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Dr. Cynthia's Your Vibrant HEART
Restoring Health, Strength & Spirit from the Body's Core
By Cynthia Thaik
Revitalize Press Copyright © 2014 Cynthia Thaik, M.D.
All rights reserved.
The Heart Is a Many-Splendored Thing
"What is straight? A line can be straight, or a street, but the human heart, oh, no; it's curved like a road through mountains." —Tennessee Williams
What Is a Heart?
When the Four Aces sang "Love Is a Many-Splendored Thing," they were inadvertently referring to a complex set of emotions triggered by the heart. The lyrics would not have been quite as catchy if "love" was replaced with "heart." Yet in reality, it is the heart itself that is a thing of splendor—an incredibly complex, unmatched work of art with multiple facets, each as magnificent as the other.
I am not referring just to the marvel of the physical heart, but also to the metaphysical heart—the heart that not only keeps us alive, but represents the different aspects of self: emotions, mind, body, soul, and spirit.
The heart has long been recognized as a symbol of love, but it is also referred to as the spiritual, emotional, moral, and even intellectual core of the human body. The heart was once believed to be the seat of the human soul. In various religions, the heart symbol also has numerous meanings, including charity, hope, energy, flow, happiness, and joy.
In this chapter, we will explore the facets of your physical and spiritual heart. We'll begin at what most people perceive to be the beginning: the physical heart and where it comes from.
Stages of Heart Development
While we might debate for ages about whether life starts at the point of conception, there is no arguing that life is present in the first heartbeat, which occurs approximately twenty-one days after conception.
As seen in Figure 1-1, heart development has five stages. It begins when cardiac precursor cells migrate to form a primitive heart tube. Even at the very early stage as a tube, the heart has different regions and layers. The primitive heart tube closely resembles a fish heart, and it is within this tube that the first flickering of a heartbeat is detected.
In the second stage of heart development, called heart looping, the tube-shaped heart contours into an S shape, bending to the right in a d-looping. It is within this contour that the chambers of the heart will develop.
The third stage, called the two-chambered stage, allows for the development of the two-chambered (one atrium, one ventricle) heart, which resembles the heart of a frog.
The fourth stage of development is the three-chambered heart, triggered by the atrium dividing into two atria. At this stage, the embryo heart resembles that of a snake or a turtle heart.
The final stage of heart development occurs by the end of the tenth week of pregnancy, with the development of the four-chambered heart consisting of two atria, two ventricles, and two great blood vessels—distinguished as a human heart and capable of running a fully functional cardiovascular system.
Given the complexities and intricacies of heart development, it is amazing that in most live births the heart is perfectly formed and functional.
Similarly, it is of no surprise that heart defects are the most common type of birth defect in the United States, affecting nearly 1 percent of births a year (approximately forty thousand births). Heart defect is the leading cause of birth-defect-related illness or death. It is estimated that 15 percent of heart defects are associated with a genetic condition. Approximately 20 to 30 percent of those with heart defects have other physical, develop mental, or cognitive problems.
Today, the prevalence of minor cardiac defects is increasing, while the prevalence of more serious defects is stable. The survival rates of the more serious cardiac defects have significantly improved with better diagnostic tools and surgical treatment.
Based on available studies, the federal Centers for Disease Control and Prevention (CDC), based in Atlanta, estimates that more than one million adults in the United States live with a heart defect. Most of these people survive into adulthood, and while there might be some limitation to exercise capacity, most live normal or near-normal lives.
How Your Physical Heart Works
The primary function of a heart is to deliver oxygen-rich blood to the cells and organs of the body. Each person's magnificent heart functions tirelessly, beating approximately 80,000 to 140,000 times a day, depending on the resting heart rate. This accounts for forty-two million heartbeats a year. An average resting cardiac output would be 5.6 liters per minute for a human male and 4.9 liters per minute for a female, but the heart is capable of delivering three to four times that amount during exercise, and a world-class athlete can deliver up to 40 liters per minute.
The blood circulates in a closed-circuit system, returning to the heart from the rest of the body through the venous system of blood vessels. The blood travels through the right atrium through the tricuspid valve into the right ventricle. From there, it travels through the pulmonary valve into the pulmonary vessels, traversing the lung alveoli, picking up oxygen for the blood cells. From the lung, the blood travels back through the left atrium through the mitral valve into the left ventricle.
The left ventricle is considered the main workhorse of the heart. It is the chamber responsible for propelling the blood through the aortic valve to the rest of the body through arterial blood vessel circulation. Figure 1-2 demonstrates the path of blood flow through the heart.
The Amazing Work of Cardiac Cells
There is no reliable scientific knowledge of the number of cells comprising the human heart, although one abstract hypothesis estimates, using DNA content measurement, that there are hundreds of millions to billions of cardiac cells.
It was once thought that neither the human heart cells nor the brain cells were capable of regenerating, but we now know otherwise. Scientists from the Karolinska Institute in Sweden report that into early adulthood, we're continually renewing about 1 percent of our heart cells a year. That regeneration slows down, but it still occurs in old age, with a little less than half of 1 percent of cells regenerating at age seventy-five. All told, we've renewed about 40 percent of our heart cells by age seventy, neuroscientist Jonas Frisén told Science magazine, providing hope that even a damaged heart stands a chance of being repaired to health.
Regardless of the number of cardiac cells, the cells of the heart work together as a functional syncytium—with all the cardiac muscle cells interconnected to one another mechanically, chemically, and electrically, and acting as a single enormous muscle.
Physical Heart, Emotional Heart
The connection between the physical heart and the emotional heart can be expressed in any number of ways. For me, one of the most stirring expressions of it comes through the miracle of motherhood. In comparison to what I experienced twenty-five years ago in my training, the advances of modern technology now allow physicians to diagnose many complex congenital heart diseases and even intervene in utero.
A Mother's Faith
Kari, a pharmaceutical representative who visits me often, was at age thirty-seven excitedly anticipating the birth of her second child. All blood tests required by the state showed her chances of having a baby with any birth defect to be low.
Then, out of the blue, the unthinkable showed up at her seventh-month ultrasound. Her baby was found to have transposition of the great arteries: there was no crossing of the baby's blood from the right to the left side of the organ.
Kari's heart sank as she was told that her baby did not have a chance of surviving and that she should consider an abortion. The next week brought a frantic pace of repeat ultrasounds, as well as consultations with four pediatric cardiologists and one of the top cardiothoracic surgeons in the area.
The decision to keep her child was based in faith. Her son's open-heart surgery on his third day of life lasted three-and-a-half hours. Today he is a beautiful three-year-old boy in great shape, and other than the scar on his chest, you would not know that he was born with a life-threatening heart defect.
Unfortunately, not all of these stories have happy endings. After feeling the exhilaration and utter joy of having given birth to a perfectly formed and healthy baby boy, Jonathan, I experienced two miscarriages in quick succession. My second conception resulted in a pregnancy that did not reveal a heartbeat in the expected third or fourth week. Yet even the sadness and disappointment of that loss pales in comparison to the experience of our third child, who survived several weeks longer.
Any mother who has undergone such a loss understands the fear and anticipation of the first ultrasound scanning for any detection of the heartbeat that signifies life. To have felt the comfort and relief of seeing a heart beating at the appropriate heart rate at the third week, only to have a repeat ultrasound two weeks later reveal a still heart, created a pain beyond belief.
Even though both children died early in their development, the emotions I experienced after their losses were devastating. The magnitude of the second loss was intensified by the mere presence of a heartbeat for a few short weeks.
I can only imagine, then, the pain when the loss occurs just minutes or hours or days after a full birth. I witnessed the intense sorrow of a young mother who held her newborn boy for just a few short hours after he was born with a multitude of congenital defects (including cardiac), which were well beyond any remedy that modern medicine could offer at that time.
As the young mother gently caressed that child, kissing, hugging, and holding him in her arms, I—a young medical student not yet having undergone my own tragedies—wondered which would be a worse fate: to have a few short hours of being able to hold that breathing, living, warm being and to feel and hear that heartbeat before losing the child, or to lose the child within the womb and never have the child be born alive at all.
Anyone who has experienced motherhood knows the myriad emotions that one experiences upon learning that within your body lives the heartbeat of another. The nine months of incubation allow for a full appreciation of the awesomeness of creation. This being, who started from the division of a single cell, develops complex nerve connections, digestive organs, and functioning cardiac, circulatory, and other systems—all within nine short months.
One can truly appreciate the marvels of creation when one considers that only a very small percentage of live births result in a baby not being anatomically perfect with ten fingers, ten toes, and a beautifully formed face with all of its components. Those of us who have had the misfortune of experiencing otherwise also have a great appreciation for the delicacies of this process. Fortunately for me, the universe rewards patience and persistence. My faith in the miracle of life was restored following the births of my beautiful daughter, Sarah, and my energetic boy, Andrew.
The Emotional Heart
The intricacies and the complexities of the physical heart are paralleled by the intricacies and complexities of the emotional heart. Many would argue, and appropriately so, that navigating through life with the emotional heart is like maneuvering through a labyrinth marked by temperamental swings from deep despair to heights of exhilaration.
Unlike the physical heart that needs to deal only with physical stress, the emotional heart must deal not only with physical stress, but also with emotional, mental, and psychological stress. Whereas the physical heart only has to adapt to the makeup of the individual, the emotional heart deals with the rewards and burdens of self and is greatly influenced by interactions with loved ones, society at large, and the environment.
All too often, we tend to run away from our emotions, as if acknowledging their existence is a sign of weakness. But if we don't embrace and allow our emotions to express themselves, then their vibratory energy becomes internalized and becomes expressed in the form of symptoms, or dis "ease." Denying their existence does nothing to ease the pain, but rather prevents us from enjoying life as it is truly meant to be experienced.
Emotion is energy in motion, and it represents the energy that lows from and through our heart to the rest of our body. By embracing the emotions that low from our heart, we harness the love, kindness, compassion, warmth, harmony, joy, peace, appreciation, gratitude, and resilience that reside in all of us.
An Emotional Heart Attack
The heart is a symbol of love, and love is an emotion. All emotions vibrate at different frequencies. Anger, hatred, and resentment have low vibratory energies. Happiness, joy, and kindness have high ones. The emotions of love and gratitude vibrate at the highest frequency. Love heals the heart and inspires peace, harmony, and calmness. In order to maintain a balanced and healthy physical heart, we must take care to feed the emotional heart.
An emotionally broken heart has been shown to lead to a physically broken heart. Dr. Stephen T. Sinatra—a board-certified cardiologist and certified psychotherapist with forty years of clinical experience in treating, preventing, and reversing heart disease—in his book Heartbreak and Heart Disease speaks about this all-important mind-body connection to heart disease. It is estimated that 1 to 2 percent of patients diagnosed with a heart attack in the United States suffers from an emotionally broken heart. The presentation is very similar (chest pain, shortness of breath, palpitations), but the pathophysiology is markedly different.
A physical heart attack is usually caused by a blockage of the coronary artery by either atherosclerosis (the hardening of the blood vessel with cholesterol and other depositions) or thrombosis (blood clotting).
An emotional heart attack is caused by a surge of adrenaline and other neurohormones, which overwhelms and weakens the heart muscle, leading to a ballooning of the apex and causing the heart to take the shape of a Japanese teapot—thus its name, takotsubo cardiomyopathy ("tako-tsubo" means "fishing pot for trapping octopus"). It is also referred to as broken-heart syndrome.
While there are a few different artery anomalies among the proposed origins for broken-heart syndrome, case studies looking at the larger picture suggest that emotional triggers or clinical stressors (such as an asthma attack or a sudden illness) are often present. The prevalence is higher in the winter months, and the vast majority of the patients are female, typically postmenopausal.
I saw a case of broken-heart syndrome in my career. It was during a terrible snowstorm, when a mother and her teenage son were brought into the emergency room after a catastrophic automobile accident. The mother had been driving and had suffered only minor cuts and injuries, while her son was severely injured. She was in near hysterics as she watched the emergency-room personnel work frantically to save her son's life.
Suddenly, she clutched her chest and slumped over. She was having a heart attack, but subsequent tests did not reveal any significant blockage of her arteries. The conclusion was that the extreme emotional stress of the automobile accident and the fear of her child's potential demise triggered the attack. Fortunately, both mother and son survived.
Although the above example is an extreme case, it is vital that we take care of our emotional health, as negative emotions have a tremendous impact on our heart and our overall health. Negative emotions often lead to despair and depression, which have been shown to wreak biological havoc within our bodies. Depression leads to the increased secretion of cortisol, a stress hormone released by the adrenal glands that is associated with heart disease, diabetes, and obesity.
Surges of neurotransmitters, such as serotonin and norepinephrine, can also lead to agitation, restlessness, anxiety, high blood pressure, and rapid heart rate. Depression also leads to increased inflammatory markers, such as C-Reactive Proteins (CRP), which have been shown to predict future heart-attack risk. Depression is furthermore linked to diminution of the immune system.
Excerpted from Dr. Cynthia's Your Vibrant HEART by Cynthia Thaik. Copyright © 2014 Cynthia Thaik, M.D.. Excerpted by permission of Revitalize Press.
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