00:23:42.85\00:23:45.36
leak more, so the
key is not so much having
00:23:45.37\00:23:47.69
the mitral valve
prolapse is whether
00:23:47.70\00:23:49.35
it's the valve is not
closing well so it leaks,
00:23:49.36\00:23:53.32
right. So, that's the
main thing we follow Ashley
00:23:53.33\00:23:56.37
is it leaking
very much. On the test
00:23:56.38\00:23:59.90
we've already talked
about that we do that
00:23:59.91\00:24:01.65
with is echocardiogram
which tells us how much
00:24:01.66\00:24:03.85
it's leaking. Now
this valve is not a
00:24:03.86\00:24:06.17
perfect valve, so in a
patient like you Ashley,
00:24:06.18\00:24:08.96
I would say if
you've mitral valve prolapse
00:24:08.97\00:24:11.32
and the valve leaks
you have to very careful
00:24:11.33\00:24:14.26
around un-sterile procedures.
00:24:14.27\00:24:16.19
Like dental
procedures, anything unsterile,
00:24:16.47\00:24:19.44
you would want to
take some antibiotics
00:24:19.45\00:24:21.31
before that
procedure. Just to cover in case
00:24:21.32\00:24:23.76
of bacteria could gain access
00:24:23.77\00:24:25.33
to your bloodstream.
Because in this type of
00:24:25.34\00:24:26.95
valve it could
join up with a valve
00:24:26.96\00:24:29.76
and cause an infection, right.
00:24:29.77\00:24:30.96
That is medication,
is medication an option
00:24:31.69\00:24:35.09
for that situation?
Usually you don't need
00:24:35.10\00:24:36.83
medications for this.
Some people with mitral valve
00:24:36.84\00:24:39.24
prolapse do have a
lot of palpitations
00:24:39.25\00:24:41.90
or the skip beats. If you
have a lot of palpitations
00:24:41.91\00:24:45.24
or the skip beats and
we can't treat it with
00:24:45.25\00:24:47.90
natural
measures, such as exercise,
00:24:47.91\00:24:51.54
low stress, we could
put them on a medication
00:24:51.55\00:24:54.62
that would block the skip beats.
00:24:54.63\00:24:56.18
And those are
called the beta-blockers,
00:24:56.19\00:24:58.13
but for you Ashley I
think you're already doing
00:24:58.14\00:25:00.30
the most important
thing and that's the
00:25:00.31\00:25:01.90
high intensity
aerobics, right, because that
00:25:01.91\00:25:03.51
helping your system
more, but you should take
00:25:03.52\00:25:05.25
antibiotics if you
have unsterile procedure.
00:25:05.26\00:25:07.62
And we call that, let me go one,
00:25:07.63\00:25:09.19
we call that
dental prophylaxis usually
00:25:09.20\00:25:11.87
because the most
procedures are done
00:25:11.88\00:25:12.99
in the mouth. So, I
would tell your dentist
00:25:13.00\00:25:14.81
every time that I
have this and he will give
00:25:14.82\00:25:17.30
you an antibiotic
before the procedure.
00:25:17.31\00:25:18.78
Now is there anything
in her life for instance
00:25:19.05\00:25:22.63
that she can't do,
let's say go to Pike's Peak,
00:25:22.64\00:25:25.66
different attitude,
no. Skin, scuba diving,
00:25:25.67\00:25:29.12
anything like that.
No, she can do all of that
00:25:29.13\00:25:31.88
as long as the valve is
not leaking too severely,
00:25:31.89\00:25:34.43
right. And most
of cases it's not,
00:25:34.44\00:25:36.18
it's not
leaking too severely and
00:25:36.19\00:25:37.84
they can do
whatever. In rare cases though
00:25:37.85\00:25:39.75
it is leaking severely
and in that case it would
00:25:39.76\00:25:42.77
need to go on. Now
there is no infection
00:25:42.78\00:25:45.13
in this valve, this
valve is just not working well.
00:25:45.14\00:25:47.03
In these instances
the valve at some cases
00:25:47.04\00:25:49.06
need to replaced. Right.
00:25:49.07\00:25:50.46
Alright, our sixth
question Jim is from
00:25:52.80\00:25:57.66
Maxwell in England.
His friend told him that
00:25:57.67\00:26:01.63
he has four
artificial heart valves,
00:26:01.64\00:26:04.19
he thinks he is exaggerating.
00:26:05.65\00:26:07.35
Can you have this
many bad heart valves,
00:26:08.55\00:26:11.06
that's a good question.
00:26:11.52\00:26:12.49
Wow! We talked
early about the valves
00:26:12.87\00:26:15.57
in the heart.
And we identified the
00:26:15.58\00:26:17.23
tricuspid valve,
the pulmonic valve,
00:26:17.24\00:26:19.61
the mitral valve
and the aortic valve.
00:26:19.62\00:26:21.66
I think Maxwell your
friend is exaggerating.
00:26:23.67\00:26:26.56
I've never seen
anyone that had four
00:26:26.82\00:26:28.93
heart valves
replaced. I have seen one valve
00:26:28.94\00:26:32.77
very common,
sometimes I see two heart valves
00:26:32.78\00:26:35.99
replaced and
usually these people have
00:26:36.00\00:26:37.76
rheumatic heart fevers.
00:26:37.77\00:26:39.29
Jim, what is
rheumatic heart fevers?
00:26:40.86\00:26:42.89
Rheumatic heart
fever is a condition,
00:26:42.90\00:26:45.27
usually it's been
years ago and people use
00:26:45.98\00:26:48.90
to not get antibiotics
for certain infections
00:26:48.91\00:26:51.21
and then usually
people would get infections
00:26:51.22\00:26:53.12
not get treated
with antibiotics,
00:26:53.13\00:26:54.81
the infections
would gain access to the
00:26:55.32\00:26:57.76
bloodstream,
subsequently the bacterial bugs
00:26:57.77\00:27:01.64
would get on the
valves and damage them.
00:27:01.65\00:27:03.57
And in the healing
process these valves become
00:27:04.09\00:27:06.90
thickened and it
didn't work correctly,
00:27:06.91\00:27:09.13
we call that a
rheumatic heart valve, right.
00:27:09.14\00:27:11.04
And these type of
infections could get on
00:27:11.05\00:27:12.93
multiple valves and
I've had seen people with up
00:27:12.94\00:27:15.41
to three valves affected
with rheumatic heart fever.
00:27:15.42\00:27:18.05
But, Maxwell, I've
never seen four artificial
00:27:18.33\00:27:21.45
heart valves. In
fact I've only seen two
00:27:21.46\00:27:23.78
with the repaired
one. The most common valves
00:27:24.08\00:27:26.56
that we you know
have surgery on is the
00:27:26.57\00:27:29.15
aortic valve, the
mitral valve, rarely,
00:27:29.16\00:27:31.67
rarely do you
have a tricuspid valve,
00:27:31.68\00:27:33.42
and the pulmonic valve
that usually have other
00:27:33.43\00:27:35.82
methods to help that
valve when it gets bad.
00:27:35.83\00:27:38.64
And so I hope that
answers your question
00:27:39.51\00:27:41.42
Maxwell and if you
really wanted to know for sure,
00:27:41.43\00:27:43.15
you could look at
friend's medical records,
00:27:43.16\00:27:44.99
or he could do, have
one of these tests called
00:27:45.00\00:27:46.66
an echocardiogram.
We've covered a lot of ground
00:27:46.67\00:27:49.75
today about heart valve disease,
00:27:49.76\00:27:51.75
we talked of leaky
valves, whether a person
00:27:51.76\00:27:53.75
should take Coumadin
or not, we've talked about
00:27:53.76\00:27:55.88
infections and one of
the things I wanna leave
00:27:55.89\00:27:58.67
with everyone today
is make sure you're clean
00:27:58.68\00:28:00.45
especially with
regards to your bloodstream
00:28:00.46\00:28:02.59
because we don't want
an infection to gain access
00:28:03.22\00:28:05.42
to your heart. Thank
you for joining us today
00:28:05.43\00:28:07.69
for Wonderfully
Made and may God richly
00:28:08.09\00:28:10.45
bless you as you
live close to Him.
00:28:10.46\00:28:13.13