Participants:
Series Code: WM
Program Code: WM000360
00:35 Praise God for I am fearfully and wonderfully made!
00:39 This is a beautiful quotation that's found in the Psalms. 00:42 Welcome to "Wonderfully Made" 00:44 I'm so glad you took time out of your busy and hectic 00:47 schedules to join us. 00:48 Today, we're going to talk about 00:50 the important topic of heart rhythms. 00:53 My name is Dr. Jim Marcum, and I'm a cardiologist 00:56 with the "Chattanooga Heart Institute" 00:58 and with me today is Dan Miller 01:01 Dan Miller is a businessman from Chattanooga as well 01:04 but he's also a consumer advocate of healthcare... 01:08 and I'm so glad he's here 01:09 And our goal today is to talk to you as if we were 01:13 right there in the house with you. 01:14 We've collected questions from ALL over the world 01:17 dealing with this important topic of heart rhythms. 01:21 What we've done is... hopefully, we can cover 01:24 everything of interest, and Dan is going to, 01:25 if we talk a little bit too technical, Dan is going to 01:28 sort of correct us, and slow us down a little bit 01:30 and he's going to make this so everyone feels like 01:32 we're right in your living room today talking. 01:36 So Dan, with that introduction, 01:37 let's get going with the questions! 01:39 Okay, thank you, Jim. 01:41 The first question is from Brenda. 01:45 She lives in Atlanta, and she's 38 years old. 01:49 She works as an executive secretary... 01:52 and her question is this... 01:54 She has noticed that her heart pounds and races at times. 01:59 It usually happens when she's preparing to go to bed 02:03 and it really bothers her. 02:06 What could be causing this? 02:08 Well, Brenda, that is an excellent question. 02:11 Many people, especially in your age group, 02:14 have this problem with pounding hearts... 02:16 Dan, have you ever had a problem with a pounding heart? 02:19 Yes I have... 02:20 Now, have you ever noticed any time of the day 02:22 when this pounding usually occurs? 02:24 Generally in the evenings. 02:26 Generally in the evening... Well that's a common time 02:28 when pounding does occur... 02:29 And the reason the pounding occurs then is 02:31 there's some much stimuli that goes on during the day 02:34 and at the evening time, people start to notice 02:37 and slow down a little bit, and then they start feeling 02:39 things that they normally wouldn't feel 02:41 when they're too busy during the day. 02:43 Well, Brenda... The most common cause of 02:46 this in your age group would be something that's called... 02:50 "premature ventricular contractions" 02:53 Sometimes we just call this "PVCs" 02:56 This is very frequently... Now how do I know that 02:59 without testing? Well, I don't 03:01 But, the way we would test is put a fancy device 03:04 called a "Holter monitoring device" 03:07 Have you ever heard of a Holter monitor yet? No I haven't 03:09 Well, let me explain a little bit about what 03:11 Holter monitoring is... 03:12 That's a special device... we put on electrodes 03:15 and we can tell every beat of your heart for X-amount of time. 03:19 We can measure from 24 to 48 hours 03:22 and this is one of the most useful tools that we have 03:25 to detect rhythms of the heart. 03:27 Let's put up our first graphic regarding 03:30 premature ventricular contractions, or PVCs. 03:33 Many different things can cause these PVCs. 03:36 It can be a structural abnormality within the heart. 03:38 That is... the heart doesn't work well. 03:40 It's either too weak, or valves messed up, 03:43 or some other problem. 03:44 Caffeine in the United States... 03:46 Caffeine is a frequent cause of PVCs. 03:48 There are certain over-the-counter drugs 03:51 that can cause it, especially those for 03:53 cold medications that have a substance called 03:56 "pseudoephedrine" 03:57 STRESS is a cause of PVCs. 04:00 And there is a host of medical problems that cause these 04:03 premature ventricular contractions. 04:05 So, this is a very common problem, Brenda 04:08 And, getting back to your question, 04:11 I would be very curious, if you were my patient, 04:14 whether you did have a structurally normal heart 04:16 And I would ask you a bunch of questions about the 04:18 stress and medications you were on, 04:20 and we'd probably want to put a monitor on you. 04:22 Does Brenda's age put any bearing on any of this? 04:26 Well, in pregnant years, okay we think of PVCs as 04:30 something that's causing stress to the heart. 04:33 And that stress can come from anywhere. 04:36 It can come from the job... 04:39 Not sleeping well at night... 04:40 It can be caused from a substance like 04:42 nicotine or caffeine. 04:43 It could come from being scared. 04:45 If I scared you, Dan... today if I go BOO! 04:47 ...you would jump and you might have a PVC 04:49 Well all these things can cause the heart to skip. 04:53 In this age group, another thing that we have 04:56 to keep in the back of our mind is 04:57 ...Could this person be pregnant? 04:59 That would put definitely a stress on the heart. 05:01 What happens, physiologically, when you're under stress, 05:05 you make a hormone, and that hormone is called "epinephrine" 05:08 And that epinephrine is usually what causes 05:11 the heart to skip and beat... 05:12 And one of the treatments that we do if it skips, 05:14 or just unbearable, and we can't do anything, 05:17 is we try to block that receptor with medications. 05:20 So Brenda, what could be causing this? 05:22 Well, back to your question... 05:24 it could be the medicines you take... 05:26 It could be... a RARE cause would be a structural 05:29 abnormality, but usually in your age group, 05:31 it's just the stress of everyday life 05:33 that's causing the skipped beats... 05:34 and that could cause from many things. Right 05:36 All righty... let's go to our second question then... 05:41 This comes from Mel in Toronto. 05:46 The speed of his heart is about 38 to 42 beats per minute. 05:52 He takes Atenolol for high blood pressure 05:58 and it's making him very tired. 06:02 Do you think that he needs a pacemaker? Oh... okay 06:05 Mel, that's a question we hear a lot of, 06:08 and before I answer your question, 06:10 a lot of people don't even know what a pacemaker is. 06:13 Have you ever seen a pacemaker? I have not... 06:14 Okay, well I brought a pacemaker with me today 06:17 and this is a pacemaker, and this keeps the heart going 06:21 when it's not beating strong enough. 06:23 And the way we have this pacemaker, is inserted 06:25 right here under the skin, and here is the lead 06:28 that goes inside the right ventricular chamber 06:31 and sometimes we put a lead in the top chamber which is 06:33 the right atrium, and this not only beats the heart, 06:37 but every single beat that the heart does, it can monitor it. 06:41 And we have ways on a pacemaker, 06:43 we can tell everything that's happening within the heart. 06:45 Now what is this made out of? 06:47 Okay... this pacemaker is made of a substance, an element 06:50 called "titanium" which is very stable in the body 06:54 and these are special plastics that go in the body 06:57 that the body doesn't react to it, so you don't have a 07:00 bad reaction, or anything like that. 07:02 Pacemakers are one of the most frequent treatments 07:05 we have for heart disease. 07:06 Before we had pacemakers, when the heart went 07:10 slower and slower and slower... 07:11 it would just STOP! 07:12 And if a heart is not beating, we have no blood pressure. 07:15 And one of the first pacemakers that went in... 07:18 I don't know if people realize this, was... 07:19 Did you ever hear of Alfred Hitchcock? Yes sir 07:23 Okay, well Alfred Hitchcock had one of the first pacemakers 07:26 And back in those days, the pacemakers were 07:28 about the size of my hand, 07:29 and it went in the belly. 07:31 And that's what it took to keep his heart going... 07:34 But through the years, as you see, the pacemakers have gotten 07:36 smaller and smaller 07:37 and it's my prediction that some day, they're going to be 07:40 on the size of a computer chip. 07:41 Now, can these be monitored any other way than 07:45 ...how does the monitoring process work? 07:47 Well, we have a couple of ways we can monitor it, Dan 07:50 One of the ways we can do it 07:51 is with a handheld device over it... 07:53 that we can tell every beat that the heart has. 07:55 Another way, nowadays, we can actually download 07:58 the information that's stored in these computer chips 08:02 on the internet... Right 08:03 And I can actually see every beat of a patient's heart 08:06 for a long period of time, 08:07 in addition to see how often the pacemaker is used 08:09 ...To see when it's wearing out 08:12 ...To see when the battery might need to be replaced. 08:15 So you're saying I can be traveling somewhere 08:17 and you could monitor me from long distance anyway... 08:22 Totally mobile with the pacemaker... 08:24 You know, another thing that people don't realize is 08:27 ...Some people ask me 08:28 "Can I get into MRIs, and magnetic fields?" 08:31 Well usually, we advise not to get in an MRI machine. 08:35 Now, an MRI machine is a fancy machine that 08:37 takes pictures of you because it's got such a strong 08:39 magnet, it can pull on that. 08:40 We don't want it to be pulling on someone's heart. 08:42 It's like in airports, and restaurants, 08:44 and stuff like that... that have the signs 08:46 Right, you can still go there but it would detect metal 08:49 in you and the alarms would go off... 08:51 So it's frequently the cause of... 08:52 especially now with all the problems we've had 08:54 at the airports, it's a very 08:56 frequent problem... But you know what? 08:57 We forgot to answer Mel's question here... Yes we did 09:01 Mel... Making you tired. 09:04 Well, could the rhythm be making you tired? 09:06 It's going 38 to 42 beats per minute. 09:08 A normal heart runs about 70 beats per minute. 09:11 So the rhythm itself might be making you tired. 09:13 OR, it might be the Atenolol 09:16 Atenolol is a medication which slows down the heart. 09:19 It slows down the wiring of the heart, 09:21 so that could be making you tired. 09:23 Do you need a pacemaker? 09:25 A pacemaker is needed usually when the heart can't 09:29 generate enough blood pressure to supply the brain. 09:32 So, you might feel dizzy, you might pass out 09:36 ...you might feel weak... Those are symptoms that would say... 09:38 "Hey! I think you might need a pacemaker" 09:41 Let's go up to our second graphics 09:44 that has to do with when a person might need a pacemaker 09:47 and here are the indications for a pacemaker... 09:49 The heart is too slow, okay, but, well Mel's going too slow 09:53 and he's tired. 09:55 Well so, he's having some symptoms... 09:56 Usually we see dizziness, 09:58 so that might be a reason. 10:00 Conduction disease... what that means is the 10:02 actual wires of the heart... the batteries, 10:04 the thing that keeps the heart going are diseased. 10:07 And the last thing, is sometimes people need to 10:11 take the medications to slow the heart down. 10:14 The medications are so important to slow the heart rate 10:17 that we put a pacemaker in 10:19 just so the patient can take the medications. 10:22 So sometimes, in that instance, 10:23 those people also need a pacemaker. 10:25 But Mel is taking a medication which could slow his heart. 10:29 So the first thing that I would do with Mel here, 10:32 is, Mel, I would stop your Atenolol, 10:34 and use a different medication to treat your blood pressure... 10:38 And then, I would put a monitor on you... 10:43 one of these Holter monitors and see what the rhythm is doing 10:45 and see if anymore symptoms occur. 10:47 If more symptoms don't occur, 10:49 I don't think I would worry a lot. 10:52 Another thing, Dan, I might do... 10:53 is I would watch Mel's heart rate when he walked. 10:56 Lots of people... athletes go very, very slow 10:59 when they're not doing anything, 11:00 but if it speeds up when you do things, 11:02 that's a great sign. Right 11:04 Now let me ask YOU a question... 11:06 Do you know... many people don't realize this 11:10 What part of the day do you think your heart goes 11:13 the slowest, and what part do you think it goes the fastest 11:17 I would say slowest would probably be in my sleep... 11:23 That's correct! 11:24 Fastest would probably be when I first wake up? 11:28 That's right! That's great Dan! 11:30 You're on top of this. 11:32 If you don't have a lot of stress on you, 11:34 or other outside stimuli, 11:36 like you're getting cut or hit, 11:38 your heart is going to go fastest in the mornings 11:41 because the hormonal system 11:43 starts kicking in, and slowest at night 11:44 In fact, I've seen people's hearts on these monitors 11:46 run, with no problems at all, run in the 20s to 30s at night. 11:50 It goes pretty slow... Right 11:52 And that's when the body is resting. 11:53 The heart has a time to catch up from the day. 11:55 So, Mel, good luck with your heart, and I hope that 11:59 answered your question. 12:02 All right, let's go to question #3... 12:05 It's from Robert in Pennsylvania. 12:08 He says, "I'm a minister of a 1,500 member congregation 12:13 in Pennsylvania... we recently had a parishioner die 12:18 after the morning services. " 12:20 "What are your thoughts on getting an automatic 12:23 external defibrillator?" Okay 12:27 And most of his congregation is elderly, so this is really 12:31 something that concerns him. 12:33 Well, this defibrillator issue is coming up more and more. 12:38 In the Chattanooga area recently, 12:40 we had a young person that actually died from one of these 12:44 dangerous heart rhythms. 12:46 It's very rare for a young person to have these, 12:49 and every year, you hear about a football player that has 12:52 one of these abnormal rhythms that was 12:53 otherwise undetectable. 12:57 So the issue is... is should everyone, in different places, 13:01 carry these defibrillators? 13:02 Because if you can get a defibrillator to a person 13:04 quickly, you can literally save many lives. Right 13:08 And the economics of it is... 13:10 you know, should these big churches where there are 13:14 lots of people that could potentially have an arrhythmia 13:17 from a heart problem die... 13:18 Now before I answer this question, 13:20 I just want to go over, out of all the causes 13:23 of death in America, the most likely cause of death is 13:26 going to be cardiovascular disease 13:28 And a lot of people don't realize that 43% of all deaths 13:31 in the United States, is due to cardiovascular disease. 13:35 And that's greater than wars, and cancers, 13:38 and infections, than everything combined. 13:40 An interesting statistic is ... if you have a heart attack, 13:44 guess how many people, guess what percentage dies 13:46 before they even make it to the hospital from a heart attack? 13:49 I have no idea. ... 33% 13:52 Most people don't think it's that high. 13:53 But if you have a heart attack, 13:55 there's a 1 in 3 chance that you're going to die before 13:57 you even make it to the hospital. 13:58 That's why these defibrillators are so much in the news 14:02 and so much... you know, everyone is wanting to 14:05 talk about them. 14:06 So, thoughts on an automatic external defibrillator 14:10 I think this would be an excellent 14:13 thing for your congregation. 14:14 And the training involved really is very simple 14:17 In fact, we brought a defibrillator with us today 14:20 It is at this point in time, let me put this on you, Jim 14:27 We're going to sort of pretend that... 14:30 and the first thing we do is, we turn it on 14:31 to show everybody how it actually works. 14:33 It's not that hard to work, and you'd be surprised how 14:35 easy it is to work, and if you're looking at 14:38 Robert, if you're looking at the show this evening, 14:40 I want you to sort of put this in the back of your mind 14:43 for your congregation 14:46 A lot of people think it's hard to work, 14:47 but it's not... very easy! 14:48 Okay, is the device on? 14:50 You turn it on. Okay 14:51 And we're going to get things going here. Okay 14:58 I think it's ready to open up. 15:01 You push the button on the front of the machine. 15:03 The device opens up... and you have to hit it again 15:08 Push it one more time. Okay... 15:15 This device, we're going to have to get it going here. 15:19 It's supposed to come on here. 15:21 It talks to you, actually, when it comes on. Correct 15:25 Now, we have a trainer with me today, 15:27 so let's back up... "CALL FOR HELP NOW" 15:30 Here it goes... So at this point is where I call for help 15:33 "REMOVE CLOTHING FROM CHEST" 15:34 So I would remove my clothes. Right 15:36 At this time, you'd be laying on the ground, 15:37 and I'd take your clothing away from your chest. 15:40 We're going to install this on your shirt, 15:43 so you'll need to take your jacket off. 15:45 "PULL RED HANDLE TO OPEN BAG" 15:48 So I would pull this out... 15:49 "PEEL EACH PAD AT THE PLASTIC" 15:53 "AND APPLY PAD TO EXPOSED CHEST" 15:57 You'll tear the 2 pads in half... 16:03 "REMOVE CLOTHING FROM CHEST" 16:06 So it repeats it if you don't do something right... 16:09 or you can't... This one actually has a 16:10 picture showing us where to put the pad 16:13 So I would apply that one at that point... 16:16 "PULL RED HANDLE TO OPEN BAG" I would pull this off... 16:21 "PEEL EACH AT THE PLASTIC" 16:24 This one goes under your arm... 16:25 "AND APPLY PAD TO EXPOSED CHEST" 16:28 "DO NOT TOUCH PATIENT" 16:31 "EVALUATING HEART RHYTHM" 16:34 And at this point in time, it automatically evaluates... 16:38 "STAND BY" Okay 16:40 "PREPARING TO SHOCK" 16:41 "EVERYONE CLEAR" I would get out of the way... 16:44 "DO NOT TOUCH PATIENT" 16:45 "DELIVERING SHOCK" ... alarm beeps... 16:50 Okay! Well, as you can see... 16:53 Was that the first time you've every done this? Yes it is 16:56 Now that was not too hard to put on... 16:59 And yet, if I really would have had a dangerous heart rhythm, 17:02 that potentially could have saved my life. 17:05 I would have really wanted this on that young person 17:08 that day... You know, that happened to 17:10 collapse in a gym. 17:12 I would really want this on, because if someone 17:14 could have been trained to put this on immediately, 17:17 it would have saved his life. Correct 17:18 Now, a question we might get is... 17:21 "Can you mess up with one of these?" 17:22 I mean, can... Can you be shocked accidentally? 17:26 I've never heard it happening... 17:28 And the reason it didn't shock me is because 17:30 my heart rhythm was normal. 17:32 It's trained to only shock that abnormal heart rhythm 17:34 which is called "ventricular fibrillation" 17:37 or "ventricular tachycardia" 17:38 That's the ones you see people over people's heart 17:41 shocking it, you know, dramatically... 17:43 ...like in the hospital. 17:44 So, Robert, that's how you use these, 17:47 and the price of these defibrillators are 17:49 coming down every year. 17:51 One of the questions that comes up is... 17:53 "What about the liability issues?" 17:55 You know, are you liable if you have one? 17:58 Are you liable if you DON'T have one? Right 18:00 And these are being worked through right now, 18:02 but most people have a short training course... 18:05 They have to be Basic Life Service Support. 18:08 But when I talk to people about whether they need one of these, 18:12 I say, "Well, you just don't choose not to 18:15 for the legal reasons. " 18:17 I mean, you want to have this to save lives. Correct 18:20 And if you didn't have it" What would happen? Right 18:22 And what's the worse thing that can happen if you mess up? 18:25 Do it over... I would suppose. Right 18:28 But if you don't even have the 18:29 machine, you know, if someone is going... 18:30 You don't even have that chance... Exactly 18:32 And if you don't get the paramedics there within 18:33 5 minutes and deliver that shock, 18:35 that patient has very little ability of having 18:38 significant long-term recovery. 18:41 So, Robert, there it is. That's a defibrillator 18:44 and we hope you consider getting it... 18:46 And if there are any more questions, 18:49 the people that run these defibrillator companies 18:52 they're on the websites. 18:53 This one happens to be one done by a company called "Medtronic" 18:58 They are more than happy to give you information on this. 19:01 Beep-beep... It's extremely easy 19:03 Okay, well we stopped it... I hope it doesn't go off again! 19:05 Let's not... Okay, we don't want it to start talking 19:07 We've got to finish this show, Dan... ha, ha, ha 19:09 So with that, let's go to the next question. 19:11 Beep-beep... okay, let's leave that closed there. 19:16 And the next question will be from Lynette in Tennessee. 19:20 "The speed of my heart races at times. " 19:24 "I was at Disney World a few years ago, and nearly 19:27 fainted from this rhythm. " 19:29 "I have 2 small children and live an active lifestyle. " 19:33 "This RARELY occurs... Should I be concerned?" 19:37 Well, yeah, the speed of the heart races. 19:41 You can go ahead and put that up if we need to. 19:43 Lynette, this is a good question. 19:45 In the heart, there are sometimes groups of cells that 19:49 become very, very unhappy. 19:51 And these cells can generate a fast rhythm, 19:54 and sort of a generic name we gave for that is a big name. 19:57 It's called "supraventricular tachycardia" 20:00 where the heart goes real fast. 20:02 And sometimes when the heart goes fast like this, 20:04 you don't get blood pressure to your head... 20:06 and that's what makes you feel so poorly. 20:09 One of the things we say when it happens... 20:12 Okay, "Lay down and put your feet up" 20:15 And you can sometimes rub on this part of your neck 20:18 and sometimes this will actually slow your heart down enough 20:21 until you can catch your breath. 20:23 If it continues for a long period of time, 20:25 YOU REALLY need to go to the hospital, 20:28 so we can either put a monitor on you, or get an EKG 20:31 to see what this rhythm is about... 20:34 Because you don't want to be having this rhythm 20:36 when you go down with your kids. 20:38 Could a ride at Disney World have brought that about? 20:43 Yeah, I guess it's possible, but usually these rhythms 20:47 are triggered on their own. 20:49 I mean... most people have these that they're doing 20:51 nothing, and then it just comes on! 20:53 Now we do know that there are some triggers 20:55 that make it worse - - if you're dehydrated 20:57 Sometimes you can take a stimulant from the heart 21:00 and some of the more common stimulants that you might see 21:02 at a theme park would be stress from 21:04 2 small kids all day... Standing in line 21:06 Yes, if you don't have the fast passes... 21:08 you'll have to stand in line a lot at Disney World. Exactly! 21:11 Another thing, we talked about caffeine. 21:13 If you get dehydrated, if you're not drinking all day, 21:16 you don't have enough fluid, those are some other 21:17 things that could trigger this rhythm. 21:19 In people that just have it rarely, I'd recommend 21:22 no treatment, just monitor. 21:23 But if it happens on a regular basis, more frequently 21:26 We can actually go up inside a body and destroy 21:29 these dangerous heart rhythms now with a 21:31 small amount of energy. Right 21:32 And if people don't want to do that, we can also 21:34 take medications. 21:35 Now, is it a person's fault that they have this? 21:38 No, not really... most people are just sort of born that way 21:41 and they have these abnormal pathways, 21:43 and they have to just live with that. 21:45 So Lynette, good luck with your rhythm, 21:46 and if it keeps coming on, 21:48 I would go see your healthcare provider. 21:51 All righty, next question is from Earl in Minnesota. Okay 21:57 He says, "Atrial fibrillation runs in my family. " 22:03 "I am 86, my doctor says I have arterial fibrillation 22:09 and he wants to put me on a blood thinner. " Ooo 22:12 "I don't want to. " Okay 22:14 "What do you think?" 22:16 Atrial fibrillation is another one of these rhythms 22:20 of the heart. 22:21 Now we didn't talk much about it earlier, but 22:23 the normal rhythm is called "sinus rhythm" 22:26 That means each rhythm is generated from the special 22:29 battery that God gave us called "the sinus node" 22:32 ...that's a normal rhythm 22:33 So, if it's going too slow, we call that "sinus bradycardia" 22:37 or too slow of a heart rhythm. 22:39 If it's going fast, we call it "tachycardia" 22:41 Those are normal rhythms of the heart, 22:43 but just going slow for another reason. Right 22:46 Sometimes you have, sort of, 22:48 these misconnections that we talk about... 22:50 And if it's coming from the TOP part of the heart, 22:52 this abnormal faring from all sorts of FUNNY spots, 22:56 we call that "atrial fibrillation" 22:58 And that's where the top part is literally going like this... 23:01 It's just squeezing all over. 23:02 It's not working symmetrically 23:05 with the bottom part of the heart. 23:07 And guess what happens to blood if the heart is 23:10 squeezing like a... worm when it comes through? 23:12 Squeezed out? 23:13 Well, some of it is squeezed out but not as much as normal. 23:16 But actually, when it's moving like THIS, 23:18 you can get blood clots because the blood 23:20 doesn't pass through. 23:21 And if a blood clot gets in there and passes through 23:24 from the upper chamber to the lower chamber, 23:26 and the lower chamber pumps that blood clot somewhere, 23:29 it could go to the head, and cause a stroke. 23:32 In fact, about 15% of all strokes in the United States, 23:37 are caused by this rhythm atrial fibrillation. 23:41 So, Earl, that's why your doctor wants to 23:45 put you on a blood thinner... 23:46 He wants to lower your risk of having a stroke. 23:49 Now, is there some people that don't get a blood thinner? 23:52 You know, um... Yeah, if the risk of bleeding outweighs 23:57 the risk of the blood thinner then you wouldn't get it. 24:00 And, you have to have frequent monitoring 24:02 when you're on Coumadin. 24:03 Now, do you know what Coumadin really is? 24:04 I do not... What is that? 24:06 Coumadin is rat poison! 24:08 A lot of people don't like to realize 24:10 that it's just rat poison. 24:11 A lot of people don't like to take it because it's rat poison 24:14 But it has lowered the risk of having a blood clot in the body. 24:18 And in atrial fibrillation, you have to evaluate the 24:21 risk of being on the blood thinners, 24:22 whether you can take in the monitoring, 24:24 versus the risk of falling, and bleeding. 24:27 These are all very important things 24:29 to think about when you're on Coumadin... 24:31 But Earl, if you came to me and you had atrial fibrillation, 24:34 first of all, I would say, Coumadin needs to be considered, 24:39 The next thing I'd want to look at is the different causes... 24:41 You know, why do you... It's a very common rhythm 24:44 and with that in mind, let's bring up the next graph 24:46 about the causes of atrial fibrillation... 24:49 Okay, remember this is where the top part is going 24:52 faster than the bottom part. 24:53 Sometimes it can again be because there's something 24:56 wrong with the heart itself. 24:57 That is, there's a structural heart problem. 25:00 It might be that it's stretched out... 25:02 It might be the valves that's bad. 25:04 There might be an old heart attack. 25:06 Something's wrong with the heart itself that's causing it. 25:08 Sometimes you can have a thyroid condition 25:11 Remember the thyroid regulates these rhythms. 25:13 You can have a thyroid abnormality 25:15 Sometimes high blood pressure can actually cause this 25:18 rhythm, atrial fibrillation, because it stretches it out. 25:20 And there is a host of other causes. 25:23 And Earl, I want to, sort of go through some of those 25:25 other causes with you, just in case 25:28 you might have one of these. 25:30 Again, we talked about being dehydrated. Right 25:33 Having an infection. 25:35 Certain medications can sort of cause it to be 25:37 more likely to happen. 25:39 Just being sick can cause it to happen... Correct 25:42 Now, one of the things that the heart likes most is oxygen! 25:45 We found that people that don't get enough oxygen 25:48 So if Earl has a lot of lung disease... 25:50 THAT could be a trigger for this atrial fibrillation. 25:54 And in this rhythm, you feel pretty bad, 25:56 if the heart is going too fast. 25:58 So atrial fibrillation is one that usually you have to go 26:01 in the hospital to get it treated... 26:02 so it's a pretty tough thing to have. 26:05 So I think Coumadin is reasonable 26:07 And the other thing, you know, 26:08 if we can fix the underlying cause. 26:10 You know, Earl, if you have problems with your lungs, 26:12 if there is an infection, you're not getting enough 26:14 oxygen, let's fix that. Right 26:16 Now, do you have to do tests to balance 26:20 the amount of Coumadin that you're getting... 26:22 Can you get too much Coumadin? Yes you can... 26:24 And we have to frequently check the blood to see 26:27 if the blood is TOO thick, or too thin while on your Coumadin 26:29 ...Because if it's too thin, and you bonk your head, 26:31 you could have a very, very serious problem... Right 26:37 You know, in the slide, you also mentioned that 26:41 the thyroid has a lot of problems... 26:44 There are a lot of people with thyroid problems 26:46 in the United States today, it seems like... There are! 26:49 I, personally, have some problems with mine 26:52 and so that's something even beneficial for me to remember. 26:57 Right... it can go, you know, too low, too high 27:00 Thyroid is a very common regulator of the heart. 27:02 It regulates the heart's speed. 27:03 And actually, a lot of people don't realize, 27:05 but a low heart RATE can cause you to have a slow heart. 27:10 Now before we close today, I wanted to show the people 27:13 we talked about rhythms... 27:14 we talked a little bit about the slow ones... Right 27:16 a little bit about the fast ones 27:18 And today, I just want you to get INTERESTED in 27:20 your heart rhythm. 27:21 One other thing I'd like to 27:22 show you that we brought with us today... 27:24 This is a defibrillator! 27:26 Remember earlier in the show we had an external defibrillator 27:29 Now what an external defibrillator is... 27:31 is a device that we put on IMMEDIATELY 27:34 when someone is having a sudden problem with their heart. 27:38 Now this device, in people with weak hearts 27:40 or people who have diseased hearts 27:41 that need this technology all the time. 27:43 This can be inserted under the skin, and it can deliver 27:46 a shock, and this one can actually pace the heart 27:49 any time it might be needed. 27:50 Well we're almost out of time today, Dan 27:53 I want to thank you for joining us. 27:54 I hope that the audience has learned something about 27:57 the rhythms of the heart... 27:58 The fast ones, the slow ones... 27:59 a little bit more knowledge about what to do. 28:02 And we hope that ALL of you can have hearts that 28:05 NEVER go out of rhythm. 28:06 And we hope that God will create in you, a new heart 28:09 one that depends on Him daily to keep your heart 28:12 running smoothly. |
Revised 2014-12-17