Heart - continued

Here s a simple way to stimulate your lymphatic system get a natural-bristle brush meant for dry skin brushing from your local health food store. Before your morning shower, brush your dry skin in circular motions. Start at your feet and work up all sides of your legs. Then work in circles up your abdomen toward your heart. Continue brushing in circles up all sides of your arms. By doing this, you re stimulating your blood and lymph fluid to remove acidic wastes. Remember, always brush toward your heart that s the way the lymphatic system naturally flows. This simple exercise takes only a minute or two but offers great health rewards. 

NSAIDs that preferentially inhibit COX-2 more than COX-1 (Vioxx and Celebrex) target the pain associated with inflammation such as rheumatoid or osteoarthritis with fewer stomach problems because prostaglandin I2 is synthesized by COX-1 in the stomach. In the heart, continuous muscular movements cause capillary wear. Cytokines induce COX-2 to make prostaglandin I2 which dilates the capillaries and prevents excessive blood clotting by thromboxane A4, a COX-1 enzyme product. A COX-2 inhibitor stops prostaglandin I2 synthesis. The heart capillaries do not dilate and there is a greater risk of coronary artery obstruction (heart attacks). 

When pure nitrous oxide is inhaled without the admixture of oxygen, the patient loses consciousness completely. The face is cyanotic, the respiration becomes stertorous and dyspneic, and ceases after a weak convulsion, while the heart continues to beat for some time afterward. If the mask through which the patient has been inhaling the gas is removed when the cyanosis becomes marked, complete anesthesia lasts for 30 to 60 seconds, and the patient then recovers within a few minutes. The pharmacology of nitrous oxide and that of halothane is compared in Table 16. 

If, for any reason, the heart continues to contract and relax without functional valves (open conduit), conditions revert to those visualized by Liebau, but net cardiac output reduces to a neghgible level. Noordergraaf et al. [71] measured less than 60 ml/min on the model referred to earher without valves and around 5000 ml/min with valves. This invalidates Liebau s suggestion that the cardiac valves might be superfluous. 

Fig. 12.3 Normalized energy decay curve for systole (up) and diastole (down) - Pathology type aortic stenosis (discontinued line) as compared to normal heart (continued line)...

Cardiac transplantation is the ultimate therapeutic option in end-stage CHF. Orthotopic cardiac transplantation is the surgical technique of choice, whereas heterotopic cardiac transplantation is performed primarily when there is high resistance in the pulmonary circulation of the recipient (and a heart-lung transplantation is impossible), the donor heart is too small, or in selected cases with acute but potentially reversible heart failure. In orthotopic transplantation the donor heart is joined to the recipients atria, aorta, and pulmonary artery. In heterotopic transplantation, the donor heart is implanted into the right thoracic cavity and anastomosed with the recipient s heart in a complex maimer in such a way that the donor heart takes over most of left ventricular output, while the recipient s heart continues to ensure right ventricular output. 

Cardiac muscle. Obviously, it is found only in the heart. Continually contracting and relaxing with a built-in rhythmic-ity until death, it pumps about 8,000 gallons (30,400 liters) of blood through 12,000 miles (19,200 km) of blood vessels each day. 

While the number of medical centers performing cardiac transplantation continues to grow, the shortage of donor hearts continues to limit the availability of this type of surgery particularly in the US, where only 2000-2700 procedures a year are performed (Massad 2004 Poston and Griffith 2004 Winkel et al. 1999). Worldwide, an estimated 4000 cardiac transplantations are performed annually (Taylor et al. 2004). As of May 2004,66,000 heart transplantations have been reported to the International Society for Heart and Lung Transplantation (Hosenpud et al. 1999 Taylor et al. 2004). 

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