Cardiologist Answers Heart Questions From Twitter | Tech Support | WIRED

WIRED
19 Mar 202416:56

Summary

TLDRIn this informative and engaging video, cardiologist Dr. Sunil Rao addresses various questions about heart health from an online audience. He explains that a heart rate above 120-130 beats per minute could be considered high, especially during illness, and offers the 220-minus-age rule for exercise. Dr. Rao discusses heart skips, arrhythmias, and the importance of EKGs in diagnosing heart conditions. He also covers the audible nature of heartbeats, the use of defibrillators, and the reality of 'broken heart syndrome.' The video touches on the impact of exercise on resting heart rate, the signs of a heart attack, the role of aspirin, and the effects of diet and lifestyle on heart health. Dr. Rao also explains the function of cholesterol, the differences between stents and bypass surgery, and the importance of heart rate variability and pacemakers. He highlights the genetic factors in heart disease, the link between gum health and heart health, and the influence of alcohol, cigarettes, and high blood pressure on cardiovascular health. The video concludes with a reminder of the importance of a healthy lifestyle for maintaining heart health.

Takeaways

  • 💓 **Varying Heart Rates**: A universally 'too high' heart rate doesn't exist. Factors like fever or exercise can cause rates to fluctuate, with a rough guideline being 220 minus your age for maximum heart rate during exercise.
  • 🏃 **Exercise Intensity**: Aim for 70 to 85% of your maximum heart rate during exercise, which can be calculated as 145 to 155 beats per minute for someone who is 40 years old.
  • 🫀 **Heart Skips**: Occasional heart skips, or premature beats, are common and can be due to caffeine or stress. Frequent skips may indicate an arrhythmia, which can be diagnosed with an EKG.
  • 📉 **EKG Readings**: A normal EKG shows regular intervals and consistent waveforms, while an abnormal one may display irregular deflections and waveforms, such as in atrial fibrillation.
  • 👂 **Heart Sounds**: It's common to hear your heartbeat, especially when lying down, and it could be the sound of blood through the neck vessels.
  • 🚫 **Defibrillator Use**: A defibrillator can restart a heart in ventricular fibrillation, not when the heart is flatlined.
  • 💔 **Broken Heart Syndrome**: Psychological stress can cause temporary heart dysfunction, which can appear like a heart attack on an EKG but typically recovers over time.
  • ❓ **Cardiac Arrest Causes**: Specific incidents like Damar Hamlin's cardiac arrest can result from impacts at certain times in the cardiac cycle and emphasize the importance of CPR knowledge.
  • 🏋️‍♂️ **Resting Heart Rate**: A high resting heart rate despite regular exercise may indicate insufficient cardio activity or other health issues, warranting a doctor's check.
  • 🔥 **Heart Attack Signs**: Symptoms include chest pressure, shoulder pain, and jaw pain, with women possibly experiencing shortness of breath and abnormal fatigue.
  • 💊 **Aspirin Use**: Low-dose aspirin isn't recommended for heart attack prevention in those without cardiovascular disease due to the risk of bleeding complications.

Q & A

  • What factors can cause a person's heart rate to become too high?

    -A person's heart rate can become too high due to various factors such as fever, the flu, or during physical exertion like running on a treadmill. It's also influenced by age, with a general guideline being 220 minus your age to estimate the maximum heart rate during exercise.

  • How does one determine their target heart rate during exercise?

    -The target heart rate during exercise can be estimated by aiming for about 70 to 85% of the maximum heart rate, which is calculated as 220 minus your age.

  • What is a common sensation that people experience when their heart skips a beat?

    -When a person feels their heart skipping a beat, it is often due to a premature beat followed by a pause as the heart compensates and returns to its normal rhythm.

  • What is an arrhythmia and how can it be diagnosed?

    -An arrhythmia is a general term for an abnormal heart rhythm caused by problems with the heart's electrical system. It can be diagnosed through an EKG, which records the electrical activity of the heart.

  • How does an EKG work and what does an abnormal EKG indicate?

    -An EKG, or electrocardiogram, records the heart's electrical activity through lines that represent the heart's rhythm. An abnormal EKG shows irregular deflections and waveforms, which can indicate conditions like atrial fibrillation.

  • Why might someone hear their heartbeat without using a stethoscope?

    -It's common for individuals to hear their heartbeat in their ears, especially when lying down or going to sleep. This could be due to the sound of blood flowing through vessels near the ear or the neck.

  • Under what conditions can a defibrillator restart a heart?

    -A defibrillator can restart a heart during a cardiac arrest when the heart is in ventricular fibrillation, where the heart's chambers are quivering instead of beating effectively. It cannot be used if the heart is flatlined.

  • What is broken heart syndrome and how does it manifest?

    -Broken heart syndrome, also known as takotsubo cardiomyopathy, is a condition where the heart suddenly stops working normally due to severe psychological stress. It can appear similar to a heart attack on an EKG but typically recovers over time.

  • Why might a fit athlete still have a fast resting heart rate?

    -A fast resting heart rate in a fit athlete could be due to insufficient cardiovascular training, even if they are physically active. Other factors could include stress, caffeine intake, or an underlying medical condition.

  • What are the signs of a heart attack and how do they differ between men and women?

    -Common signs of a heart attack include chest pressure or tightness, shoulder pain, and jaw pain. Women might experience different symptoms such as shortness of breath and unusual fatigue.

  • How does low-dose aspirin affect heart health and when is it recommended?

    -Low-dose aspirin can help prevent future heart attacks in those with existing cardiovascular disease by thinning the blood. However, it's not recommended for healthy individuals to prevent heart disease due to the risk of bleeding complications.

  • What is the impact of a high-salt diet on heart health?

    -A high-salt diet can lead to high blood pressure, which in turn increases the risk of heart disease. It's especially concerning for those with salt-sensitive hypertension.

Outlines

00:00

💓 Understanding Heart Rate and Conditions

Dr. Sunil Rao, a cardiologist, addresses various heart-related concerns. He explains there's no universal 'too high' heart rate, as it can vary with conditions like fever. A general guideline for max heart rate during exercise is 220 minus your age. Skipping beats might be due to premature beats compensated by a pause, but frequent occurrences could indicate arrhythmia. An EKG is a tool to diagnose heart conditions, with normal EKGs showing regular intervals and abnormal ones showing irregular waveforms, like in atrial fibrillation. Dr. Rao also discusses common experiences like hearing one's heartbeat and the use of defibrillators in certain heart conditions, not for flatlining.

05:02

🏥 Medical Insights on Heart Health

The video script continues with Dr. Rao answering more questions. He talks about 'broken heart syndrome,' a condition where the heart is affected by severe stress, which can mimic a heart attack but typically recovers over time. He also discusses the case of athlete Damar Hamlin, who experienced a cardiac arrest likely due to a chest hit disrupting the heart's electrical activity. The importance of CPR education is highlighted. Dr. Rao further explains why a fit person might still have a high resting heart rate, and the signs of a heart attack, emphasizing the need for quick diagnosis and treatment. He also touches on the use of aspirin in preventing heart attacks, its risks, and benefits for those with existing cardiovascular disease.

10:03

🥩 Diet and Heart Health Interactions

Dr. Rao discusses the impact of diet on heart health, emphasizing the importance of reducing salt intake to prevent high blood pressure, especially in salt-sensitive individuals. He defends eggs as a good source of protein and dispels myths about dietary cholesterol. The dangers of saturated fats, particularly in fried foods, are also covered. The effects of COVID-19 on the heart are mentioned, including increased risks of heart attacks and blood clots. When comparing treatment options for blocked arteries, Dr. Rao explains how stents and bypass surgery work and their respective statistics. He also defines cholesterol, distinguishing between good and bad cholesterol, and the role of medication like atorvastatin in managing it.

15:04

💖 The Function and Care of the Heart

The final paragraph delves into the mechanics of the heart, highlighting its daily workload and the role of valves in maintaining blood flow. Cholesterol's impact on the heart is discussed, focusing on LDL as a risk factor for heart attacks and strokes. The importance of exercise, a healthy diet, and medication in managing cholesterol levels is stressed. Heart rate variability and heart rate recovery are introduced as indicators of heart health. Dr. Rao explains heart murmurs, pacemakers, and the genetic factors that can predispose young individuals to heart attacks. He also discusses the correlation between gum health and heart health, advocating for both. Lastly, he talks about the potential of a plant-based diet to reverse heart disease and the impact of lifestyle choices like alcohol and tobacco use on heart health.

Mindmap

Keywords

💡Heart Rate

Heart rate refers to the number of times the heart beats per minute. It is a crucial indicator of cardiovascular health. In the video, Dr. Sunil Rao explains that a high heart rate can be normal in certain circumstances, such as during a fever or flu, but it's generally not recommended to exceed 180 beats per minute during exercise for a 40-year-old, which is calculated by 220 minus the age.

💡Arrhythmia

Arrhythmia is a term used to describe any abnormality in the heart's regular rhythm. It is mentioned in the context of skipped heartbeats, which can be a common occurrence due to factors like caffeine or stress. However, frequent skipped beats may indicate an arrhythmia, which can be diagnosed with an EKG.

💡Electrocardiogram (EKG)

An EKG is a diagnostic tool that measures and records the electrical activity of the heart, which can help identify various heart conditions. The video explains that a normal EKG shows regular intervals and waveforms, while an abnormal EKG, such as one from a person with atrial fibrillation, will show irregular deflections and waveforms.

💡Atrial Fibrillation

Atrial fibrillation is a type of arrhythmia where the top chambers of the heart beat irregularly. It is characterized by an abnormal EKG with irregular waveforms. The condition can lead to blood pooling and clot formation, which poses a risk of stroke if a clot travels to the brain.

💡Defibrillator

A defibrillator is a medical device used to deliver an electric shock to the heart to restore a normal rhythm in certain life-threatening arrhythmias. The video clarifies that while defibrillators can restart hearts in ventricular fibrillation, they cannot be used on a flatlined heart, which is indicated by a straight line on the heart monitor.

💡Broken Heart Syndrome

Broken heart syndrome, also known as Takotsubo cardiomyopathy, is a condition where the heart temporarily stops working normally due to severe psychological stress. It can appear similar to a heart attack on an EKG, but without blockages in the heart's arteries. The video mentions that patients often recover and go on to have normal lifespans.

💡Cardiac Arrest

Cardiac arrest is a sudden loss of heart function, breathing, and consciousness, often caused by an electrical disturbance in the heart. The video discusses the case of Damar Hamlin, a professional football player who experienced cardiac arrest due to a chest hit at a critical time in the heart's electrical activity cycle.

💡Resting Heart Rate

Resting heart rate is the number of heartbeats per minute while a person is at rest. It is typically between 60 and 100 beats per minute. The video suggests that even fit individuals can have a high resting heart rate, and if it remains high despite regular exercise, a medical check-up is advisable.

💡Heart Attack

A heart attack occurs when the blood supply to a part of the heart muscle is blocked, often by a blood clot, leading to damage or death of heart tissue. The video describes classic symptoms like chest pressure and shoulder pain, and notes that women may experience different symptoms such as shortness of breath or abnormal fatigue.

💡Aspirin

Aspirin is a medication that has both anti-inflammatory and blood-thinning properties. The video explains that while aspirin can help prevent future heart attacks in those with existing cardiovascular disease by thinning the blood, it is not recommended for healthy individuals to take aspirin as a preventative measure due to the risk of bleeding complications.

💡Cholesterol

Cholesterol is a waxy substance that is present in the cells of the body and is important for cell membrane structure. However, high levels of 'bad' cholesterol, or LDL cholesterol, can contribute to the formation of plaques in the arteries, increasing the risk of heart disease and stroke. The video emphasizes the importance of managing cholesterol levels through diet, exercise, and medication if necessary.

Highlights

There's no one-size-fits-all number for what's considered a too high heart rate; it can vary based on factors like fever or exercise.

A general guideline for maximum heart rate during exercise is 220 minus your age.

Exercising at about 70 to 85% of your maximum heart rate is recommended.

Premature heartbeats can cause a sensation of the heart skipping a beat, which is usually harmless but could indicate an arrhythmia if frequent.

An EKG can diagnose issues with the heart's electrical system, such as atrial fibrillation.

Atrial fibrillation can lead to blood clots and increase the risk of stroke.

It's common for individuals to hear their heartbeat, especially when lying down or going to sleep.

A defibrillator can restart a heart in ventricular fibrillation, but not if the heart is flatlined.

Broken heart syndrome is a real condition where intense stress causes temporary heart dysfunction.

Damar Hamlin's cardiac arrest was caused by a hit at a specific time in the heart's electrical activity.

Highly trained athletes can still experience heart attacks due to factors like genetics or rare conditions.

A plant-based diet may help reverse heart disease, though adherence can be challenging.

Alcohol and cigarettes can have long-term detrimental effects on the heart and blood vessels.

High blood pressure is different from the temporary increase in blood pressure during exercise; the latter can be beneficial.

Heart rate variability is an indicator of a healthy heart, showing the heart's ability to respond to the body's needs.

A heart murmur is an extra sound heard during a heartbeat, which can be normal or indicative of a valve issue.

Pacemakers provide a regular electrical signal to the heart muscle to ensure normal beating.

Gum health has been correlated with heart health; poor gum health may increase the risk of cardiovascular disease.

Transcripts

00:00

- I'm Sunil Rao, a cardiologist at NYU Langone Health.

00:02

Let's answer some questions from the internet.

00:04

This is "Heart Support."

00:05

[upbeat rhythmic music]

00:10

@ThiggyMan asks: "Ay...

00:12

What heart rate is considered too high?"

00:14

There's no one number

00:15

that's considered too high for everyone.

00:17

If you have a fever, if you have the flu,

00:18

your heart rate may go up to 120, 130,

00:20

and that's probably, quote, too high for you.

00:23

Let's say you're on the treadmill and you're wondering,

00:24

"Gosh, how high should my heart rate get?"

00:26

Well, there's a rule of thumb that you can remember.

00:28

220 minus your age.

00:30

So let's say you're 40 years old.

00:31

That would equal 180 beats per minute,

00:34

which would be really the maximum heart rate

00:36

that you're aiming for.

00:36

Really what you wanna do is try to get

00:38

to about 70 to 85% of that heart rate,

00:41

which would be somewhere between 145

00:44

and 155 beats per minute while you're exercising.

00:47

If you notice that your heart rate's going above 180,

00:50

you probably oughta cut back a little bit.

00:52

tehRisa asks: "I need a doctor to tell me medically

00:54

what is happening in my chest when my heart skips a beat

00:57

while reading a cute romance manga."

00:59

Occasionally what will happen is that the heart

01:01

will have a beat that occurs prematurely.

01:03

Well, the heart has a way to compensate for that.

01:04

It has a pause,

01:07

and then it gets back on rhythm.

01:08

It's that pause that you're feeling

01:09

when you say your heart is skipping a beat.

01:11

Many of us have occasional skipped beats that happen.

01:14

Maybe we had a little too much caffeine that day.

01:16

Maybe we're nervous about a job interview,

01:18

nervous about a first date.

01:19

That's very, very common.

01:20

But if you notice that your heart is skipping beats a lot,

01:24

you may have what's called an arrhythmia.

01:25

Arrhythmia's just a general term

01:27

that says there's something wrong

01:28

with the electrical system:

01:29

atrial fibrillation, atrial flutter,

01:31

ventricular tachycardia, there are a whole bunch

01:33

of other things that can be diagnosed very, very easily

01:36

by getting an EKG.

01:37

Okay, so next question.

01:39

"EKGs, how do they work?"

01:41

EKG is an electrocardiogram.

01:43

Here's a normal EKG.

01:45

And you can see that these lines are occurring

01:48

at a very regular interval.

01:50

And the baseline has a few curves on it,

01:53

but those curves are pretty much the same

01:55

with every single beat that's happening.

01:57

That's a normal EKG.

01:59

And what does an abnormal EKG look like?

02:01

First of all, these deflections that are going up and down

02:05

are occurring very, very irregularly.

02:07

Look at the spaces between these deflections.

02:10

You see how there's so many different waveforms here?

02:13

There are lots of lumps and bumps.

02:14

This is an EKG of a person who has something

02:16

called atrial fibrillation.

02:18

And that's when the top chambers

02:20

of the heart beat irregularly.

02:22

So let's go to our heart model.

02:23

So there are the upper chambers of the heart,

02:26

and there are the lower chambers of the heart.

02:27

When someone has atrial fibrillation,

02:29

the top chambers of the heart stop beating.

02:31

And that's that irregular waveform

02:32

that you pick up on the EKG.

02:34

The problem with that is that the blood can pool

02:37

in parts of the heart.

02:38

And if it forms a blood clot,

02:40

no matter how tiny it might be inside the heart,

02:42

and that blood clot travels to your brain,

02:44

it can put you at risk for having a stroke.

02:46

@ChicagoSeavey asks: "Guys I can hear my heartbeat...

02:49

Without a stethoscope????

02:50

Is that normal???"

02:51

It's very, very common to hear your heartbeat in your ear.

02:53

So a lotta people can hear it when they're laying down

02:55

and when they're going to sleep.

02:56

You may be even be hearing the blood going

02:58

through the blood vessels in your neck.

02:59

Some people hear it, some people don't.

03:01

That's a very, very common finding

03:02

and really nothing to worry about.

03:04

@BaseballMurse7 asks: "True or false:

03:06

you can restart the heart with a defibrillator?"

03:08

Well, that's true, you can.

03:09

Now, there are a couple things that are important

03:11

to keep in mind here.

03:12

Oftentimes, on television,

03:13

they show, for example, a patient's heart who's stopped

03:16

and the monitor shows a flat line.

03:18

You actually can't use a defibrillator to restart

03:20

a patient's heart if they're flatlined.

03:21

What you do use it for is when the bottom part of the heart,

03:25

these chambers of the heart, go into something

03:27

called ventricular fibrillation.

03:29

In other words, they're not beating.

03:30

They're just quivering.

03:31

And because these chambers are responsible

03:33

for pumping blood to the rest of the body,

03:34

if they're not pumping,

03:35

the rest of the body ain't getting any blood.

03:37

And so the external defibrillator that we use

03:39

when someone has a cardiac arrest can basically restart

03:42

the heart and get it pumping again.

03:43

But you can't do it if the person's flatlined.

03:45

@derapops asks: "Is broken heart syndrome a real thing?"

03:48

Absolutely, it's a real thing.

03:49

In fact, I just treated a patient

03:50

with broken heart syndrome this morning.

03:52

It's a situation where the heart all of a sudden

03:55

stops working normally

03:56

because of some kind of psychological stress.

03:58

Even on the EKG,

04:00

it can look like someone's having a heart attack.

04:01

And when we look for blockages,

04:03

we find they don't have any blockages.

04:04

But the good news is that that recovers over time.

04:07

These patients often go on to have normal lifespans.

04:09

But absolutely, yes, broken heart syndrome is a thing

04:12

and we're seeing more and more of it,

04:13

just because of life stresses

04:14

that people are having these days.

04:16

@kjewels71 asks: "Will we ever learn what happened

04:19

to Damar Hamlin...exactly what caused his cardiac arrest?"

04:21

So Damar Hamlin, a professional football player,

04:23

he unfortunately had cardiac arrest during a game.

04:26

And what happened to him is that he was hit in the chest

04:28

at exactly the right time during the electrical activity

04:32

of the heart so that his heart stopped.

04:33

It has to happen in such a specific time

04:36

of what we call the cardiac cycle

04:38

or during the normal heartbeat

04:39

that it is a very, very rare phenomenon.

04:41

And thankfully, he's really become an advocate

04:43

for community education around CPR,

04:45

so that if someone does have a cardiac arrest,

04:47

they can be resuscitated very, very quickly.

04:49

It's really important for all of us really

04:51

to get educated about basic life support and CPR.

04:54

So rolls asks, "i train and work out a [beep] ton

04:57

why is my resting heart rate still fast asf?"

05:01

First of all, it may be that even though you're hitting

05:03

the gym a lot, maybe you're not doing enough cardio.

05:06

Your heart rate when you're just resting

05:08

should be somewhere between 60 and 100.

05:10

Anything below 60 is probably a little too slow,

05:13

but keeping in mind, marathon runners, for example,

05:15

they'll have very, very slow heartbeats.

05:17

And that's normal for them.

05:18

So to find your own resting heart rate,

05:20

what you wanna do is sit in a quiet room,

05:21

feel your pulse in your wrist or in your neck,

05:24

and count the beats for six seconds.

05:26

Multiply what number you get by 10,

05:28

and that'll give you what your resting heart rate is

05:31

in beats per minute.

05:32

If you're in pretty good shape,

05:33

you're exercising regularly,

05:34

and your resting heart rate still is high,

05:36

it's probably a good idea to see your doctor

05:37

and just get checked out.

05:38

itzkayshoe asks: "Hey guys what are the signs

05:41

of a heart attack?

05:42

I can't feel my arms."

05:43

Well, I'm not that if you can't feel your arms,

05:45

that's really the sign of a heart attack.

05:46

The classic symptoms of a heart attack are chest pressure

05:48

or chest tightness.

05:49

You may feel shoulder pain

05:50

either in your left shoulder or both shoulders.

05:52

It may radiate to your jaw.

05:53

You may feel jaw pain.

05:55

Women may have symptoms

05:56

that are a little bit different from men.

05:58

They may feel shortness of breath.

05:59

They may feel profound fatigue

06:01

that's really abnormal for them.

06:02

A heart attack is when part of the heart muscle dies

06:05

because the blood supply to that heart muscle

06:07

has been choked off.

06:08

I have a picture for you here that shows

06:09

the blood vessels that supply the heart muscle.

06:11

What you see here is there's a narrowing

06:13

in that blood vessel,

06:14

and that blood is not able to get past that blockage.

06:17

That's what causes the pain that people are feeling

06:19

in their chest, and our job as cardiologists

06:22

is to diagnosis this as quickly as we can,

06:24

go in there and actually open that blockage,

06:26

which is exactly what we do

06:27

with balloon angioplasty and stents.

06:29

@chicafromthechi asks, "So does a low dose aspirin

06:33

help prevent heart attacks or not?"

06:34

If you don't have manifests of cardiovascular disease,

06:37

it's really not recommended that you take an aspirin,

06:39

specifically if you're trying to prevent heart disease.

06:41

It doesn't prevent heart attacks

06:43

and does put you at risk for bleeding complications,

06:45

because aspirin can be directly irritating

06:47

to the lining of the stomach.

06:48

Aspirin is a blood thinner.

06:50

And because a heart attack involves blood clots

06:52

that are occurring inside the blood vessels of the heart,

06:54

aspirin can actually address those blood clots

06:56

by actually breaking them up and reestablishing flow

06:59

to the heart muscle.

07:00

If you have cardiovascular disease already,

07:02

aspirin can prevent future heart attacks

07:04

by gently thinning your blood.

07:05

Or if you're actively having a heart attack,

07:07

it can treat a heart attack by breaking up the blood clot

07:10

that's causing it.

07:11

But if you don't have either one of those things,

07:12

low-dose aspirin really is not gonna prevent you

07:14

from having a heart attack.

07:16

@DoGsMoveSilent says: "You get served this for breakfast.

07:19

What's your reaction?"

07:20

My reaction is, I probably didn't order this.

07:22

But let's take a look at what's on this plate.

07:24

Processed meats can be very, very high in saturated fat,

07:26

but they also might be high in salt.

07:28

So for example, the beans, which are a great source

07:30

of protein and fiber, you know,

07:32

these beans might be from a can.

07:34

And canned vegetables and canned beans do have

07:36

a lot of salt in them. For most of us, salt is fine.

07:38

But some of us do have what's called

07:39

salt-sensitive hypertension.

07:41

And minimizing the amount of salt or sodium in our diet

07:44

can certainly protect you

07:45

from developing high blood pressure.

07:46

Eggs are perfectly fine for you.

07:48

They're a great source of protein.

07:50

You should eat the yolk.

07:51

You know, one of the reasons that people said

07:52

that eggs were bad for you,

07:53

'cause they said it was high in cholesterol.

07:54

It turns out that dietary cholesterol contributes

07:57

very, very little to your blood cholesterol.

07:58

What does contribute to your blood cholesterol

08:00

is saturated fat.

08:01

And prepared appropriately,

08:03

eggs can be very low in saturated fat.

08:04

I'll confess, I love French fries.

08:06

But anything that gets fried can increase saturated fat.

08:09

Saturated fat in and of itself can increase

08:12

your blood cholesterol,

08:13

and blood cholesterol is directly linked

08:15

with the development of heart disease like heart attacks.

08:18

@BettyPhuck9 asks: How does covid affect your heart?"

08:21

Well, COVID has a lot of effects on the heart.

08:22

The viruses can infect the lining of the blood vessels,

08:25

leading to blood clots forming and an increased risk

08:27

of heart attack.

08:28

COVID-19 can also affect the heart muscle itself

08:30

and weaken the heart muscle.

08:31

During the pandemic, we saw an increased risk

08:33

of heart attacks, so it's really, really important

08:35

to try and avoid COVID-19 and prevent it if at all possible.

08:39

@Batla_G asks: "A 45 years old close relative has found 100

08:42

and 95% blockage in two arteries

08:44

and they're exploring options between Stents and Bye Pass.

08:47

Can someone suggest what's less risky?"

08:49

Well, I'm sorry to hear that your relative's having issues.

08:52

I certainly can't comment on their specific case,

08:54

but let's talk a little bit about stents and bypass surgery

08:56

and what they do.

08:57

So a stent is just a wire mesh tube

09:00

that's made out of a specific type of metal

09:01

that goes inside the arteries of the heart muscle

09:04

and props open blockages.

09:06

It may be a blockage

09:07

that's filled with cholesterol, for example.

09:08

So the stent is this metal part,

09:10

and it comes crimped on this balloon.

09:12

And this red tip is the end of the balloon catheter itself.

09:15

Once we position this on the X-ray in the right spot,

09:18

we can use this device

09:19

and push saline, which is salt water,

09:22

and expand that balloon.

09:23

What I'll do is I'll turn this device

09:25

and push that saline into this balloon.

09:29

There is goes.

09:30

And it pops open that stent.

09:32

I can then deflate the balloon

09:34

and remove the balloon catheter

09:37

and then leave the stent behind.

09:39

So that's how stents work.

09:40

But how does bypass surgery work?

09:41

A surgeon will take blood vessels oftentimes

09:44

from your legs or maybe from your arm

09:46

and attach them to the aorta here

09:48

and put it into an area that's past the blockage.

09:51

Think of it as a blocked highway.

09:52

So if the highway is blocked,

09:53

oftentimes there's a bypass that goes around it.

09:55

Around 12% of the patients with atherosclerosis

09:58

affecting the heart get bypass surgery.

10:00

About 65% or so get stents.

10:02

@catgirlgale says: "wtf is a cholesterol?"

10:04

Well, cholesterol is just a substance in your body

10:06

that's all over your body.

10:08

It's an integral part of the cell membranes

10:10

that make up your body.

10:11

But cholesterol also can float around in your body

10:13

and cause blockages in the blood supply to the heart muscle,

10:16

the blood supply to your brain,

10:17

the blood supply to your legs.

10:18

There are different types of cholesterol.

10:19

There's good cholesterol and there's bad cholesterol.

10:22

Bad cholesterol's the one

10:23

you really oughta pay attention to.

10:24

It's also called LDL cholesterol.

10:26

That's the cholesterol that if it's too high

10:28

can cause heart attacks and strokes.

10:29

It's important to minimize the amount of LDL cholesterol

10:32

that's measured in your blood.

10:33

Exercise, minimizing the amount of saturated fat.

10:36

There are some very, very good and very, very safe medicines

10:39

that will allow you to lower your blood cholesterol.

10:41

One of the more common medications for cholesterol

10:42

is something called LIPITOR.

10:43

The generic name is atorvastatin.

10:45

It's a very cheap drug.

10:46

It's incredibly effective and has been shown

10:48

not only to lower cholesterol safely

10:50

but also prevent heart attacks.

10:52

lazzypoo asks: "how does the human heart just do that?"

10:55

The human heart is really pretty amazing.

10:56

It does a lotta things.

10:57

It pumps 100,000 times a day.

10:59

It pumps 2,000 gallons of blood

11:01

through nearly 60,000 miles of blood vessels.

11:04

It's got these blood vessels that are going into it

11:06

and coming out of it.

11:07

Now, they're not really this color inside the body,

11:09

but these blue blood vessels are carrying blood

11:11

that needs oxygen.

11:12

The organs in your body have already used the oxygen.

11:15

They're sending it back to the heart.

11:16

It comes in through this right side of the heart,

11:18

and these white structures here are valves

11:20

that open and close and allow the blood to flow through.

11:23

And then it pumps through the right side

11:24

and goes to the lungs where it can pick up the oxygen

11:27

that we're breathing.

11:27

And that blood then comes back

11:29

to the left side of the heart.

11:30

And the left side of the heart pumps it

11:31

through this giant blood vessel that you can see here

11:33

called the aorta.

11:34

From the aorta, there are all kinds of branches

11:36

that go to all the organs throughout the body.

11:37

And they can then get the oxygen that they need

11:39

for normal functioning.

11:41

@SarahBarleyMc asks: "Can anyone tell me

11:43

how Heart Rate Variability impacts on your health?"

11:45

Heart rate variability is just the normal variation

11:49

in our heart rate during the day.

11:50

A lot of consumer goods are measuring things

11:53

like heart rate variability.

11:54

The reason that heart rate variability is important is

11:56

that it's an indicator of a healthy heart.

11:58

Because if you're getting excited, for example,

12:00

your heart rate should go up.

12:01

If you're relaxed, your heart rate should come down.

12:03

If your heart rate is unable to maintain

12:06

that kind of variability,

12:07

it's a sign that something may be abnormal

12:10

with your cardiovascular health.

12:11

Probably the thing that matters a little bit more

12:13

than heart rate variability is what's called

12:14

heart rate recovery.

12:16

So for example, if you're exercising,

12:17

how fast does your heart rate return back to normal?

12:20

Your heart rate probably should come back

12:22

to 90% of your resting heart rate

12:25

after you stop exercising within two to three minutes.

12:28

If it's taking longer than that,

12:29

you can actually improve your heart rate recovery

12:31

by continuing to exercise.

12:34

@rosamarei asks: "wtf is a heart murmur

12:37

and why do I have it?"

12:38

Well, a heart murmur is just a sound

12:39

that your cardiologist or your doctor hears

12:41

when they listen to your heart with a stethoscope.

12:43

Here's what a normal heartbeat should sound like.

12:46

[heart beating]

12:48

And if you have a heart murmur, that's an extra sound.

12:50

So if you have aortic stenosis or a narrowing

12:53

of the aortic valve, for example,

12:54

that sounds a little bit like this.

12:56

[heart beating]

12:59

Some murmurs do develop when you're a child,

13:01

and they go away.

13:02

Some murmurs, you may not have until you get older.

13:04

As we get older, our heart valves,