HEART HEALTH and The Physiology of a Broken Heart


There is a light that shines above all things on earth.
Above us all,
Above the heavens; the very highest heavens.
This is the light that shines in our heart.
Upanishads


The Cardiovascular System

The heart,  4.7 to 5.5 litres of blood, and 96, 560 miles of blood vessels transport oxygen, water, nutrients, electrolytes, hormones, antibodies, proteins, and metabolic waste products to and from all body tissues and is also known as the circulatory system. It is separate from the lymphatic system.


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Blood

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Blood circulates through the body three times per minute; traveling 19,000 kilometres a day. It nourishes the cells of our body  and helps to fight disease, stabilize body temperature and pH, and maintains homeostasis (stability of the internal environment). Blood is bright red when its hemoglobin is oxygenated and dark red when it is deoxygenated

Blood is considered a specialized form of connective tissue, relating to its origin in the red marrow of bones and the presence of potential molecular fibres in the form of fibrinogen. Adult red blood cell production is limited to the larger bones.

Our adaptive immune system, based largely on white blood cells, helps to resist infections and parasites.


The Human Heart

The human heart is a unique muscle, weighing approximately 300 grams, and is designed to pump 175 million litres of blood throughout a lifetime, perpetually.


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The Electrical System of The Heart - The Beat of Life

The heart’s electrical system is responsible for creating the signals that trigger the heart to beat. These signals prompt the heart’s muscle to contract. With each contraction, blood is pumped throughout the body. The process begins in the upper chambers of the heart (atria), which pump blood into the lower chambers (ventricles). The ventricles then pump blood to the body and lungs. This coordinated action occurs because the heart is wired to send electrical signals that tell the chambers of the heart when to contract.


The Electrical System of The Heart - 1:59



An arrhythmia refers to an abnormal rhythm or speed of rhythm of the heartbeat. An abnormal rhythm or speed is defined as one which is not physiological.

A resting heart that beats slower than 60 beats per minute, or faster than 100 beats per minute, is regarded as having an arrhythmia. A heartbeat slower than 60 beats per minute is known as bradycardia, and a heartbeat faster than 100 is known as a tachycardia.


Blood Pressure
Blood pressure is a vital sign that tells us about the arterial pressure of the systemic circulation. Resistance in blood vessels can cause blood pressure to rise. 

The first or blue section of the blood pressure chart below explains the systolic and the diastolic pressure, the two pressures used for expressing blood pressure ranges.

As shown in the blue section of the chart, blood pressure ranges are typically shown with the systolic number (blood pressure in the arteries) before or above the diastolic pressure (blood pressure between heartbeats), e.g. 120/80 mm Hg (millimeters of mercury).

The systolic pressure measures blood pressure when the heart is contracting; it is the maximum arterial pressure during contraction. The diastolic pressure is the resting pressure, between heartbeats as the pressure goes down ahead of the next heart pumping action.

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The second section of the chart shows the different blood pressure range categories and their corresponding readings. For young adults aged 20 to 40, the normal, healthy blood pressure ranges are 120/80 but there is also normal to high, 130/85 and normal to low, 110/75. The high blood pressure ranges for this age group progress in stages from 140/90 up as high as 210/120. The low blood pressure ranges go from 90/60 to a dangerously low level of 50/33. By the age of 50, the average, normal blood pressure ranges has risen to 129/85 and at 60, there is a further increase in the average normal range to 134/87.

Prolonged high blood pressure (hypertension) can cause damage to blood vessels, the heart, kidneys, eyes, and to the brain, and increase the risk of  peripheral vascular disease, heart attack, and stroke

Low blood pressure (hypotension) can indicate physical fitness but abnormally low blood pressure can also indicate dehydration - in severe cases, hypovolemic shock,  poor nutrition, endocrine problems (diabetes - low blood sugar, parathyroid disease, adrenal insufficiency), severe infection or allergy, blood loss, bradycardia, heart valve problems, heart attack, or heart failure. 

The third section of the blood pressure chart gives lifestyle change recommendations to manage high blood pressure with approximate systolic blood pressure reduction. 

For comprehensive recommendations from HEALTH COACH: To Salt or Not to Salt? That is the Question.
Dietary Fiber, Healthy Carbohydrates, and Healthy Fats


Heart Disease
Inflammation is a natural defense to a foreign invader such as a bacteria, toxic substance, or a virus. Chronic inflammation in the artery wall is the real cause of heart disease; without inflammation being present in the body, cholesterol would not accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped. 

Inflammation protects your body from bacterial and viral invaders. However, if we chronically expose the body to injury by toxic substances, such as foods, the human body was never designed to process, chronic inflammation will be the result. Chronic inflammation is just as harmful as acute inflammation is beneficial. 

The overload of refined, processed carbohydrates, omega-6 fatty acids, and unhealthy, processed sodium in prepared foods, are some of the key factors contributing to chronic inflammation. When your cells reject the extra glucose, blood sugar rises, producing more insulin, and glucose is converted to stored fat. Any excess weight from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar.

Blood sugar is controlled in a very narrow range. When your blood sugar level rises several times a day, every day, extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall creates chronic inflammation. Processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6 is essential - it is part of every cell membrane controlling what goes in and out of the cell; it must be in the correct balance with omega-3 essential fatty acids. 

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation. The North American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 - omega-6 to omega-3. The recommended ratio is 2 to 1 - Omega 6 to Omega 3. 


DO YOU KNOW?

Windkessel Effect
When translated from German, Windkessel Effect means an air chamber or elastic reservoir, and refers to, and measures the shape of the arterial blood pressure waveform in terms of the interaction between the stroke volume (the volume of blood pumped from one ventricle of the heart with each beat) and the compliance of the aorta and large elastic arteries (Windkessel vessels). 

Arteries distend when the blood pressure rises during systole (a force that drives blood out of the heart) and recoil when the blood pressure falls during diastole (the part of the cardiac cycle when the heart refills with blood following systole contraction). Since the rate of blood entering these elastic arteries exceeds that leaving them due to the peripheral resistance, there is a net storage of blood during systole which discharges during diastole.



Thrombosis: A thrombus, or blood clot inside a blood vessel obstructs blood flow; platelets and fibrin in blood form a clot to repair blood vessels and prevent blood loss.

Causes of clots:
  • Blood vessel injury - injury to the vessel wall in general and to the endothelial lining specifically may be the major event that precipitates the thrombotic process.
  • Surgery that reduces blood flow to a part of your body
  • Major surgery on a hip, knee, leg, calf, abdomen, or chest
  • Orthopedic surgery, such as hip replacement
  • Abnormal blood lipids, particularly elevated total cholesterol, LDL (low-density lipoprotein) cholesterol, triglycerides, and low HDL (high-density lipoprotein) cholesterol, pose a risk to endothelial cell health. 
  • Elevated high-sensitivity C-reactive protein is an indicator of inflammation and blood vessel injury; high levels are predictive of future risk of heart attack or stroke. CRP also exerts several pro-thrombotic activities, and may be associated with risk of venous thrombosis.
  • Sustained high blood pressure compromises the integrity of the endothelium, and can cause endothelial activation and initiation of clotting. For optimal endothelial protection and blood clot prevention, a target blood pressure of 115/75 mmHg is suggested.
  • Elevated blood glucose levels, even those that remain in the lab-normal range, may significantly increase the risk of developing a blood clot. A clinical study involving patients with coronary artery disease (CAD), found that patients with fasting glucose levels above 88 mg/dl had greater platelet dependent thrombosis than those with levels below 88 mg/dl. The authors of this study remarked: The relationship is evident even in the range of blood glucose levels considered normal, indicating that the risk associated with blood glucose may be continuous and graded. These findings suggest that the increased CAD risk associated with elevated blood glucose may be, in part, related to enhanced platelet-mediated thrombogenesis.
  • Excess abdominal body fat. Abdominal obesity, also known as android obesity, consists of excessive deposition of fat tissue around the trunk of the body (e.g. the belly). The fatty tissue around the trunk is prone to secrete inflammatory chemicals and cause high blood sugar and hypertension, all factors that pose dire risk to the health of the endothelial cells. Maintaining an ideal body weight is critical to reducing thrombosis risk.
  • Elevated homocysteine has been associated with a 60% increase in venous thrombosis risk. Homocysteine damages the endothelium, increases endothelial cell and platelet activation, and lowers fibrinolytic (clot breakdown) activity
  • History of stroke, transient ischemic attack, heart attack, or coronary artery disease all indicate a susceptibility to arterial thrombosis and are among the strongest predictors of future thrombotic events.
  • Atrial fibrillation, the most common type of abnormal heart rhythm, can lead to blood pooling in the heart and subsequent clot formation in the left atrium.
  • Hypercoagulable states (sometimes called thrombophilias) are conditions in which the nature or composition of the blood encourages coagulation. Some hypercoagulable states are inherited disorders that increase the activity of clotting factors or reduce the activity of natural anticoagulants. 

Some of the more common non-genetic hypercoagulable states include:
  • Thyroid disorders, which alter the balance of clotting factors and anticoagulants and can increase the risk of thrombosis. Hyperthyroidism (high thyroid function) increases the risk of thrombosis due to disruption of the clotting process, such as increased production of clotting factors, increased thrombin activity, and reduced rate of fibrinolysis (clot breakdown). Hyperthyroidism also can increase blood volume, which can lead to high blood pressure and cardiac arrhythmias, both of which are risk factors for thrombosis. Hypothyroidism (low thyroid function) also increases the risk of thrombosis. Hypothyroid patients cannot clear clotting factors of the blood as quickly, have elevated levels of fibrinogen, and have reduced rates of fibrinolysis.
  • Elevated plasma fibrinogen, the main coagulation protein, which may result from a variety of conditions such as smoking, thyroid disorders, or infection.
  • Pregnancy, which shifts the balance of hemostatic factors towards coagulation and enhances the activation of platelets, especially in pre-eclampsia (preganacy-associated hypertension).
  • Cancer, which can increase risk of venous thrombosis 4- to 7-fold, especially in metastatic cancers or those where the infiltration of tumors or compression of blood vessels disrupt blood flow. Pancreatic, brain, and gastric cancers, especially increase the risk of thrombosis. Blood clots may be predictive of cancer risk as well.

          These are some of the reasons why surgery can increase your thrombosis risk: 
          • Tissue debris, protein, and fats may move into veins following surgery.
          • Vein walls can become damaged, which may also release substances that promote blood clotting.
          • Prolonged bed rest following surgery.

          Other risk factors:
          • Unhealthy - neglect of basic health habits compounded by unhealthy habitsPoor circulation
          • Dehydration
          • NSAID painkilling drugs that are used to treat anything from headaches to severe arthritis double the risk of cardiac fibrillation and thrombosis (patients with heart problems are recommended to avoid these drugs completely, and generally the drugs should be taken at the lowest possible dose for the shortest possible time). 
          • Medications - drugs may exert a prothrombotic state by a variety of mechanisms–those affecting the vessel wall, the blood flow, and/or different blood constituents.
          • Hormone therapy
          • Inflammatory bowel disease
          • Cancer and cancer treatment
          • Diabetes
          • Vasculitis - inflammation of blood vessels
          • Injury that reduces blood flow to part of your body, such as a broken hip or leg
          • Varicose veins
          • Cesarian section
          • Contraceptives
          • Inactivity
          • Extra weight
          • Smoking
          • Heart conditions
          • Atherosclerosis
          • Hereditary
          • Unhealthy aging
          Symptoms:
          • Pain
          • Swelling
          • Heat
          • Fatigue of affected part
          • Patches of discoloured skin, redness
          • Swollen and distended veins
          • Coughing with blood in mucus
          • Chest pain
          • Accelerated heart rate, pulse, and breathing
          • Dizziness

          Blood Clot Prevention and Treatment
          • Basic Health Habits
          • Reduce inflammation
          • Olive Oil  
          • Olive Leaf Extract
          • Tea
          • Quercetin
          • Salvia
          • Grape seed Extract
          • Resveratrol
          • Lycopene
          • Pomegranate
          • Garlic
          • Fish oil
          • Ginger
          • Curcumin
          • Nattokinase enzyme
          • Niacin (not niacinamide)
          • Vitamin C


          Varicose Veins
          Causes of varicose veins:
          • Neglect of basic health habits compounded by unhealthy habits
          • Refined and processed foods
          • Nutritional deficiency
          • Dehydration
          • Poor digestive health
          • Prolonged periods of sitting and standing 
          • Medications
          • Poor circulation
          • Alcohol
          Avoid:
          • Bisphenol A (BPA) is an estrogen like chemical that comes from hard plastic. Plastics with BPA are used to line cans and make bottles, unless stated otherwise, canned foods contain BPA. Estrogen has been linked with a higher risk of spider veins.
          • Poor muscular support (strength and flexibility)
          • Weakened valves from neglect of basic health habits, prolonged sitting and standing, with the aid of physical activity, massage therapy, and leg elevation
          • Poor Circulation
          • Symptoms and causes of poor circulation:
          • Neglect of basic health habits, compounded by unhealthy habits 
          • Ulcers Varicose veins 
          • Discoloured skin 
          • Swelling 
          • Hair loss, weak nails 
          • Digestive problems 
          • Immune system deficiencies 
          • Cold extremities 
          • Exhaustion 
          • Erectile dysfunction 
          • Numbness 
          • Cognitive dysfunction 
          • Lack of appetite 
          • Angina 




          Healthy Blood, Vessels & Circulation
          All basic health habits are the key to healthy blood, blood vessels, and circulation, which means your heart does not have to work as hard, and heart disease risk is reduced or eliminated. These recommendations also help to prevent and to treat varicose veins.



        • Dietary Fibre is essential for balanced nutrition and normal digestive function; it also reduces the risk of other disorders such as high cholesterol, which can affect the vascular system. A high-fibre diet can also help you maintain a healthy weight and prevent varicose veins, a condition in which the walls and valves of the veins weaken. Women who are moderately overweight have a 50 percent increased risk for developing varicose veins, while the risk increases with greater weight gain.

        • Bioflavonoids are plant pigments that are largely responsible for the colours in fruits and vegetables. These nutrient compounds are found in foods such as dark leafy greens, dark berries, Mediterranean pine bark extract, garlic, and onions. Some types of bioflavonoids such as those found in cranberries, blueberries and grape seed help to relieve swelling, aching and pain from varicose veins. These nutrients help to strengthen the walls and valves of blood vessels, helping to reduce blood leakage.

        • Vitamin C is needed to manufacture the elastic fibers collagen and elastin, which keep the walls of the veins and arteries flexible and strong. This helps the vascular walls resist pressure and contract after dilating due to blood flow. It also helpful for varicose veins by strengthening the valves of the veins and reducing leakage. 

        • Vitamin E is an essential nutrient that helps keep blood-clotting proteins called platelets from sticking together and forming clots in the blood vessels. This promotes artery and vein health and healthy blood circulation. Individuals with diabetes are at higher risk of blood clots, and this can lead to heart disease and stroke.

        • Vitamin B3 is also known as niacin, is an essential nutrient that is useful in the treatment of high cholesterol and triglyceride levels in the blood. Lowering blood cholesterol levels helps to reduce fatty plaques that cause blood vessel blockage and blood clots. Niacin also helps to reduce atherosclerosis, or stiffening of the artery walls, helping to keep the blood vessels durable and flexible.

        • Rutin is part of the large family of flavonoids and is helpful in the prevention and treatment of varicose veins. These plant pigments have multiple effects on the body, one of the most important being to reduce the fragility and permeability of capillaries, therefore reducing your risk of developing new varicose veins. Rutin has antioxidant, anti-inflammatory, vasoprotective (protective of blood vessels) and antithrombotic (protection against blood clots) properties.

        • Hesperidin and Diosmin are unique bioflavonoids derived from citrus fruit rinds and are classified as a flavonoids. Like other bioflavonoids, hesperidin and diosmin work best when taken with Vitamin C and other bioflavonoids in a diet rich in plant foods including vegetables, fruits, whole grains, legumes and beans. These micronutrients are helpful in strengthening blood vessels, and preventing and treating varicose veins.

        • Quercetin is another bioflavonoid known to promote healthy circulation.

        • Magnesium is essential for stable blood pressure and heart function, healthy muscle function, and for the cellular metabolism and synthesis of most of the nutrients needed by the body, and for cellular detoxification. Most North Americans have an imbalance of calcium and magnesium; 80% have diets that are deficient in magnesium. The proper ratio is 1:1 calcium and magnesium with the proper balance and support of Vitamin D and K.



        • Haematoma of Tissue
          haematoma, contusion, or bruise, occurs when blood capillaries or blood vessels are broken, or lose their structural integrity, allowing blood to leak from these closed vessels and to pool in the surrounding soft tissues, causing discoloration, swelling, and pain.

          Bruises can also be caused by neglect of basic health habits, compounded by unhealthy habits, nutrient deficiencies, insufficient blood clotting factors, and serious illness like leukaemia

          Nutrients that are key to blood vessel integrity are zinc, essential fatty acids, protein, and antioxidants from fresh, colourful vegetables and fruit, especially citrus fruits.

          Natural Remedies to Heal Bruises

          • Massage affected area immediately - this helps to prevent the blood from pooling and forming a bruise.
          • Bromelain (500 mg 3x daily) - An enzyme found in pineapple which reduces swelling.
          • Vitamin C (500-1000 mg daily) - An antioxidant that helps manufacture collagen, critical for healing damaged blood vessels.
          • Bioflavonoids (500 mg complex 3x daily) - Bioflavonoids have a similar wound healing action as vitamin C.
          • Vitamin K (2 mg x 2 weeks) - Involved in blood clotting. Do not take vitamin K supplements if you are on blood thinners.
          • Arnica Oil (apply to skin 2x daily) - Apply over the area of the bruise only if the skin is unbroken.
          • Frankincense essential oil contains Boswellia and other compounds that can reduce the appearance of bruising.  Rub several drops of frankincense directly on the bruised area 3x daily.






          The Physiology of a Broken Heart  
          Cardiomyopathy

          Emotions can cause actual physical events within the architecture of the heart. Extreme emotion can cause adrenaline to fill the bloodstream to such an extent that the blood becomes like a poison, damaging muscles, including the heart.

          Left Ventricular Systolic Dysfunction
          In the 1990s, Japanese researchers coined the term Takotsubo Cardiomyopathy (broken heart syndrome) to describe a stress-induced apparent heart attack. It was so-named because the ballooning of the left ventricle characteristic of this sort of cardiomyopathy is reminiscent of a type of fishing pot, called Takotsubo, which are used to trap octopuses.




          The following symptoms and effects of cardiomyopathy caused by extreme psychological or acute emotional stress have been observed:


          • Adrenal and nerve response to extreme stress - production of stress hormones including adrenaline, two to three times as high as heart attack victims and seven to 34 times higher than normal, accompanied by dehydration, and higher plasma catecholamine levels
          • A sudden temporary weakening of the myocardium caused by transient ischaemia affecting the heart's pumping ability
          • Severe chest pain and other symptoms similar to a heart attack
          • No blockages in the coronary arteries
          • Pulmonary edema
          • Cardiac arrest, cardiogenic shock, or severe heart failure
          • Simultaneous multivessel coronary spasm, epicardial coronary spasm, or microvascular spasm
          • 95% of cases are women; a large majority is menopausal
          • Oestrogen has an influence on vasoreactivity and the neurohumoral axis. Elderly women are also known to develop abnormal basal thickening of the cardiac sigmoid septum.
          • Mental relationship between love and depression
          • Symptoms of this condition are akin to those of acute myocardial infarction, but no obstructive lesions are found in the coronary arteries, and left ventricular apical ballooning is present.
          • Stress cardiomyopathy is now a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.
          • Elevated neurohumoral substances: including epinephrine, norepinephrine, acetylcholine, histamine, serotonin and gamma-aminobutyric acid.
          • Neurohumoral transmission: the transmission of a nerve impulse from neuron to neuron or from neuron to effector organ by means of a neurohumoral substance.
          • The anterior cingulate cortex, responsible for regulating physical pain distress, becomes more active during these times. This is seen in victims of depression who also register physical pain due to the detection of nociception (is the encoding and processing of harmful stimuli in the nervous system, and therefore, the ability of a body to sense the potential harm which triggers a variety of responses, resulting in the experience of pain).

          The anterior cingulate cortex (responsible for regulating physical pain, distress) becomes more active during these times. This is seen in victims of depression who also register physical pain due to the detection of nociception, which triggers a variety of responses, resulting in the experience of pain. Research shows that people who are depressed, or who are under extreme long term psychological stress are more at risk to develop heart disease and other cardiovascular diseases which can cause thickening of artery walls and changes in brain blood flow. 

          Research shows that people who are depressed, or who are under extreme long term psychological stress are more at risk to develop heart disease and other cardiovascular diseases which can cause thickening of artery walls and changes in brain blood flow.

          Pain is the way the mind responds to trouble inside the body; it is a response in an attempt to learn about and motivate recovery. Emotion is a response to an event outside of yourself. The mind and our emotions can have a direct, measurable effect on our physical bodies.





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