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Series Code: UP
Program Code: UP190127B
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00:01 Welcome back to the Ultimate Prescription.
00:02 I'm your host Nick Evenson 00:04 here with Dr. James Marcum, practicing Cardiologist 00:06 with the Chattanooga Heart Institute. 00:07 And today, we're talking about heart valves. 00:10 And, Dr. Marcum, in the last segment, 00:11 we talked a bit about trans aortic valve replacement. 00:14 Yeah. And why you might want that. 00:16 What are some of the risks involved? 00:18 Yeah, there's always risk and there's risk 00:21 of having the surgery itself, 00:23 which mainly includes bleeding, 00:25 there's a small risk of dying from any procedure. 00:28 There's a small risk of stroke and that, 00:30 but we also talk about the benefits of not doing it. 00:34 Usually the valve gets old fairly quickly, 00:36 and then you not only lose quality of life 00:39 but you die from this. 00:42 Now some people say, 00:43 "No, I don't want anything done." 00:45 It's ready, it's my time 00:46 and they choose not to have it done 00:48 and that's fine. 00:49 I know that, you know, 00:51 it's hard to make these decisions. 00:52 I know that you have a grandmother 00:54 that watches these programs on. 00:55 I do have grandma if you're watching, "Hello." 00:57 Okay. If you're watching. 00:58 Okay, but when people get older things do wear out. 01:01 And that's why it's important to have a detailed discussion 01:04 about what's available, the risk and benefits 01:07 and some people say," No, this is not for me. 01:09 I don't wanna take the risk of that. 01:11 I don't wanna have that. I'm ready. 01:13 I'm ready to meet Jesus." And that's okay. 01:16 But technology has improved, it's become a lot safer. 01:20 And some people opt to have these procedures, 01:22 whether they be a new valve. 01:24 Now valve disease is a very complex, 01:27 we can't talk about everything. 01:28 Right. 01:30 But the things I want people to know about 01:31 is if you're short of breath 01:33 or having a symptom, see your doctor. 01:35 And one of the things that causes symptoms 01:37 might be the valve is getting older, 01:39 and we have lots of options 01:41 for valves that are wearing out. 01:43 Now sometimes, you know, we talked about my patient 01:46 has had the symptom for a long time. 01:49 We call that chronic disease. 01:52 Now some people have emergencies. 01:54 The valve just, you know, has a problem right away. 01:57 We call that emergent valve problem. 02:00 And if the valve happens, you know, 02:02 something happens wrong emergently 02:04 something has to be done right away. 02:05 So what would cause that? 02:07 A trauma to the valve, you know, 02:09 an infection to the valve, 02:11 a trauma where something was ripped in the heart 02:14 having a heart attack 02:15 where the blood supply to the valve wasn't good. 02:18 And the valve was affected by that 02:19 caused a lot of leaking something tear. 02:22 So the valve where its scaffolding 02:24 was becomes disrupted, 02:26 those are medical emergency route, 02:28 so that we have to do something right away 02:30 from that that's called an emergency. 02:32 And then sometimes we have a slower symptom 02:34 that develops over time. 02:36 That's a chronic situation. 02:38 So my patient was more of a chronic 02:40 that gradually got worse, but lots of different options 02:43 on the valves on both the mitral and the aortic. 02:46 Sometimes the third valve that we sometimes work on 02:49 is called the tricuspid valve. 02:53 That's the one between the low pressure chamber 02:55 the right ventricle, sometimes we have to do stuff 02:58 with that valve as well. 02:59 So lots of different options on different valves. 03:02 All right, now let's see if I've got this straight. 03:04 We were just talking about the trans aortic valve... 03:06 Yeah. 03:07 Which is controlling the blood flow 03:09 between the left atrium and ventricle? 03:11 In the left ventricle in the body. 03:13 In the body. Okay. 03:15 So it pumps out that valve to the entire body. 03:17 That's the one that let, you know, 03:18 the heart pumps goes out the aorta to entire body. 03:21 That's the aortic valve. 03:22 Okay, now let's talk about the mitral valve, 03:24 the other one in there. 03:25 Yeah. Okay. 03:26 Where's that controlling blood flow to? 03:28 The mitral valve control, you know, the lungs, 03:30 fill up the blood with oxygen, 03:32 and it circulates through the lungs 03:34 and it comes back to the left atrium, 03:36 and then from the left atrium it moves to the left ventricle, 03:39 and the left ventricle then pumps it out to the body. 03:42 Okay. So this is that valve. 03:44 So when there's a problem with the mitral valve, 03:46 what kind of options are there? 03:47 Well, you know, first of all, how would we find out that 03:50 we had a problem, again, shortness of breath, 03:52 sometimes the heart, the flow can back up 03:56 and the heart can start fibrillating, 03:57 that might be a clue. 03:59 Sometimes people can get fatigued and tired, 04:01 but the one I see most is shortness of breath 04:04 when I do things. 04:05 And that's a clue that 04:06 the mitral valve might be involved. 04:08 So what would I do? 04:10 I would get my stethoscope out and I would listen 04:12 and there's things that they teach us in medical school 04:15 and residency where we can tell characteristics 04:17 of which valve is malfunctioning. 04:19 Okay. 04:20 So I would listen to that valve and say, 04:21 "Wow, that valve sounds like 04:23 it's got a holosystolic murmur." 04:25 That's the way they describe it. 04:27 And I said, "Well, I need more information." 04:29 So I would do a test, 04:30 an echocardiogram where we can look at the valve. 04:33 We can look at it from just putting 04:34 some ultrasound on it. 04:36 Sometimes we can swallow a probe and look behind that. 04:40 That's called a transesophageal echocardiogram. 04:43 Sometimes we can get clues about the valves 04:45 through angiography and looking at that. 04:48 We now have MRIs and, you know, 04:51 different types of scans that can look at 04:53 how the valve is opening and closing. 04:55 And once we found out that it was leaking, 04:57 then we try to figure out 04:59 why it's leaking, you know, is it an infection? 05:02 Is it from a lack of blood supply? 05:04 Is it because it's just wearing out? 05:06 Is it something congenital? 05:08 So once we figured out the cause, 05:10 then we could figure out 05:11 what would be the options for treatment. 05:13 Sometimes the valve leaks a little bit, 05:15 and we just keep an eye on it. 05:16 Sure, yeah. 05:18 Okay, but sometimes it leaks a lot. 05:19 And if we don't do something about it, 05:21 it's gonna cause further problems 05:23 down the road. 05:24 So sometimes we choose to treat it right away. 05:27 One of the new develops in cardiology now, you know, 05:30 for years we could, sometimes a surgeon 05:32 can open you up and repair the valve. 05:35 Sometimes you can replace either a metal valve in 05:38 or put a bioprosthetic valve, 05:40 that's been sort of the gold standard, 05:42 but over the last two years, for leaky heart valves 05:45 and for certain valve conditions, 05:47 we have a procedure that we don't cut anyone open. 05:50 It's called a mitral valve clip. 05:53 And this is brand new technology. 05:55 All right, well, let's take a look at that. 05:56 And you can describe what's going on here for us? 05:58 Yeah. 06:00 Well, here is a heart, and that's the mitral valve, 06:02 and see that blue, 06:03 that's the valve leaking a whole lot. 06:05 So the blood instead of going forward 06:08 and out the aorta, which is to your right, 06:10 it's going backwards and it's leaking. 06:12 And that is what causes someone to be short of breath. 06:14 Well, we have this procedure, 06:17 where we actually clip the two valves together. 06:20 And there's an example of clicking it. 06:22 So now we have two orifices, and it will cause a lot less 06:26 of this regurgitation leaking. 06:28 So see how much before and now after 06:31 we notice a lot less leakage backwards, 06:33 and that's a sort of a non-invasive way 06:36 we can use to help the blood 06:38 from the mitral valve from leaking backward. 06:40 Do all patients candidate for this? 06:42 No, not all, only specific patients 06:45 would benefit from this, 06:46 but that's what all the testing can do 06:48 to look at these valves. 06:50 So we can do a lot of different things 06:53 to help the valves. 06:54 Yeah, so I imagine the mitral clip, 06:55 maybe has less risk than actually opening up. 06:59 Yeah, yeah. 07:00 Less risk of infection, quicker recoveries. 07:02 What are some of the other benefit? 07:03 Well, the benefits, main benefits 07:04 is you don't have to have open-heart surgery. 07:06 Yeah. But it's not for everybody. 07:09 And again, there are risks from this. 07:10 And really, you know, 07:11 there's always a risk of bleeding, 07:13 there's still a risk of infection, 07:14 there's still a small risk of stroke and damage, 07:17 but this is for a new technology 07:19 for a special class of patients that have a leaky heart valve. 07:23 And that valve is called mitral regurgitation. 07:25 But the big point today I want for our listeners 07:27 is to know that if you're short of breath, 07:30 see your doctor. 07:31 There are lots of things that we can do, 07:33 lots of different things we can offer. 07:35 Modern medicine has its place in helping these valves out. 07:38 So are there medications that are associated 07:40 with these procedures that patients might have 07:43 to take for a shorter time or a prolonged time after? 07:45 No, it's according to their underlying 07:47 whether the heart's strong, 07:48 whether it's weak, whether the fluids backing up, 07:51 you know, sometimes the fluids backing up they need diuretics. 07:54 Sometimes they need 07:55 different types of blood thinners. 07:56 Sometimes their blood pressure's high. 07:58 They need medicines to strengthen the heart. 08:00 So yes, there are some medications 08:02 that's used to help sort of slow down the aging process 08:06 to help the heart not work as hard 08:08 to help blood clots not developing, 08:10 blood doesn't move as well. 08:12 So yeah, there's medications 08:13 but each individual is so unique, Nick, 08:16 there's not a sort of a standard mix, 08:18 but we look at the patient, see what medicines 08:20 we can do to help the quality of life the best. 08:23 So we talked a little bit about modern medicine, 08:26 how it benefits, 08:27 valves that are that don't open well, 08:29 valves that leak, 08:30 but there's other heart conditions as well. 08:32 That's right. That's right. 08:34 And during this series of programs, 08:35 if you keep watching the Ultimate Prescription, 08:37 we'll share more of those with you. 08:38 But I wanna move on to our biblical prescription 08:41 for the day. 08:42 We've got a great app that shares these with folks, 08:45 but I want you to go ahead 08:46 and give us one right now if you would. 08:48 Yeah. 08:49 On the biblical prescription for today is Daniel 1:20. 08:53 "And in all matters of wisdom," they were talking about Daniel 08:56 and his friends, "and understanding that 08:58 the king enquired of them, 09:00 he found them ten times better than 09:03 all the magicians and astrologers 09:04 that were in all his realm." 09:06 That's very interesting. 09:08 And if you think about Daniel, 09:10 here is a gentleman that's moved from his country, 09:13 away from his mom and dad, 09:15 living in a foreign culture, everything's different. 09:17 Everything's different. And yet he says, no... 09:21 This story talks about, you know, 09:22 when he ask them to bring him pulse and water. 09:27 Yeah. Basically, a healthy diet. 09:29 But it was more than a healthy diet. 09:31 It was about worship as well 09:33 'cause he was gonna stay true 09:34 to the things he was taught as a child. 09:36 Remember that text, "In all things acknowledge Him, 09:39 and He will direct the paths." 09:40 So they're acknowledging God 09:41 to remembering the way they were raised. 09:44 That's why I brought up kids, you know, we all have kids, 09:46 we all wanna teach them these ways. 09:47 So when they grow up, they're not gonna forget him. 09:50 So he even in a foreign country, 09:52 he stuck with what he was taught 09:54 by mom and dad. 09:55 He stuck with his beliefs, a healthy diet, 09:58 in worship and in a short period of time 10:00 he was how much? 10:02 Ten times better than 10:04 all the magicians and astrologers. 10:06 God blessed Daniel for his worship, 10:08 for his staying close 10:10 to biblical prescriptions in nutrition. 10:12 He was blessed with a better body. 10:14 God made him a special person. He was in charge of everything. 10:19 Yeah, I think, when we think about the story of Daniel, 10:21 it's easy to just think about the nutrition. 10:23 Well, plants are better for you, 10:24 obviously, but 10 times better, that's more than... 10:27 Oh, yeah. 10:28 Just nutrition that's definitely worshiping God 10:30 working in his life to do something supernatural. 10:33 Yeah. Yeah. And he did. 10:34 And this is a very powerful study 10:35 that we talked about how worship and staying true 10:38 to God's Word in all aspects of life, 10:41 you know, and how it's a blessing 10:43 and, you know, some sometimes God blesses us 10:45 more than others. 10:46 But Daniel was the second in command of two kingdoms, 10:51 you know, of the world at that time. 10:53 And he was a smart guy, and he also worshiped 10:57 remember later on in the study, no matter what, 10:59 he was gonna worship and sometimes at great peril, 11:02 he stuck with that plan of worship, you know, 11:05 and that made a big difference in his life. 11:07 God blessed him as he followed God's plan for his life. 11:11 So I think that's good. 11:13 Very interesting and how biblical prescriptions 11:16 are something that we can depend on 11:18 throughout life. 11:20 You know, I'm very curious, 11:21 we talked about valves, you know, 11:23 and things are gonna change in valves. 11:24 If God doesn't take us home, 11:26 what's gonna be 10 or 20 years from now? 11:28 We didn't have mitral clips. 11:30 We didn't have trans aortic valve replacements 11:32 just 10 years ago. 11:34 Technology is growing faster now than ever before. 11:37 Yeah. 11:38 Not only medical technology, but now we're learning 11:40 even about lifestyle technology. 11:42 We're finding out 11:43 how our gut influences our health, 11:45 how our brain, our stress, our rest patterns, 11:48 everything that comes into our brain affects us. 11:51 That's right. That's right. 11:52 Well, Dr. Marcum, thanks for sharing 11:54 that biblical prescription. 11:55 And, viewers, if you would like to learn more 11:56 and employ more biblical prescriptions in your life, 11:59 go to HeartWiseMinistries.org. 12:01 You can leave a prayer request there, 12:03 you can find lots of health information, 12:06 articles, videos, radio podcasts. 12:08 But also you can find our Biblical Prescriptions 12:10 for Life app there. 12:11 And it's a free download on iOS or Android, 12:14 and it will share 10-minute worship 12:17 with you every day, 12:19 a worship routine that you can do 12:20 to better employ these biblical principles 12:23 and these prescriptions in your life. 12:25 Dr. Marcum, thank you very much 12:26 for sharing with us on today's program. 12:28 And we look forward to more at another time. 12:31 Viewers, Dr. Marcum will close the program 12:32 with prayer in just a moment. 12:38 As we end our program today, 12:40 I'd like to invite you to join me in prayer. 12:44 Father God, we wanna thank You for the technology 12:47 that You have to give to us to help us 12:50 to feel better and serve You better and, 12:52 but more than that, Father, we want to continue 12:54 to worship with You and help us have the power 12:57 to make the changes in our lives. 12:59 And to continue to spread the gospel 13:01 wherever we might go by serving 13:03 and loving others is our prayer. 13:05 Amen. 13:07 If you might have more questions 13:08 about valvular heart disease, 13:10 I want to encourage you to go to our website, 13:12 that's HeartWiseMinistries.org. |
Revised 2020-02-15