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Medical Glossary
Home > Heart Health > Medical Glossary
Heart attack
 see entry Myocardial infarction.  
Heart murmur
An abnormal sound perceived while auscultation (listening to) the heart. This sound is produced by any disturbance in blood flow, for example when blood flows through a narrow opening or when flow turbulences exist. Conditions causing such disturbances are usually associated with valvular defects or defects in the septum dividing the two cardiac parts, the left and the right part. Sometimes, particularly in children, murmurs can be heard even if no anatomical defects are present. Murmurs are divided in systolic and diastolic murmurs, according to the phase of the heart action during which it is auscultated, the systole or the diastole, respectively.
Heart muscle

See entry: Heart

Heart rate (pulse rate)
See under: Pulse.
Heart scan

A method for the assessment of cardiac anatomy and physiology as well as of its Coronary arteries. It is based on injecting a radioactive substance and examining its distribution in the various segments of the heart walls.

In the course of this test, radioactive substances are used (mainly thallium 201 or technetium 99). These substances are characterized by their ability to reach such areas in the myocardium that are supplied with blood and include viable muscle cells.

A computerized gamma camera rotates around the patient and registers heart images from different perspectives.

Scanning of the heart (also called Scintigraphy) can be performed at rest and in stress situations.

Heart-lung machine

In most cardiac surgical procedures temporary interruption of the contractile activity of the heart is required in order to enable the surgeon the performance of the desired repair of the existing damage.

In such situations, blood must be stored in an external machine that practically mimics the heart and lung action.

Such machines include a pump and an oxygenation system. Blood is sent to the machine by tubing inserted to the veins draining oxygen-depleted blood into the right heart. After oxygenation, blood is returned under pressure to a great artery.

Heartbeat
See under Pulse.
Herz-Bypass-Operation
Mit einer Bypass-Operation wird für ein verengtes Blutgefäß am Herzen eine Umleitung gelegt (Bypass: engl. für Umleitung). Meistens werden dafür Venen aus den Beinen oder die inneren Brustarterien verwendet. Bei einer Bypassoperation ist der Einsatz einer Herz-Lungen-Maschine meist notwendig. Minimal invasiv werden zunehmend Bypässe am Herzen auch ohne Herz-Lungen-Maschine operiert. Bypässe mit Arterien sind widerstandsfähig und das Risiko für kurzfristig auftretende Re-Stenosen, als neue Verengungen, ist niedriger als bei Bypässen mit Venen.
Holter monitoring

An examination for identifying and documenting heart rate disorders. The patient is connected to a portable device, which continuously records the electrical activity of the heart for a 24-hour period.

After the examination is completed the result is analyzed in order to identify and diagnose the rhythm disorder.

Among the advantages of this test the fact must be mentioned that the examination is made during 24 hours and does not depend on the feelings and reactions of the person tested, whereby rhythm disorders that are difficult to identify can be evaluated, including such that the patient is not aware of their existence or such occurring during sleep or appearing for a very short time and therefore difficult to distinguish.

Among the disadvantages is the fact that an episode that did not occur during the particular 24-hour period of measurement cannot be documented.

Homocystein

Homocystein is an amino acid and its high level in blood increases the risk of the development of Atherosclerosis and thereby the risk of cardiac disease and heart attack.

The main reason for increased Homocystein levels in blood is folic acid deficiency and deficiency of vitamins of the B group. Consuming fruit and vegetables as well as supplementation of these vitamins helps in decreasing homocystein levels in blood.

Hypercholesterolemia

Greater than normal Cholesterol levels in blood. The tendency of developing high Cholesterol levels is effected by genetic factors, nutrition, age, body weight and others.

High Cholesterol level is one of the risk factors for the development of Ischemic heart disease.

Hyperlipidemia

Higher than normal blood fat (lipid) levels.

Hypertension

This is a very frequent disorder, characterized by blood pressure elevation on repeat measurements with values exceeding 140/90 mm Hg.

According to the recent guidelines of the Israeli Hypertension Association, blood pressure values below 120/80 mm Hg are defined as normal, values between 120-139/80-89 mm Hg require follow-up, because people with values in this range are at a double risk for developing Hypertension in the future.

Values between 140/90 and 159/99 mm Hg are defined as mild Hypertension and values above 180/110 mm Hg are defined as severe Hypertension.

Values between mild and severe constitute moderate Hypertension.
In the vast majority of cases, the causative factor is unknown.

In the minority of cases, an organic cause can be found, such as kidney problems, hormonal (endocrine) disorders and others.

In the medical literature, this disorder is called "silent killer", because it is usually symptomless.

Therefore, it is very important to adopt a habit of measuring blood pressure periodically in order to detect the disease timely.

After the initial diagnosis is made, the treatment is established. The first step of the treatment is usually a change in life style leading to weight loss, physical activity and dietary adaptations.

If no response is present, a therapeutic attempt with drugs is performed.

There are many anti-hypertensive drugs with different action mechanisms.

In most cases, treatment is necessary for lifetime.

Treatment and balancing are very important, because this disorder is one of the most important risk factors for the development of Ischemic heart disease. 

Hypotension

Low blood pressure (less than 90/50).

Low blood pressure often does not reflect any medical problem, unless it is caused by another medical condition, for example myocardial infarction.

Sometimes, people with low blood pressure may suffer from weakness and even loss of consciousness when additional drop of blood pressure occurs, for instance during particularly hot weather. Abundant drinking can prevent these symptoms.

Low blood pressure does not constitute protection from future development of hypertension.

Interventricular septum

The partition wall dividing the two ventricles. Normally, this wall is impermeable, so oxygen-rich blood in the left ventricle cannot mix with oxygen-depleted blood from the right ventricle.

In certain congenital heart defects, this septum can have an opening. The solution of the problem, if necessary, is a surgical correction.

Lead

This term is associated with Electrocardiographic (ECG) recording.

The term "lead" relates to the point in space received in result of placing of electrodes in pre-defined points in the body around the heart.

The standard ECG includes 12 leads, i.e. 12 points in space that "look", each one from its perspective, at the electrical activity of the heart. Each lead records the activity that it "observes".

As a general rule, when a lead identifies electrical activity approaching it, a rising graph is recorded and when the activity is drawing away, a descending graph is drawn.

The knowledge of the location of the leads in space and of the pathways of the electrical activity flow in the heart helps to decipher the ECG and to identify pathology.

Left ventricle

The left ventricle is filled during the diastole from the left atrium with oxygen-rich blood. During systole the left ventricle empties directly to the Aorta and from there, by means of its many branches, it reaches all arteries of the body. Thus different body organs can regularly be nourished with oxygenated blood.

The left ventricle has a stronger and thicker wall than the right one and works against greater pressure resistance; its oxygen consumption is greater and therefore it is more vulnerable in situations when oxygen supply is compromised, such as infarctions.

Mitral regurgitation
Defective Mitral valve, which is located between the left atrium and the left ventricle of the heart. As a result of this defect in the valvular closure, leakage from the left ventricle to the left atrium is present during systole Symptoms may include breathing difficulties and rhythm disturbances. The treatment, depending on severity, is surgical.
Mitral stenosis

Narrowing of the Mitral valve located between the left atrium and the left ventricle. Resulting from this narrowing, impaired blood flow is encountered during the diastole from the atrium to the ventricle.

On cardiac auscultation, a diastolic murmur is perceived.

Symptoms are usually associated with blood congestion in the atrium (due to more difficult voiding) and they include shortness of breath as well as rhythm disturbances due to anatomical changes of the atrium and more.

If necessary, surgical treatment is applied: dilation of the narrowed valve or its replacement.

Mitral valve

The Mitral valve is located between the left atrium and the left ventricle.

Its task is enabling blood flow from the atrium into the ventricle during the contraction of the atria, but it also must prevent back flow into the atrium during the ventricular systole, when the ventricular pressure mounts markedly.

Insufficiency of the mitral valve causes back flow to the atrium, thereby excess load for the atrium and even blood return to the lungs.

Mitral valve prolapse (MVP, Barlow’s syndrome)

An anatomical defect of the Mitral valve, causing prolapse of one of the valvular leaflets towards the atrium during closure.

It is a frequent disorder, with increased frequency of appearance in women at age 20 to 40, with a hereditary component.

Most often, the structural defect is unnoticed and is detected incidentally, but sometimes it can cause leakage during valvular closure (Mitral regurgitation).

MUGA (Multiple Gated Acquisition Scan)

A method for the evaluation of cardiac anatomy and physiology by injecting a radioactive substance, Technetium 99.

One of the most important indices that can be obtained from this examination is the value called ejection fraction (EF).

Ejection fraction is the percent of what enters the left ventricle and what leaves it during each heart beat. In a healthy heart, ejection fraction is about 55% or more. This means that 55% of the blood content included in the left ventricle at the peak of its filling phase (end diastolic) is expelled from it at the peak of the contraction (end systolic).

The lower the EF values the more severe is the functional impairment of the heart.
The examination can be performed at rest or during effort in order to evaluate changes in cardiac output under stress conditions.

Myocardial infarction
This process is called in popular language “heart attack”. Myocardial infarction is caused by occlusion of an artery responsible for blood and oxygen supply to a given area of the heart. Such occlusion usually occurs by a joint action of a lipid plaque (atherosclerosis, sclerosis) and an overlying blood clot (thrombus). As a result of such occlusion, the vital oxygen supply is cut-off from this area and the involved cells undergo a process of necrosis, during which a proportion of cells are irreversibly damaged and die.
Myocardial ischemia
Ischemia is a condition, in which there is discrepancy between oxygen requirement at a given time and the amount of oxygen supplied to the heart. Such discrepancy is usually due to a partial narrowing of an artery caused in most cases by the formation of a lipid plaque in the arterial wall. Narrowing of an artery (stenosis) limits the blood amount flowing through it, with reduced amount of oxygen supplied to the area by such a vessel. Because the oxygen requirement of the heart grows with increased body activity, situations that increase the activity of the heart, such as exercise or mental stress may induce this discrepancy between oxygen demand and supply and thus induce ischemia.
Myocarditis

An inflammatory disease inflicting the heart muscle.

It can be a reaction to viral or other infection, exposure to some substances or an inflammatory process called "auto-immune", in which different mechanisms can induce an inflammatory process without involvement of infectious agents.

The disease can have different manifestations in different individuals. It can vary from complete lack of symptoms, through mild flu-like symptoms accompanied by chest pain and shortness of breath and up to heart failure or a lethal rhythm disorder.

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