Pediatric Cardiac Surgery - How The Heart Works

We all know that the heart is a vital organ in the body. Without optimal operation, the heart can trigger a laundry list of symptoms and problems throughout other organ systems of the body. We simply cannot live without a heart, and a heart that's not functioning properly won't provide the same quality of life as a normal heart. That's why pediatric cardiac surgery takes place so frequently, to correct heart defects and abnormalities that would limit the life of children and adults. The heart is a complex mechanical pump, and like all mechanical things it can suffer problems and break down. It can become clogged, need repair, leak, slow down and underperform, overwork and burn out, etc. This is why researchers, doctors and scientists have spent decades trying to understand how the heart works. When you're able to understand how to keep it functioning, you can prevent or reverse damage, defects and disease. A Growing Need for Pediatric and Adult Cardiac Surgery Heart disease has long been the leading cause of death in the United States. More than two thousand people die each year due to heart disease, averaging to a death every 44 seconds. To reduce the death toll, doctors often perform detailed examinations on new born children. This early detection for heart defects can help to identify risk factors or existing heart defects that could develop into problems later. The Design of the Heart The human heart is a hollow muscle in the shape of gradual cone. It sits between the lungs, behind the sternum, which is where the rib cage comes together in the middle of the chest. Two-thirds of the human heart is located to the left of the sternum while the other 1/3 sits to the right of the sternum or midline region of the chest. The pointed or coned end of the heart, known as the apex, points down and to the left. For most of us, our heart measures the same size as an adult with the apex being 5 inches long, 3.5 inches wide and about 2.5 inches from front to back. The human heart measures about the same size as a human fist. In children the heart is smaller, which necessitates specialty procedures for pediatric heart surgery when a surgical correction must be made. No matter the age, the heart is made up of three layers. The outside of the heart is a layer known as the pericardium. This is a fluid filled sac that encases and protects the heart, shielding it from other organs much like the lungs have a plural lining. The middle layer of heart muscle is known as the myocardium and the inside lining of the heart is known as the endocardium. Your Heart Beat Depending on the severity of the heart defect and the affect it has on the operation of the heart, a physician may detect a heart murmur which is an abnormality in the way the heart beats. This can often be heard with a stethoscope. The normal sound of the heart resembles a "lub-dub lub-dub" sound. The first sound (lub) is a result of the acceleration and slow down of blood and the vibration within the heart when the tricuspid and mitral valves close. The second sound (dub) is caused by the same acceleration and slow down of your blood, along with vibrations in the closure of the pulmonic and aortic valves. The speed of that heart rate will vary. With pediatrics the heart naturally beats faster to compensate for the small size of the body. This is necessary for heat production. As we grow into adults, our heart rate naturally falls. Newborns for example average a pulse rate of approximately 130 which can vary up to 140 during the first few months of life. By the time most children reach their early teens their heart rate will drop to around 80-90. As adults, our heart rates find a home in the range of 60 to 100 depending on a number of factors including heart health, level of physical fitness, smoking, alcohol use, diet, medications, etc. Corrections in lifestyle are often the top recommendation to reduce the risk of heart disease but some families have genetic predispositions to heart defects which are passed on to their children during fetal develop. In time we hope to see a reduction in heart disease and less of a reliance on corrective medications and procedures such as pediatric cardiac surgery.