A Heart to Heart

Can you really bust a gut?

Is life possible without a spleen, which, now that you think of it, does what?

Bodyworks is a new feature that from time to time will highlight a body part--and even provide wonderful bits of information that you can dazzle friends with at your next dinner party. Today, we start with the pitter-patter of the heart.

*

For more than 30 years, it’s been left in San Francisco.

It’s been broken and achy-breaky.

And there’s no telling how many times it’s been crossed to prove one’s honesty or drawn with a stick in the sand to declare one’s love.

You know it as the heart. But here’s what you might not know:

The Numbers, Please

* The average heart pumps about 2,000 gallons of blood a day.

* The average heart beats about 60 to 100 times per minute--about 100,000 a day--and tallies up a lifetime total, if it’s lucky, of 3 billion beats.

* During exercise, the heart rate increases to as much as 160 to 170 beats per minute in young people. (During sex, it can also reach exercise-type heights, depending on your level of enthusiasm.)

The Truth About Size

* “The average [heart] is about the size of a clenched fist,” says Dr. Benjamin H. Lewis, an attending physician at Columbia Presbyterian Hospital in New York and assistant professor of clinical medicine at Columbia University.

* Heart size varies slightly from person to person, with bigger people having slightly bigger hearts.

* Athletic conditioning tends to make the heart a bit bigger, as do most types of heart disease.

Location! Location! Location!

* Centrally positioned in the chest, the right margin of the heart lies directly underneath the right side of the breastbone.

Basic Operating Manual

* The heart is a dual pump. Deoxygenated blood arrives under low pressure from the body by way of the vena cava into the upper heart chamber, called the right atrium. It’s transferred to the lower chamber or right ventricle and then pumped by way of the pulmonary artery to the lungs.

The lungs reoxygenate the blood and return it by way of the pulmonary veins to the left side of the heart. The blood travels next to the left atrium, is transferred to the left ventricle and then is pumped under high pressure to all parts of the body by way of the large vessel called the aorta.

What It Wants

* Besides blood, the heart has a place in its heart for unfried foods, exercise, clean air, less stress.

What It Gets

The opposite, in 90% of cases.

Only about 10% of people take excellent care of their heart by not smoking, exercising regularly, eating healthfully and keeping their cholesterol under control, says Dr. Robert Chesne, chief of cardiology at Daniel Freeman Hospitals here. He nonetheless sees hope in that statistic. “It’s probably up from 5%.”

Once the heart sputters, hearing seems to improve: There’s no better student for a crash course on loving your heart than one with a newly diagnosed heart condition, physicians concur.

Heart-Doc-Speak

* Cardiologists diagnose and manage heart problems medically.

* Interventional cardiologists rely on balloons, stints and other techniques to reverse the effects of heart disease.

* Cardiac surgeons specialize in heart operations.

* Cardiothoracic surgeons do heart and chest procedures.

* Cardiopulmonary surgeons specialize in heart and lung operations.

* Pediatric cardiologists diagnose and manage childhood heart problems medically.

* Congenital heart surgeons correct birth defects.

A Primer: You Say Electrocardiogram, I Say Echocardiogram

* An electrocardiogram records the electrical activity of the heart and can alert the physician quickly to abnormalities.

* An echocardiogram uses ultrasound waves to visualize and examine heart structures.

* A treadmill stress test records heart rate, blood pressure, EKG and other parameters while a person physically exerts himself walking a treadmill.

* An angiogram involves injection of dye into the heart chambers or blood vessels to create a detailed picture of the interior of the structures.

When Things Go Wrong (Early)

* Heart defects occur in eight of every 1,000 live births, says Dr. Alan Lewis, associate director of the division of cardiology at Childrens Hospital Los Angeles and USC professor of pediatrics. “That’s 1% of babies.”

Most common are ventricular-septal defects and valve abnormalities. And most are random, not traceable to specific environmental or genetic factors nor behaviors during pregnancy.

When Things Go Wrong (Later)

In adulthood, poor diet, smoking, excess stress, lack of exercise and high blood pressure can contribute to heart disease. But so can family history and other inherited factors. Earlier this year, Johns Hopkins researchers identified an inherited factor that makes blood especially likely to clot, setting you up for early heart attack. The factor, called LA2, was found in 20% of subjects.

Scared Straight (Briefly)

While new heart patients tend to hang on every word their doctor says, the advice they follow best is to quit smoking cigarettes and to modify their diet. But some advice is heeded for only a short time.

“Nearly all stop smoking after surgery,” says Dr. Anne Billingsley, cardiothoracic surgeon at St. Francis Medical Center in Lynwood. But what she calls their “good as gold” period generally lasts only a few months. Once they feel normal again, many slide back into old, unhealthy ways.

Doctorly Advice (for Adults)

“Don’t smoke. Watch your diet. Get out there and exercise.”

Doctorly Advice (to Parents)

Ration your child’s intake of junk food and TV.

Paging Dale Carnegie

“You come to me, you got heart disease, I’m on your butt,” Chesne says. “I’m tough, I’m a mean doctor. We are going to have an adult relationship. Here are the things you have to do [watch your diet, exercise, control cholesterol]. That’s harder than what I have to do. I am going to see you every three months.”

You Can Mend a Broken Heart

Picture the scenario, a kinder, gentler Chesne suggests, of opening a clogged vessel via angioplasty. “A minute ago, it was closed,” he says. “Now it’s wide open. You can’t beat that.”