Wonderfully Made

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Series Code: WM

Program Code: WM000360


00:35 Praise God for I am fearfully and wonderfully made!
00:39 This is a beautiful quotation that's found in the Psalms.
00:42 Welcome to "Wonderfully Made"
00:44 I'm so glad you took time out of your busy and hectic
00:47 schedules to join us.
00:48 Today, we're going to talk about
00:50 the important topic of heart rhythms.
00:53 My name is Dr. Jim Marcum, and I'm a cardiologist
00:56 with the "Chattanooga Heart Institute"
00:58 and with me today is Dan Miller
01:01 Dan Miller is a businessman from Chattanooga as well
01:04 but he's also a consumer advocate of healthcare...
01:08 and I'm so glad he's here
01:09 And our goal today is to talk to you as if we were
01:13 right there in the house with you.
01:14 We've collected questions from ALL over the world
01:17 dealing with this important topic of heart rhythms.
01:21 What we've done is... hopefully, we can cover
01:24 everything of interest, and Dan is going to,
01:25 if we talk a little bit too technical, Dan is going to
01:28 sort of correct us, and slow us down a little bit
01:30 and he's going to make this so everyone feels like
01:32 we're right in your living room today talking.
01:36 So Dan, with that introduction,
01:37 let's get going with the questions!
01:39 Okay, thank you, Jim.
01:41 The first question is from Brenda.
01:45 She lives in Atlanta, and she's 38 years old.
01:49 She works as an executive secretary...
01:52 and her question is this...
01:54 She has noticed that her heart pounds and races at times.
01:59 It usually happens when she's preparing to go to bed
02:03 and it really bothers her.
02:06 What could be causing this?
02:08 Well, Brenda, that is an excellent question.
02:11 Many people, especially in your age group,
02:14 have this problem with pounding hearts...
02:16 Dan, have you ever had a problem with a pounding heart?
02:19 Yes I have...
02:20 Now, have you ever noticed any time of the day
02:22 when this pounding usually occurs?
02:24 Generally in the evenings.
02:26 Generally in the evening... Well that's a common time
02:28 when pounding does occur...
02:29 And the reason the pounding occurs then is
02:31 there's some much stimuli that goes on during the day
02:34 and at the evening time, people start to notice
02:37 and slow down a little bit, and then they start feeling
02:39 things that they normally wouldn't feel
02:41 when they're too busy during the day.
02:43 Well, Brenda... The most common cause of
02:46 this in your age group would be something that's called...
02:50 "premature ventricular contractions"
02:53 Sometimes we just call this "PVCs"
02:56 This is very frequently... Now how do I know that
02:59 without testing? Well, I don't
03:01 But, the way we would test is put a fancy device
03:04 called a "Holter monitoring device"
03:07 Have you ever heard of a Holter monitor yet? No I haven't
03:09 Well, let me explain a little bit about what
03:11 Holter monitoring is...
03:12 That's a special device... we put on electrodes
03:15 and we can tell every beat of your heart for X-amount of time.
03:19 We can measure from 24 to 48 hours
03:22 and this is one of the most useful tools that we have
03:25 to detect rhythms of the heart.
03:27 Let's put up our first graphic regarding
03:30 premature ventricular contractions, or PVCs.
03:33 Many different things can cause these PVCs.
03:36 It can be a structural abnormality within the heart.
03:38 That is... the heart doesn't work well.
03:40 It's either too weak, or valves messed up,
03:43 or some other problem.
03:44 Caffeine in the United States...
03:46 Caffeine is a frequent cause of PVCs.
03:48 There are certain over-the-counter drugs
03:51 that can cause it, especially those for
03:53 cold medications that have a substance called
03:56 "pseudoephedrine"
03:57 STRESS is a cause of PVCs.
04:00 And there is a host of medical problems that cause these
04:03 premature ventricular contractions.
04:05 So, this is a very common problem, Brenda
04:08 And, getting back to your question,
04:11 I would be very curious, if you were my patient,
04:14 whether you did have a structurally normal heart
04:16 And I would ask you a bunch of questions about the
04:18 stress and medications you were on,
04:20 and we'd probably want to put a monitor on you.
04:22 Does Brenda's age put any bearing on any of this?
04:26 Well, in pregnant years, okay we think of PVCs as
04:30 something that's causing stress to the heart.
04:33 And that stress can come from anywhere.
04:36 It can come from the job...
04:39 Not sleeping well at night...
04:40 It can be caused from a substance like
04:42 nicotine or caffeine.
04:43 It could come from being scared.
04:45 If I scared you, Dan... today if I go BOO!
04:47 ...you would jump and you might have a PVC
04:49 Well all these things can cause the heart to skip.
04:53 In this age group, another thing that we have
04:56 to keep in the back of our mind is
04:57 ...Could this person be pregnant?
04:59 That would put definitely a stress on the heart.
05:01 What happens, physiologically, when you're under stress,
05:05 you make a hormone, and that hormone is called "epinephrine"
05:08 And that epinephrine is usually what causes
05:11 the heart to skip and beat...
05:12 And one of the treatments that we do if it skips,
05:14 or just unbearable, and we can't do anything,
05:17 is we try to block that receptor with medications.
05:20 So Brenda, what could be causing this?
05:22 Well, back to your question...
05:24 it could be the medicines you take...
05:26 It could be... a RARE cause would be a structural
05:29 abnormality, but usually in your age group,
05:31 it's just the stress of everyday life
05:33 that's causing the skipped beats...
05:34 and that could cause from many things. Right
05:36 All righty... let's go to our second question then...
05:41 This comes from Mel in Toronto.
05:46 The speed of his heart is about 38 to 42 beats per minute.
05:52 He takes Atenolol for high blood pressure
05:58 and it's making him very tired.
06:02 Do you think that he needs a pacemaker? Oh... okay
06:05 Mel, that's a question we hear a lot of,
06:08 and before I answer your question,
06:10 a lot of people don't even know what a pacemaker is.
06:13 Have you ever seen a pacemaker? I have not...
06:14 Okay, well I brought a pacemaker with me today
06:17 and this is a pacemaker, and this keeps the heart going
06:21 when it's not beating strong enough.
06:23 And the way we have this pacemaker, is inserted
06:25 right here under the skin, and here is the lead
06:28 that goes inside the right ventricular chamber
06:31 and sometimes we put a lead in the top chamber which is
06:33 the right atrium, and this not only beats the heart,
06:37 but every single beat that the heart does, it can monitor it.
06:41 And we have ways on a pacemaker,
06:43 we can tell everything that's happening within the heart.
06:45 Now what is this made out of?
06:47 Okay... this pacemaker is made of a substance, an element
06:50 called "titanium" which is very stable in the body
06:54 and these are special plastics that go in the body
06:57 that the body doesn't react to it, so you don't have a
07:00 bad reaction, or anything like that.
07:02 Pacemakers are one of the most frequent treatments
07:05 we have for heart disease.
07:06 Before we had pacemakers, when the heart went
07:10 slower and slower and slower...
07:11 it would just STOP!
07:12 And if a heart is not beating, we have no blood pressure.
07:15 And one of the first pacemakers that went in...
07:18 I don't know if people realize this, was...
07:19 Did you ever hear of Alfred Hitchcock? Yes sir
07:23 Okay, well Alfred Hitchcock had one of the first pacemakers
07:26 And back in those days, the pacemakers were
07:28 about the size of my hand,
07:29 and it went in the belly.
07:31 And that's what it took to keep his heart going...
07:34 But through the years, as you see, the pacemakers have gotten
07:36 smaller and smaller
07:37 and it's my prediction that some day, they're going to be
07:40 on the size of a computer chip.
07:41 Now, can these be monitored any other way than
07:45 ...how does the monitoring process work?
07:47 Well, we have a couple of ways we can monitor it, Dan
07:50 One of the ways we can do it
07:51 is with a handheld device over it...
07:53 that we can tell every beat that the heart has.
07:55 Another way, nowadays, we can actually download
07:58 the information that's stored in these computer chips
08:02 on the internet... Right
08:03 And I can actually see every beat of a patient's heart
08:06 for a long period of time,
08:07 in addition to see how often the pacemaker is used
08:09 ...To see when it's wearing out
08:12 ...To see when the battery might need to be replaced.
08:15 So you're saying I can be traveling somewhere
08:17 and you could monitor me from long distance anyway...
08:22 Totally mobile with the pacemaker...
08:24 You know, another thing that people don't realize is
08:27 ...Some people ask me
08:28 "Can I get into MRIs, and magnetic fields?"
08:31 Well usually, we advise not to get in an MRI machine.
08:35 Now, an MRI machine is a fancy machine that
08:37 takes pictures of you because it's got such a strong
08:39 magnet, it can pull on that.
08:40 We don't want it to be pulling on someone's heart.
08:42 It's like in airports, and restaurants,
08:44 and stuff like that... that have the signs
08:46 Right, you can still go there but it would detect metal
08:49 in you and the alarms would go off...
08:51 So it's frequently the cause of...
08:52 especially now with all the problems we've had
08:54 at the airports, it's a very
08:56 frequent problem... But you know what?
08:57 We forgot to answer Mel's question here... Yes we did
09:01 Mel... Making you tired.
09:04 Well, could the rhythm be making you tired?
09:06 It's going 38 to 42 beats per minute.
09:08 A normal heart runs about 70 beats per minute.
09:11 So the rhythm itself might be making you tired.
09:13 OR, it might be the Atenolol
09:16 Atenolol is a medication which slows down the heart.
09:19 It slows down the wiring of the heart,
09:21 so that could be making you tired.
09:23 Do you need a pacemaker?
09:25 A pacemaker is needed usually when the heart can't
09:29 generate enough blood pressure to supply the brain.
09:32 So, you might feel dizzy, you might pass out
09:36 ...you might feel weak... Those are symptoms that would say...
09:38 "Hey! I think you might need a pacemaker"
09:41 Let's go up to our second graphics
09:44 that has to do with when a person might need a pacemaker
09:47 and here are the indications for a pacemaker...
09:49 The heart is too slow, okay, but, well Mel's going too slow
09:53 and he's tired.
09:55 Well so, he's having some symptoms...
09:56 Usually we see dizziness,
09:58 so that might be a reason.
10:00 Conduction disease... what that means is the
10:02 actual wires of the heart... the batteries,
10:04 the thing that keeps the heart going are diseased.
10:07 And the last thing, is sometimes people need to
10:11 take the medications to slow the heart down.
10:14 The medications are so important to slow the heart rate
10:17 that we put a pacemaker in
10:19 just so the patient can take the medications.
10:22 So sometimes, in that instance,
10:23 those people also need a pacemaker.
10:25 But Mel is taking a medication which could slow his heart.
10:29 So the first thing that I would do with Mel here,
10:32 is, Mel, I would stop your Atenolol,
10:34 and use a different medication to treat your blood pressure...
10:38 And then, I would put a monitor on you...
10:43 one of these Holter monitors and see what the rhythm is doing
10:45 and see if anymore symptoms occur.
10:47 If more symptoms don't occur,
10:49 I don't think I would worry a lot.
10:52 Another thing, Dan, I might do...
10:53 is I would watch Mel's heart rate when he walked.
10:56 Lots of people... athletes go very, very slow
10:59 when they're not doing anything,
11:00 but if it speeds up when you do things,
11:02 that's a great sign. Right
11:04 Now let me ask YOU a question...
11:06 Do you know... many people don't realize this
11:10 What part of the day do you think your heart goes
11:13 the slowest, and what part do you think it goes the fastest
11:17 I would say slowest would probably be in my sleep...
11:23 That's correct!
11:24 Fastest would probably be when I first wake up?
11:28 That's right! That's great Dan!
11:30 You're on top of this.
11:32 If you don't have a lot of stress on you,
11:34 or other outside stimuli,
11:36 like you're getting cut or hit,
11:38 your heart is going to go fastest in the mornings
11:41 because the hormonal system
11:43 starts kicking in, and slowest at night
11:44 In fact, I've seen people's hearts on these monitors
11:46 run, with no problems at all, run in the 20s to 30s at night.
11:50 It goes pretty slow... Right
11:52 And that's when the body is resting.
11:53 The heart has a time to catch up from the day.
11:55 So, Mel, good luck with your heart, and I hope that
11:59 answered your question.
12:02 All right, let's go to question #3...
12:05 It's from Robert in Pennsylvania.
12:08 He says, "I'm a minister of a 1,500 member congregation
12:13 in Pennsylvania... we recently had a parishioner die
12:18 after the morning services. "
12:20 "What are your thoughts on getting an automatic
12:23 external defibrillator?" Okay
12:27 And most of his congregation is elderly, so this is really
12:31 something that concerns him.
12:33 Well, this defibrillator issue is coming up more and more.
12:38 In the Chattanooga area recently,
12:40 we had a young person that actually died from one of these
12:44 dangerous heart rhythms.
12:46 It's very rare for a young person to have these,
12:49 and every year, you hear about a football player that has
12:52 one of these abnormal rhythms that was
12:53 otherwise undetectable.
12:57 So the issue is... is should everyone, in different places,
13:01 carry these defibrillators?
13:02 Because if you can get a defibrillator to a person
13:04 quickly, you can literally save many lives. Right
13:08 And the economics of it is...
13:10 you know, should these big churches where there are
13:14 lots of people that could potentially have an arrhythmia
13:17 from a heart problem die...
13:18 Now before I answer this question,
13:20 I just want to go over, out of all the causes
13:23 of death in America, the most likely cause of death is
13:26 going to be cardiovascular disease
13:28 And a lot of people don't realize that 43% of all deaths
13:31 in the United States, is due to cardiovascular disease.
13:35 And that's greater than wars, and cancers,
13:38 and infections, than everything combined.
13:40 An interesting statistic is ... if you have a heart attack,
13:44 guess how many people, guess what percentage dies
13:46 before they even make it to the hospital from a heart attack?
13:49 I have no idea. ... 33%
13:52 Most people don't think it's that high.
13:53 But if you have a heart attack,
13:55 there's a 1 in 3 chance that you're going to die before
13:57 you even make it to the hospital.
13:58 That's why these defibrillators are so much in the news
14:02 and so much... you know, everyone is wanting to
14:05 talk about them.
14:06 So, thoughts on an automatic external defibrillator
14:10 I think this would be an excellent
14:13 thing for your congregation.
14:14 And the training involved really is very simple
14:17 In fact, we brought a defibrillator with us today
14:20 It is at this point in time, let me put this on you, Jim
14:27 We're going to sort of pretend that...
14:30 and the first thing we do is, we turn it on
14:31 to show everybody how it actually works.
14:33 It's not that hard to work, and you'd be surprised how
14:35 easy it is to work, and if you're looking at
14:38 Robert, if you're looking at the show this evening,
14:40 I want you to sort of put this in the back of your mind
14:43 for your congregation
14:46 A lot of people think it's hard to work,
14:47 but it's not... very easy!
14:48 Okay, is the device on?
14:50 You turn it on. Okay
14:51 And we're going to get things going here. Okay
14:58 I think it's ready to open up.
15:01 You push the button on the front of the machine.
15:03 The device opens up... and you have to hit it again
15:08 Push it one more time. Okay...
15:15 This device, we're going to have to get it going here.
15:19 It's supposed to come on here.
15:21 It talks to you, actually, when it comes on. Correct
15:25 Now, we have a trainer with me today,
15:27 so let's back up... "CALL FOR HELP NOW"
15:30 Here it goes... So at this point is where I call for help
15:33 "REMOVE CLOTHING FROM CHEST"
15:34 So I would remove my clothes. Right
15:36 At this time, you'd be laying on the ground,
15:37 and I'd take your clothing away from your chest.
15:40 We're going to install this on your shirt,
15:43 so you'll need to take your jacket off.
15:45 "PULL RED HANDLE TO OPEN BAG"
15:48 So I would pull this out...
15:49 "PEEL EACH PAD AT THE PLASTIC"
15:53 "AND APPLY PAD TO EXPOSED CHEST"
15:57 You'll tear the 2 pads in half...
16:03 "REMOVE CLOTHING FROM CHEST"
16:06 So it repeats it if you don't do something right...
16:09 or you can't... This one actually has a
16:10 picture showing us where to put the pad
16:13 So I would apply that one at that point...
16:16 "PULL RED HANDLE TO OPEN BAG" I would pull this off...
16:21 "PEEL EACH AT THE PLASTIC"
16:24 This one goes under your arm...
16:25 "AND APPLY PAD TO EXPOSED CHEST"
16:28 "DO NOT TOUCH PATIENT"
16:31 "EVALUATING HEART RHYTHM"
16:34 And at this point in time, it automatically evaluates...
16:38 "STAND BY" Okay
16:40 "PREPARING TO SHOCK"
16:41 "EVERYONE CLEAR" I would get out of the way...
16:44 "DO NOT TOUCH PATIENT"
16:45 "DELIVERING SHOCK" ... alarm beeps...
16:50 Okay! Well, as you can see...
16:53 Was that the first time you've every done this? Yes it is
16:56 Now that was not too hard to put on...
16:59 And yet, if I really would have had a dangerous heart rhythm,
17:02 that potentially could have saved my life.
17:05 I would have really wanted this on that young person
17:08 that day... You know, that happened to
17:10 collapse in a gym.
17:12 I would really want this on, because if someone
17:14 could have been trained to put this on immediately,
17:17 it would have saved his life. Correct
17:18 Now, a question we might get is...
17:21 "Can you mess up with one of these?"
17:22 I mean, can... Can you be shocked accidentally?
17:26 I've never heard it happening...
17:28 And the reason it didn't shock me is because
17:30 my heart rhythm was normal.
17:32 It's trained to only shock that abnormal heart rhythm
17:34 which is called "ventricular fibrillation"
17:37 or "ventricular tachycardia"
17:38 That's the ones you see people over people's heart
17:41 shocking it, you know, dramatically...
17:43 ...like in the hospital.
17:44 So, Robert, that's how you use these,
17:47 and the price of these defibrillators are
17:49 coming down every year.
17:51 One of the questions that comes up is...
17:53 "What about the liability issues?"
17:55 You know, are you liable if you have one?
17:58 Are you liable if you DON'T have one? Right
18:00 And these are being worked through right now,
18:02 but most people have a short training course...
18:05 They have to be Basic Life Service Support.
18:08 But when I talk to people about whether they need one of these,
18:12 I say, "Well, you just don't choose not to
18:15 for the legal reasons. "
18:17 I mean, you want to have this to save lives. Correct
18:20 And if you didn't have it" What would happen? Right
18:22 And what's the worse thing that can happen if you mess up?
18:25 Do it over... I would suppose. Right
18:28 But if you don't even have the
18:29 machine, you know, if someone is going...
18:30 You don't even have that chance... Exactly
18:32 And if you don't get the paramedics there within
18:33 5 minutes and deliver that shock,
18:35 that patient has very little ability of having
18:38 significant long-term recovery.
18:41 So, Robert, there it is. That's a defibrillator
18:44 and we hope you consider getting it...
18:46 And if there are any more questions,
18:49 the people that run these defibrillator companies
18:52 they're on the websites.
18:53 This one happens to be one done by a company called "Medtronic"
18:58 They are more than happy to give you information on this.
19:01 Beep-beep... It's extremely easy
19:03 Okay, well we stopped it... I hope it doesn't go off again!
19:05 Let's not... Okay, we don't want it to start talking
19:07 We've got to finish this show, Dan... ha, ha, ha
19:09 So with that, let's go to the next question.
19:11 Beep-beep... okay, let's leave that closed there.
19:16 And the next question will be from Lynette in Tennessee.
19:20 "The speed of my heart races at times. "
19:24 "I was at Disney World a few years ago, and nearly
19:27 fainted from this rhythm. "
19:29 "I have 2 small children and live an active lifestyle. "
19:33 "This RARELY occurs... Should I be concerned?"
19:37 Well, yeah, the speed of the heart races.
19:41 You can go ahead and put that up if we need to.
19:43 Lynette, this is a good question.
19:45 In the heart, there are sometimes groups of cells that
19:49 become very, very unhappy.
19:51 And these cells can generate a fast rhythm,
19:54 and sort of a generic name we gave for that is a big name.
19:57 It's called "supraventricular tachycardia"
20:00 where the heart goes real fast.
20:02 And sometimes when the heart goes fast like this,
20:04 you don't get blood pressure to your head...
20:06 and that's what makes you feel so poorly.
20:09 One of the things we say when it happens...
20:12 Okay, "Lay down and put your feet up"
20:15 And you can sometimes rub on this part of your neck
20:18 and sometimes this will actually slow your heart down enough
20:21 until you can catch your breath.
20:23 If it continues for a long period of time,
20:25 YOU REALLY need to go to the hospital,
20:28 so we can either put a monitor on you, or get an EKG
20:31 to see what this rhythm is about...
20:34 Because you don't want to be having this rhythm
20:36 when you go down with your kids.
20:38 Could a ride at Disney World have brought that about?
20:43 Yeah, I guess it's possible, but usually these rhythms
20:47 are triggered on their own.
20:49 I mean... most people have these that they're doing
20:51 nothing, and then it just comes on!
20:53 Now we do know that there are some triggers
20:55 that make it worse - - if you're dehydrated
20:57 Sometimes you can take a stimulant from the heart
21:00 and some of the more common stimulants that you might see
21:02 at a theme park would be stress from
21:04 2 small kids all day... Standing in line
21:06 Yes, if you don't have the fast passes...
21:08 you'll have to stand in line a lot at Disney World. Exactly!
21:11 Another thing, we talked about caffeine.
21:13 If you get dehydrated, if you're not drinking all day,
21:16 you don't have enough fluid, those are some other
21:17 things that could trigger this rhythm.
21:19 In people that just have it rarely, I'd recommend
21:22 no treatment, just monitor.
21:23 But if it happens on a regular basis, more frequently
21:26 We can actually go up inside a body and destroy
21:29 these dangerous heart rhythms now with a
21:31 small amount of energy. Right
21:32 And if people don't want to do that, we can also
21:34 take medications.
21:35 Now, is it a person's fault that they have this?
21:38 No, not really... most people are just sort of born that way
21:41 and they have these abnormal pathways,
21:43 and they have to just live with that.
21:45 So Lynette, good luck with your rhythm,
21:46 and if it keeps coming on,
21:48 I would go see your healthcare provider.
21:51 All righty, next question is from Earl in Minnesota. Okay
21:57 He says, "Atrial fibrillation runs in my family. "
22:03 "I am 86, my doctor says I have arterial fibrillation
22:09 and he wants to put me on a blood thinner. " Ooo
22:12 "I don't want to. " Okay
22:14 "What do you think?"
22:16 Atrial fibrillation is another one of these rhythms
22:20 of the heart.
22:21 Now we didn't talk much about it earlier, but
22:23 the normal rhythm is called "sinus rhythm"
22:26 That means each rhythm is generated from the special
22:29 battery that God gave us called "the sinus node"
22:32 ...that's a normal rhythm
22:33 So, if it's going too slow, we call that "sinus bradycardia"
22:37 or too slow of a heart rhythm.
22:39 If it's going fast, we call it "tachycardia"
22:41 Those are normal rhythms of the heart,
22:43 but just going slow for another reason. Right
22:46 Sometimes you have, sort of,
22:48 these misconnections that we talk about...
22:50 And if it's coming from the TOP part of the heart,
22:52 this abnormal faring from all sorts of FUNNY spots,
22:56 we call that "atrial fibrillation"
22:58 And that's where the top part is literally going like this...
23:01 It's just squeezing all over.
23:02 It's not working symmetrically
23:05 with the bottom part of the heart.
23:07 And guess what happens to blood if the heart is
23:10 squeezing like a... worm when it comes through?
23:12 Squeezed out?
23:13 Well, some of it is squeezed out but not as much as normal.
23:16 But actually, when it's moving like THIS,
23:18 you can get blood clots because the blood
23:20 doesn't pass through.
23:21 And if a blood clot gets in there and passes through
23:24 from the upper chamber to the lower chamber,
23:26 and the lower chamber pumps that blood clot somewhere,
23:29 it could go to the head, and cause a stroke.
23:32 In fact, about 15% of all strokes in the United States,
23:37 are caused by this rhythm atrial fibrillation.
23:41 So, Earl, that's why your doctor wants to
23:45 put you on a blood thinner...
23:46 He wants to lower your risk of having a stroke.
23:49 Now, is there some people that don't get a blood thinner?
23:52 You know, um... Yeah, if the risk of bleeding outweighs
23:57 the risk of the blood thinner then you wouldn't get it.
24:00 And, you have to have frequent monitoring
24:02 when you're on Coumadin.
24:03 Now, do you know what Coumadin really is?
24:04 I do not... What is that?
24:06 Coumadin is rat poison!
24:08 A lot of people don't like to realize
24:10 that it's just rat poison.
24:11 A lot of people don't like to take it because it's rat poison
24:14 But it has lowered the risk of having a blood clot in the body.
24:18 And in atrial fibrillation, you have to evaluate the
24:21 risk of being on the blood thinners,
24:22 whether you can take in the monitoring,
24:24 versus the risk of falling, and bleeding.
24:27 These are all very important things
24:29 to think about when you're on Coumadin...
24:31 But Earl, if you came to me and you had atrial fibrillation,
24:34 first of all, I would say, Coumadin needs to be considered,
24:39 The next thing I'd want to look at is the different causes...
24:41 You know, why do you... It's a very common rhythm
24:44 and with that in mind, let's bring up the next graph
24:46 about the causes of atrial fibrillation...
24:49 Okay, remember this is where the top part is going
24:52 faster than the bottom part.
24:53 Sometimes it can again be because there's something
24:56 wrong with the heart itself.
24:57 That is, there's a structural heart problem.
25:00 It might be that it's stretched out...
25:02 It might be the valves that's bad.
25:04 There might be an old heart attack.
25:06 Something's wrong with the heart itself that's causing it.
25:08 Sometimes you can have a thyroid condition
25:11 Remember the thyroid regulates these rhythms.
25:13 You can have a thyroid abnormality
25:15 Sometimes high blood pressure can actually cause this
25:18 rhythm, atrial fibrillation, because it stretches it out.
25:20 And there is a host of other causes.
25:23 And Earl, I want to, sort of go through some of those
25:25 other causes with you, just in case
25:28 you might have one of these.
25:30 Again, we talked about being dehydrated. Right
25:33 Having an infection.
25:35 Certain medications can sort of cause it to be
25:37 more likely to happen.
25:39 Just being sick can cause it to happen... Correct
25:42 Now, one of the things that the heart likes most is oxygen!
25:45 We found that people that don't get enough oxygen
25:48 So if Earl has a lot of lung disease...
25:50 THAT could be a trigger for this atrial fibrillation.
25:54 And in this rhythm, you feel pretty bad,
25:56 if the heart is going too fast.
25:58 So atrial fibrillation is one that usually you have to go
26:01 in the hospital to get it treated...
26:02 so it's a pretty tough thing to have.
26:05 So I think Coumadin is reasonable
26:07 And the other thing, you know,
26:08 if we can fix the underlying cause.
26:10 You know, Earl, if you have problems with your lungs,
26:12 if there is an infection, you're not getting enough
26:14 oxygen, let's fix that. Right
26:16 Now, do you have to do tests to balance
26:20 the amount of Coumadin that you're getting...
26:22 Can you get too much Coumadin? Yes you can...
26:24 And we have to frequently check the blood to see
26:27 if the blood is TOO thick, or too thin while on your Coumadin
26:29 ...Because if it's too thin, and you bonk your head,
26:31 you could have a very, very serious problem... Right
26:37 You know, in the slide, you also mentioned that
26:41 the thyroid has a lot of problems...
26:44 There are a lot of people with thyroid problems
26:46 in the United States today, it seems like... There are!
26:49 I, personally, have some problems with mine
26:52 and so that's something even beneficial for me to remember.
26:57 Right... it can go, you know, too low, too high
27:00 Thyroid is a very common regulator of the heart.
27:02 It regulates the heart's speed.
27:03 And actually, a lot of people don't realize,
27:05 but a low heart RATE can cause you to have a slow heart.
27:10 Now before we close today, I wanted to show the people
27:13 we talked about rhythms...
27:14 we talked a little bit about the slow ones... Right
27:16 a little bit about the fast ones
27:18 And today, I just want you to get INTERESTED in
27:20 your heart rhythm.
27:21 One other thing I'd like to
27:22 show you that we brought with us today...
27:24 This is a defibrillator!
27:26 Remember earlier in the show we had an external defibrillator
27:29 Now what an external defibrillator is...
27:31 is a device that we put on IMMEDIATELY
27:34 when someone is having a sudden problem with their heart.
27:38 Now this device, in people with weak hearts
27:40 or people who have diseased hearts
27:41 that need this technology all the time.
27:43 This can be inserted under the skin, and it can deliver
27:46 a shock, and this one can actually pace the heart
27:49 any time it might be needed.
27:50 Well we're almost out of time today, Dan
27:53 I want to thank you for joining us.
27:54 I hope that the audience has learned something about
27:57 the rhythms of the heart...
27:58 The fast ones, the slow ones...
27:59 a little bit more knowledge about what to do.
28:02 And we hope that ALL of you can have hearts that
28:05 NEVER go out of rhythm.
28:06 And we hope that God will create in you, a new heart
28:09 one that depends on Him daily to keep your heart
28:12 running smoothly.


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Revised 2014-12-17