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Female Heart: The Truth about Women and Heart Disease

Female Heart: The Truth about Women and Heart Disease

by Marianne J. Legato, Carol Colman

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Newly reissued and with a new introduction—the everywoman's guide to her heart that is "filled with information that can be life saving."
— Dean Ornish, M.D.

Heart disease is the #1 killer of women in the United States, and this live-saving book helps women understand, avoid, and survive the disease.


Newly reissued and with a new introduction—the everywoman's guide to her heart that is "filled with information that can be life saving."
— Dean Ornish, M.D.

Heart disease is the #1 killer of women in the United States, and this live-saving book helps women understand, avoid, and survive the disease. Vital information includes a profile of the high-risk woman, specific female considerations, including pregnancy, menopause and estrogen replacement therapy, stress, and how to avoid being labeled "hysterical" by your doctor, the good news about diet and exercise, and much more.

About the Author
Marianne J. Legato, M.D., is Professor of Clinical Medicine at the College of Physicians and Surgeons and Founder and Director of Partnership for Women's Health at Columbia University.

Carol Colman is an award-winning medical writer.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
A virtual owner's manual for the female heart, this detailed, accessible book contains many accounts of current studies but too few case histories to humanize the data. Illustrations. (Mar.)

Product Details

HarperCollins Publishers
Publication date:
Product dimensions:
5.35(w) x 8.01(h) x 0.63(d)

Read an Excerpt

Chapter I

The Normal Female Heart And How It Works

The alarm clock goes off half an hour late and you have to be in the office at 9 A.M. sharp for a special meeting with the head of your division. You jump into the shower, gulp down your coffee, and get dressed in record time. You're in luck-the baby sitter is only five minutes late! You run to your car and race to the train station to catch the 8:10. Just as you pull into the jammed parking lot, the train pulls into the station. You frantically search for an empty space. You manage to find one. The train doors open and people begin to pile in. You grab your briefcase and start to run. You hear the conductor shout: "All aboard." You run even faster down the long, narrow platform. You know you can make it! You throw yourself into the last car just as the doors begin to shut. Exhausted and out of breath, you sink into the first available seat. Your palms are sweating. Your blood pressure is soaring. Your heart is pounding away at 160 beats per minute, which is nearly twice its normal rate. You sit. In a few minutes you stop panting and your pulse returns to normal. But then your mind begins to wander. You begin to think about the presentation you will be giving to your colleagues later that morning. At the mere thought of speaking in public, your stomach churns with anxiety. Your heart begins to race inside your chest. It beats faster and faster...

It's all in a day's work for your heart, an amazing muscle that in most cases meets whatever physical and psychic challenges life doles out to it and to its owner. It will take tremendous abuse, but, as you will see, even thismiraculous organ has its limits.

Long before scientists understood the function of the heart, people intuitively sensed the crucial role it played in sustaining life. Since the earliest days of recorded history, the heart has been endowed with metaphysical powers. In ancient Egypt, the fate of the soul was thought to be determined by the weight of the heart. Egyptian priests used to weigh the heart of the dead on a scale against a feather, in the belief that those who had hearts that were not "heavy with sin" went on to happiness in the afterlife. The great philosopher Aristotle thought that the heart was the seat of the soul, and attributed mystical powers to this hardworking muscle.

Even in modern times, the mere mention of the word heart conjures up images of love, romance, and emotion. We think with our brains, but we feel with our hearts. Our romanticized image of the heart is reflected in the traditional artists' rendition of this basically unattractive organ as the valentine. This pretty red figure bears little resemblance to the real item. The heart is the subject of countless poems, sonnets, and love songs, not to mention a bunch of clichés. We often use expressions such as "Follow your heart," or "Do what your heart tells you to do" when we advise someone who is struggling to make the right decision. Even those of us who understand very well the biological function of the heart talk as if our emotions are somehow connected to this fist-size pump!

Are we just being silly? No. It is not because of ignorance that the heart has become linked to feelings. During times of intense emotion, we have a heightened awareness of our heart. When we're seared, our hearts speed up. When we're extremely upset, we may feel a tightness in our chests, often experiencing the sensation of being "all choked up." When we suffer a severe disappointment, we may actually experience a sinking feeling that seems to emanate from our chests. And when we're madly in love, we may feel as if our hearts actually skip a beat when we encounter the object of our devotion. These sensations are real. They are caused by a series of biochemical reactions that enable the heart to adapt to stress. Thus, it is understandable that the earliest scientific thinkers bestowed such wondrous powers on this critical organ.

Although it wasn't until the middle of the twentieth century that we really began to understand the intricacies of the heart, some of its mysteries were unraveled by the medical researchers of antiquity. In A.D. 130, Galen, a personal physician to a Roman emperor, advanced the concept of a circulatory system through which blood flowed from the body to the heart and then back to the body. As chief physician to the gladiators, Galen presumably had many opportunities to study the inner workings of their bodies while tending to their wounds. (Even back then cardiac research was conducted principally on males!)

About a thousand years later, anatomists discovered that blood made an important detour through the lungs before being sent throughout the body. Some even suspected that blood was mixed with air in the lungs. Then, in 1517, British physician William Harvey put all the missing pieces together in his ground-breaking thesis De Motu Cordis. Harvey described the heart as a muscular chamber that functioned as a pump. In this brilliant essay, he also correctly described the circulatory system, showing that it was a closed circuit through which the blood travels through the heart, the lungs, and the rest of the body. Like many other great thinkers of his time, Harvey also equated the heart with man's soul and believed that it manufactured and imparted some "vital spirit" to the blood.

We now know that the heart is actually an elegantly designed organ that performs a vital service: It pumps life-sustaining blood to the rest of the body. Blood contains oxygen and nutrients necessary for the functioning of all the tissues and organs of the body-including the heart.

The heart is a muscular organ with four separate compartments, each of which performs a specific function. It consists of two upper chambers called atria and two lower chambers called ventricles. There are four special heart valves within the heart that open and snap shut to ensure that the blood flows in the right direction and doesn't back up into the chamber from which it has just come.

The heart is enclosed in a translucent sac called the pericardium. It is suspended in the chest from what are known as the great vessels: two muscular tubes called arteries. One of them, the pulmonary artery, carries blood to the lungs from the right-sided chambers of the heart, and the other, the aorta, distributes the freshly oxygenated blood to the rest of the body from the leftsided chambers. In most people, the heart is located on the left side of the upper portion of the chest. In some rare cases, however, a perfectly wellfunctioning heart may be found on the right side.

How blood flows to and from the healthy heart is outlined below. The diagram on page 6 is intended to help you visualize the process.

  1. As we use blood, we take oxygen out of it and put carbon dioxide and waste materials into it. This "used" blood, which is dark bluish in color, flows through two large blood vessels-the superior vena cava and the inferior vena cava-into the right atrium of the heart.
  2. After blood is collected in the right atrium, it passes through a passageway guarded by the tricuspid valve into the right ventricle. Then the right ventricle contracts. That contraction causes several things to happen. The contraction causes the tricuspid valve to shut so the blood doesn't flow backward into the right atrium. That same contraction also forces open the pulmonic valve. The pulmonic valve is the exit door. It opens into the pulmonary artery. The contraction forces blood through this exit door, into the pulmonary artery and then into the circulation of the lungs.
  3. In the lungs, the blood gives up carbon dioxide and receives oxygen. The addition of oxygen turns blood a bright red. (The reason we think of blood as red is that when we see it, it is red, because it's on the outside of the body and is therefore exposed to oxygen.)

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