Mysteries of the Heart
In the blink of an eye, I can look back on a 40 year career in the amazing (and sometimes crazy) world of cardiology. As a clinician, I've seen many remarkable changes in the diagnosis and treatment of heart disease. Over the years I've learned a lot and had the honor to work alongside some of the most brilliant minds in the field. It has been an unbelievable journey and I am thankful for it every day.
We can read paper after paper and participate in research protocols. However, even with all of this knowledge, the heart is still difficult to understand. Physiologically, it is a true marvel. The math alone is staggering. Consider this: the average heart – at rest – beats just over 4,000 times per hour; 96,000 times a day; 670,000 times a week; 35,000,000 times a year and a mind-blowing 2.7 billion times over a lifetime. If only we could create a design like this in industry
As scientists, we understand "how" it works, well at least a little… but there's more to it, isn't there? We hear it in sports all the time. "That player has heart." But what does that actually mean? Is it their will? Their total commitment to the sport and team? A desire to compete just a little harder than their opponents? It varies for all of us, even if we don't play professional sports. We all have "heart" that is weaved into the fabric of our lives. For me, it's my family and then my profession. For millions of others, I suspect it's very much the same. Simply stated, we'd do anything for our family, anything, to keep them safe and help them to be successful.
A Reflection on Cardiology's Evolution
Let's examine the advances that have been made in cardiology in this lifetime. Back in the 70s, cardiology, and specifically the cath lab, were simply a means to an end. A patient would come to the lab, we would perform a full right and left heart catheterization only to then hand him or her off to the surgeon for treatment… or worse, we'd have to tell the patient and family that there was nothing more that could be done.
If you've read any history on PTCA (percutaneous transluminal coronary angioplasty) – the procedure where a balloon is inflated in the artery to remove a blockage – you know how much we owe to Andreas Gruentzig, the man who changed everything "in a heartbeat." In the late 70s, I was part of the team that performed some of the first coronary angioplasties in the United States. To be part of medical history was an honor. To have a patient come into the lab with a heart attack and then see them laughing and joking with us shortly after was amazing.
Flash forward to the present and it's easy to see we've made great advances in treating coronary artery disease. We now have better catheters, wires and of course the widespread usage of coronary stents (devices deployed in the artery by a balloon). At first, they were simply metal sleeves put into the artery. Later came stents with medication imbedded to prevent clots and now we have bioabsorbable stents that will disappear in the artery over time. It's exciting to consider what could be next.
The Miracle of the Human Heart
Of course, it's not all about technology, as I've learned firsthand. My brother-in-law is a perfect example of just how amazing the human heart truly is. Like me, he is in his early 60s, but unlike me he's always been a health nut. He'd hit the gym every morning at 4:30 am for intense workouts. His drive was off the charts. You see, he has a passion ("heart") for motorcycle racing and has won his share of races over the years. In order to get into better shape he started to take spinning classes and soon was teaching them as well. He taught for several years until one fateful Thanksgiving, just a few years ago, when he suffered a massive heart attack while teaching.
“Technology saved his life, no question, but it was his ‘heart’ that provided the drive to recover
and resume life on his terms.”
Thankfully, there were medical folks in the class. (Talk about being at the right place at the right time). He was unresponsive, defibrillated multiple times, and transported to a trauma center. At the hospital they were able to revive him only to find out that his cath revealed many severe blockages and more collateral vessels than I've ever seen in one heart. With his crazy exercise program, his heart was desperately trying to keep up with the demand, and over time did its best to compensate. He simply out-worked his heart's ability to pump and it gave up. In his case, they had to do bypass surgery, but the good news is that he's back teaching spin and still riding his motorcycles competitively.
In my opinion, technology saved his life, no question, but it was his "heart" that provided the drive to recover and resume life on his terms. Interestingly, he now celebrates two birthdays. His birthday and his re-birthday
on Thanksgiving. His "heart" is an inspiration to me and I can only hope that should I ever be faced with something similar that I can fight back and thrive the way he has.
Meanwhile, technology continues to advance. That's a given. Data will be king and cognitive computing will revolutionize medicine in ways we can't even conceive of today. What I do know, however, is that the miracle of the human heart will continue to be at the center of our lives. It brings us great joy and pain, evokes awe and wonder, and much like my brother-in-law, it has the capacity for greatness and the ability to inspire us all.
February is American Heart Month. Visit the American Heart Association to learn more about heart health and the signs and symptoms of heart attack.