human heart

The heart is one of the most important organs in the human body, but what do we know about it? Together with an expert cardiologist Tamaz Gagloshvili, we will figure out how the heart looks and works, and why it can hurt in men and women.

So many romances, songs and poems are dedicated to the heart, which all other internal organs combined have not been awarded. And in the drawn form, the heart is so replicated that when you see it for the first time in the picture for the real, many are surprised. Let’s see what the human heart looks like and how it works.

Where is the human heart

The heart is located in the chest cavity, at the level of the sixth and eighth thoracic vertebrae. Most of it – about two-thirds – is on the left. In rare cases, with a congenital anomaly called dextrocardia, the heart may be more to the right.

What does the human heart look like and how does it work?

The heart is a hollow muscular organ, more like a pear than a picture from a Valentine’s card. Depending on the physique, the size of the individual cavities of the heart, the proportions of this “pear” may vary. Cardiologists distinguish the following most common variants of the shape of the heart: ordinary, mitral, aortic, spherical, triangular.

The location of the heart is also different: oblique (the most common), vertical, horizontal. It depends on the morphological constitution of a person. In tall thin people (asthenics) it is vertical, in those inclined to be overweight (hypersthenics) it is horizontal.

The heart of a person begins to work long before he is born. On ultrasound, the heartbeat of the fetus in the womb is fixed already at 4-5 weeks of pregnancy. The heart works continuously throughout life. Simply put, the heart is a kind of pump that ensures the constant and continuous movement of blood through the vessels in the right direction.

What is important to know about the human heart

The wall of the heart consists of three layers: epicardium, myocardium and endocardium. And the heart itself consists of four cavities (chambers): left atrium, left ventricle, right atrium, right ventricle.

The left half of the heart is separated from the right interventricular and interatrial septa. And the atria and ventricles are separated by valves – a kind of “doors” that open only in one direction and only when necessary. If they begin to open at any time or close incompletely, the work of the heart and the entire circulatory system will be disrupted.

Heart shape	Conical
adult heart size	Length – 10-15 cm, Width – 8-11 cm, Distance from the front wall to the back – 6-8,5 cm. Men’s hearts are slightly larger than women’s.
Heart volume	For women – 500-600 cm3, For men – 700-900 cm3.
Heart weight	For women – 203-302 g. For men – 274-385 g.
Heart beats per minute	60-89 beats per minute. A woman’s heart tends to beat faster.
chambers of the heart	Right and left atria, right and left ventricles
Right atrium	It includes the vena cava, through which venous blood flows from the whole body. Therefore, the right atrium is able to stretch more than the other chambers of the heart. In the walls of the right atrium is the sinus node, which sets the correct rhythm of heart contractions.
Left atrium	Significantly smaller than the right one and cannot stretch as much. The left atrium receives four pulmonary veins, through which it receives oxidized arterial blood.
Right ventricle	The most anterior part of the heart. Its walls are much thicker than those of the right atrium, but if necessary, they are quite extensible. Inside the right ventricle there are two cones – the cone of the inlet and the cone of the outlet. The right ventricle opens into the pulmonary artery.
left ventricle	It is called the main one not only in the heart, but also in the entire circulatory system. The wall of the left ventricle is three times thicker than the right one because it needs strength to push blood into the systemic circulation for the whole body.
Heart valves	Mitral, tricuspid, aortic, pulmonary
Mitral (bicuspid)	Located in the left atrium. It allows blood to move from the left atrium to the left ventricle, but not vice versa.
Tricuspid (tricuspid)	valve between the right atrium and the right ventricle. It opens to allow blood to pass from the atrium to the lungs.
Aortic valve	It lies between the left ventricle and the aorta. Regulates blood flow between the heart and aorta.
Pulmonary (pulmonary)	It lies between the pulmonary artery and the right ventricle. Provides one-way blood flow from the heart to the lungs.
Layers of the heart	epicardium, myocardium, endocardium
epicardium	A thin layer, the outer shell of the heart, which is located in a dense bag – the pericardium or heart sac. Normally, the pericardium is separated from the epicardium by a cavity filled with serous fluid.
Myocardium	The thick muscle layer is the heaviest and most important, as it makes up the bulk of the heart. Forms the thickness of the walls of the ventricles and atria, provides contractions of the heart.
Endocardium	Thin inner layer lining the cavity of the heart. Forms a valvular apparatus.

It is interesting: in 65 years, the heart makes up to 2,5 billion beats.

Scheme of blood flow in the human heart

The movement of blood in the heart is as follows:

Blood saturated with carbon dioxide moves through the veins to the heart and enters the right atrium.
The heart muscle relaxes (diastolic phase), the tricuspid valve opens, and blood flows into the right ventricle.
The valve closes, the muscle contracts (systole phase), and blood from the right ventricle is sent to the pulmonary artery.
The blood reaches the lungs, is enriched with oxygen and says goodbye to carbon dioxide and returns to the heart, namely, to the left atrium.
The left atrium relaxes and blood is sent to the left ventricle.
The left ventricle contracts and pushes blood into the aorta.

That is, the blood moves in a circle. And not just one, but two – big and small.

Circles of blood circulation

A large circle of blood circulation

The task is to deliver oxygen and nutrients to all organs, remove metabolic products and carbon dioxide from them.

The systemic circulation begins in the left ventricle. From it, blood flows into the largest vessel – the aorta, which diverges into arteries that go to all tissues of the body. Arterial blood gives off oxygen, takes away metabolic products and carbon dioxide and returns to the heart – to the right atrium, where the great circle ends. Blood passes through it in 23-27 seconds.

Small circle of blood circulation (pulmonary)

The task is to ensure the enrichment of blood in the lungs with oxygen.

Blood from the right atrium to the right ventricle moves to the lungs, where it releases carbon dioxide and receives oxygen. Through the capillaries, it goes into the veins, which flow into the left atrium. From here, blood will enter the left ventricle – and this is the beginning of a new big circle.

This is interesting: it is estimated that the heart spends the amount of energy per day that is enough to lift a 900-kilogram load to a height of 14 meters.

How does a person’s heart hurt?

In fact, not all chest pain is related to the heart. Many patients, confident that they have a cardiac problem, complain of stabbing and shooting pains in the heart area. If a person in this place stabs and shoots, depending on the position, phase of inspiration, most often it is intercostal neuralgia or problems with the gastrointestinal tract (for example, gastroesophageal reflux disease, in which gastric juice is thrown into the esophagus). To accurately determine, it is necessary to examine a person.

When the heart hurts, it does not stab or shoot through. The characteristic classic pain in the heart is pressing, burning, tearing, dagger. Patients complain “as if a concrete slab had been placed on the chest”, “the chest was squeezed like a vise”, “as if boiling water had been spilled”.

Heart pain does not appear at rest, it is usually associated with physical activity: got up, walked, climbed the stairs. Sometimes the pain appears when going out into the cold (cold angina).

And yet, if a person whose heart hurts is asked to show exactly where it hurts, he will not show the place of pain with one finger.

Why can a person’s heart hurt

Coronary artery disease (CHD)

In other words, it is a lack of blood supply to the heart. Occurs with atherosclerosis of the coronary arteries, when the vessels are clogged with plaques by 50-60% or more. Pain appears with persistent stenosis of the coronary arteries. Most often, it is provoked by physical and psycho-emotional stress, in which the heart needs more oxygen, and due to vasoconstriction this is impossible, therefore, there is a deficiency in myocardial oxygen demand, which is manifested by heart pain.

Myocardial

This is the same ischemia, only acute, with the development of myocardial necrosis. Unlike stable coronary artery disease, pain in the heart lasts longer (more than 15-20 minutes), sometimes leading to loss of consciousness due to a sharp decrease in pressure. This condition is called cardiogenic shock.

Arterial hypertension

With this disease, pain in the heart can appear at stage 2, when hypertrophy of the muscle layer develops. The pains are aching, pulling, accompanied by dizziness, the appearance of “flies” before the eyes.

Angina pectoris

Occurs during seizures, which are usually provoked by physical activity or psycho-emotional stress. With angina pectoris, strong pressing or squeezing pains are felt, radiating to the shoulder, arms, under the shoulder blade. Pain with stable angina lasts no more than 15 minutes. If it lasts 15-20 minutes or more, then it is necessary to call an ambulance, as this may be unstable angina or a pre-infarction condition.

How is a person’s heart treated?

Depending on the diagnosis, treatment can be purely medical or surgical.¹.

Drug therapy

For the treatment of each disease, there are certain drugs. Their list is impressive: for the treatment of hypertension, arrhythmia, atherosclerosis, etc.

For example, for the treatment of heart failure, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, diuretics, etc. are prescribed.

For the treatment of arrhythmia, there are several treatment options with different drugs, depending on the type of heart rhythm disorder. There are five main groups of antiarrhythmic drugs, which are further divided into subclasses.

For the treatment of IHD, antiplatelet agents, beta-blockers, ACE-I, nitrates, statins, etc. are used.².

Surgical intervention

Modern cardiology is increasingly using minimally invasive methods of surgical intervention, when the operation is performed through small punctures. For example, arrhythmia is treated with ablation (radiofrequency, ultrasound, cryoablation). It looks like this: under local anesthesia, a vein or artery (usually the ulnar artery) is pierced, diagnostic catheters are brought through it to the heart, examining the heart. With their help, the focus of arrhythmia is determined, to which a therapeutic catheter is brought along the same path.

Many heart surgeries are performed in the same way: stenting (installation of a “spring” in a narrow place of the vessel, which expands it), the introduction of an occluder (a device with which some heart defects are treated), arterial valve replacement and others.

But, for example, operations such as coronary artery bypass grafting, valve replacement, prosthetics, removal of tumors, heart transplantation are performed only on an open heart. Such an operation requires general anesthesia, opening of the sternum, sawing of bones, connection to a heart-lung machine³.

Non-drug treatment

A person’s lifestyle is important for the successful treatment of any chronic heart disease. The following rules must be observed:

Sleep 7-9 hours,
Restriction in the diet of salt and sodium-rich foods (canned food, cheeses, sausages, fast food), animal fats and trans fats,
Increasing the intake of foods high in fiber, potassium and magnesium,
Regular physical activity (in addition to regular daily walking, there should be any aerobic intense exercise 3-4 times a week – swimming, exercise bike, cardio, yoga, Nordic walking, etc.),
Complete rejection of bad habits,
Fight stress.

How to strengthen the heart at home

The main prevention of heart disease is a healthy lifestyle. A person should monitor his diet, sleep, weight, fight bad habits.

There are no vitamins that would dramatically improve the functioning of the heart, prevent heart disease. Microelements such as potassium and magnesium are very important for the work of the heart. But if there is a deficiency of these trace elements in the body (and you can find out with the help of a blood test), then you need to get them from food.

Some people have elevated levels of potassium in the blood (for example, with kidney disease). And a person, not knowing this, prescribes potassium preparations to himself, further increasing its concentration. This can lead to hyperkalemia, an acute condition that can lead to cardiac arrest.