The Heart Healers (55 page)

Authors: James Forrester

BOOK: The Heart Healers

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The FDA approval of the mitral valve clip.
I am particularly proud that one of my mentees, Dr. Saibal Kar, has the nation’s largest experience with this device, and has traveled the world teaching its use to others. The FDA’s description of the device appears at:
www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm375149.htm
.

The story of the infant with heart defect is told by the engineers and doctors.
See
www.courier-journal.com/article/20140221/NEWS01/302210103/Child-s-heart-fixed-Kosair-Children-s-Hospital-help-3-D-printing
.

Organ printing.
For videos of this remarkable process, see
www.singularityweblog.com/3d-printing-is-bio-printing-the-future-of-organ-replacement/
.

PCSK-9 inhibitors for lowering blood cholesterol.
The preliminary results with PCSK9 inhibitors indicate it is additive to statin drugs, and may be particularly useful in patients who cannot tolerate statins. Roth EM, McKenney JM, Hanotin C, Asset G, Stein EA. Atorvastatin with or without an antibody to PCSK9 in primary hypercholesterolemia.
N Engl J Med
. 2012;367:1891
–
1900.

One of the nation’s leading lipidologists reviews the information about this new drug class.
Stein EA. Low-density lipoprotein cholesterol reduction by inhibition of PCSK9.
Curr Opin Lipidol.
December 2013;24(6):510–517.

The fascinating background story of how a treatment for gout may lead to a breakthrough in preventing heart attack.
Vogel RA, Forrester JS. Cooling off hot hearts: A specific therapy for vulnerable plaque?
J Am Coll Cardiol.
January 29, 2013;61(4):411–412.

GLOSSARY

anastomosis:
a connection created at surgery. For example, during coronary bypass surgery, the surgeon creates an anastomosis between the internal mammary artery and one of the coronary arteries. At bariatric surgery, creating anastomoses between parts of the gastrointestinal tract promotes weight loss.

angina (or angina pectoris):
chest pain, most commonly exercise induced, and due to coronary artery disease.

angiogram:
an X-ray image of a blood vessel.

angioplasty:
repair of a blood vessel, as with a balloon-tipped catheter.

aorta:
the artery which connects the heart to the rest of the body, separated from the left ventricle by the aortic valve.

arrhythmia:
a disorder of the heart’s electrical system resulting in very rapid or very slow heart rate, which may be accompanied by dizziness, fainting, or even sudden death.

arteriosclerosis:
a word used interchangeably with
atherosclerosis
.

artery:
a blood vessel that carries blood to organs and tissue, as opposed to a vein which carries blood away from organs.

atheroma:
a mass of fatty and cellular material that forms in the wall of a blood vessel. Also called a plaque.

atherosclerosis:
disease of the blood vessels characterized by multiple atheromas.

atrial septal defect:
a congenital heart abnormality in which the muscular wall between the right and left atrium has a hole in it.

atrium:
a collecting chamber. In the heart, the right and left atria collect blood before delivering it to the right and left ventricles.

bariatric:
having to do with obesity.

capillary:
the microscopic blood vessels between the termination of arteries and the beginning of veins. Tissue nutrients and waste products are exchanged by the blood through the walls of the capillaries.

cardiac output:
the volume of blood the heart pumps in a minute.

cardiogenic shock:
a life-threatening condition in which the heart’s pumping function is so compromised that it can no longer maintain an adequate blood pressure or delivery of blood to vital organs.

cardiovascular:
having to do with the heart and blood vessels.

catheter:
a hollow tube. In cardiology we insert catheters into blood vessels.

complete heart block:
failure of transmission of the normal electrical impulse from the atrium to the ventricle, resulting in very slow heart rate, fainting, and even sudden death.

defibrillate:
to eliminate fibrillation. In the heart, either the atrium or the ventricle can fibrillate.

defibrillator:
a device that delivers an electric shock to either the atrium or the ventricle, with the goal of returning the electrical system to a normal rhythm. Defibrillators are used in treatment of both atrial and ventricular fibrillation.

diastole:
the period of the heart’s relaxation.

electrode:
a specialized structure, often at the end of a wire, designed to transmit an electrical pulse. For instance, electrical impulses from a pacemaker or defibrillator are transmitted to an electrode that is in contact with the heart muscle or the skin.

esophagus:
the muscular tube that connects the mouth to the stomach.

fibrillation:
uncontrolled wormlike quivering of muscle fibers. Atrial fibrillation results in diminished “priming” of the ventricular pump, and is not life threatening. Ventricular fibrillation results in absence of blood flow, and results in brain death within four minutes or less.

heart failure:
the condition in which the pumping function of the heart is inadequate. When heart failure is mild to moderate, blood backs up into the lungs, causing pulmonary congestion. When heart failure is even more severe, cardiogenic shock develops.

hemostat:
a surgical clamp that looks somewhat like a pair of scissors.

infarction:
death of living tissue.

hypertension:
high blood pressure.

hypertrophy:
excessive growth of tissue. In cardiology, the term is most commonly used with the ventricles, e.g., left ventricular hypertrophy is a common complication of hypertension.

lipid:
fat.

lipoprotein:
a particle consisting of fat and protein. In the blood, lipoproteins are insoluble fats made soluble by binding to protein, allowing fats to be transported throughout the body

lumen:
the canal within a tube, e.g., the coronary artery lumen.

mitral valve:
the one-way valve that separates the left atrium from the left ventricle.

myocardial:
having to do with the muscle (
myo
) of the heart (
cardia
).

myocardial infarction:
a heart attack

orifice:
the mouth of a tube. For instance, at coronary angiography we insert a catheter into the orifice of a coronary artery.

oxygenated:
possessing oxygen. Blood is oxygenated in the lungs, returned to the left atrium, then pumped by the left ventricle into the aorta for distribution throughout the body.

pacemaker:
a specialized tissue or device that governs a rhythmic biologic activity. The heart possesses a natural pacemaker that can be replaced by an electronic device.

percutaneous:
through the skin, e.g., replacement of a heart valve using a prosthesis mounted on a catheter is a percutaneous procedure.

pericardial tamponade:
compression of the heart by fluid trapped between the sac that surrounds the heart (pericardium) and the heart itself.

pericardium:
a tough, inelastic sac that surrounds the heart.

prosthesis:
an artificial replacement for a normal structure, e.g., a prosthetic heart valve.

pulmonary:
having to do with the lungs.

pulmonary artery:
the vessel that carries deoxygenated blood from the right ventricle to the lungs.

pulmonary capillary pressure:
the distending force within the small vessels in the lungs. This pressure increases when pumping of the left ventricle is inadequate. Increased pulmonary capillary pressure causes the symptoms of congestive heart failure.

statin:
a class of drugs that lowers blood cholesterol by both inhibiting its synthesis and by increasing its uptake by the liver.

stem cell:
a cell that, when it divides, replaces itself, and also differentiates to other more-specialized cell types.

stenosis:
narrowing. In the heart, both valves and arteries develop stenosis that restricts blood flow. Typical examples are mitral valve stenosis, aortic valve stenosis, and coronary artery stenosis.

stent:
a device used to keep a hollow tube open. In CAD, stents are frequently used following balloon angioplasty.

suture:
the fibrous thread used in stitching or the stitch itself.

systole:
the portion of the heart’s cycle during which it is contracting. The numerator in blood pressure is recorded during systole.

tetralogy of Fallot:
a congenital heart abnormality consisting of four abnormalities: pulmonary valve stenosis, right ventricular hypertrophy, ventricular septal defect, and displaced aorta.

thrombolysis:
dissolving a clot.

thrombus:
the medical term for a blood clot.

tricuspid valve:
the one-way valve that separates the right atrium from the right ventricle.

unstable angina:
chest pain that threatens to go on to become a full-blown heart attack.

valve insufficiency:
the condition when a one-way valve allows backflow. Valve insufficiency is also called regurgitation.

venous:
having to do with veins.

ventricle:
a chamber. In the heart, the right ventricle pumps deoxygenated, venous blood to the lungs; the left ventricle pumps oxygenated blood to the body.

ventricular septal defect:
a hole in the wall between the right and left ventricle.

INDEX

The index that appeared in the print version of this title does not match the pages in your e-book. Please use the search function on your e-reading device to search for terms of interest. For your reference, the terms that appear in the print index are listed below.

Abramson, William

academic medicine

Affordable Care Act

age