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Police, firefighters assist distressed dog in hot car

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Artist shares Mexican-American art,celebration traditions

<p>Most of my friends and colleagues would confirm that my super power may well be finding analogies or similes for almost any situation. Sometimes they&#8217;re pretty insightful, often they&#8217;re a bit tortured, always though, they&#8217;re entertaining.</p><p>I find it particularly helpful to use comparisons to common experiences to help patients and families understand complex medical and surgical issues. Take for example heart valves and the diseases that involve these critical, delicate appearing but surprisingly tough, bioengineering marvels.</p><p>The circulatory system is composed of the heart, and all the tubes that carry blood to and from it. In some sense the lungs and indeed all the organs and tissues of the body are somehow part of the system as well.</p><p>These are arranged in a figure of eight, just like model trains at Christmas, with the heart and its four chambers at the central crossover point, yes, that&#8217;s right, at the HEART of the system &#8230; get it? Two of the heart&#8217;s chambers are dedicated to the right side, pumping used blood to the lungs and two to the left side, pumping blood newly charged with oxygen from the lungs to the body&#8217;s other organs. Energy from the food we eat, and a huge variety of hormone messengers, immune cells and stuff we may not even understand, goes along for the ride.</p><p>It&#8217;s critical that the blood goes only one way around the circuit and the four heart valves are the &#8220;turnstiles&#8221; that keep blood flowing in that correct direction. There are two inlet valves that allow blood into the right and left pumping chambers (the ventricles) from the receiving atria. Two others are the outlet valves that keep blood that was just ejected from the heart from flooding back into the pump as it&#8217;s refilling.</p><p>The two valves on the right, or lung side, face a much lower pressure than the left sided valves which must withstand the higher pressures needed to push blood all the way to the head and toes. Nevertheless, these valves are made of tissue as thin as the surface of a blister but as strong as your ear. With each heartbeat they open and close, open and close, open and close &#8230;</p><p>Now occasionally the valves develop diseases that cause them to degenerate and the body&#8217;s aggressive attempt to heal them can cause the leaflets to stick together, scar and allow calcium, the same element in bone, to grow into the tissue, stiffening and hardening the whole valve. Other times the valve can thin, weaken, sometimes tear and leak. Both the scarring and the leaking stress the heart and can lead to heart failure and even death.</p><p>One of the most devastating problems that affect the valves though, is infection. Now for more analogies.</p><p>When I&#8217;m fly-fishing, one of the most relaxing aspects is just being in the stream, watching, hearing and indeed feeling the water flow. Depending on where you are, how high the stream is running and what obstacles are in the water&#8217;s way, the sounds can be eerily quiet and delicate or roaring and violent.</p><p>If a leaf is in the flow and the water&#8217;s running unimpeded, the leaf will just keep on going downstream. If however, there&#8217;s a boulder in the flow, a whirlpool will form and the turbulence will capture the leaf and it can swirl around in the maelstrom indefinitely.</p><p>The same thing happens in the bloodstream with germs.</p><p>Bacteria and fungi get into our bloodstreams all the time. Brushing your teeth, eating, voiding, indeed living, pushes germs into our blood constantly. Our body has plenty of very efficient blood cleaning mechanisms, some mechanical like your lungs, spleen and lymph nodes, others biological like white blood cells and antibodies. Generally, the bugs pass on by with no bad consequences. But if the valves are damaged and therefore the blood passing by flows roughly and turbulently, there&#8217;s a good chance the bacteria, like the leaves, will get trapped. Unlike the leaves, they&#8217;ll stick, grow and set up an infection that causes a great deal of trouble. This infection of heart tissue is called endocarditis.</p><p>Tune in next week for more about this serious problem that&#8217;s now exploding in our area because of IV drug use, as unfortunate users actually inject non-sterile drugs right into the bloodstream and so, often infect the valves. </p><style>
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<div class="metaInfo"><bylineMeta><p>By Alfred Casale</p><p>To Your Health</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>.Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via ae@www.timesleader.com. For a free heart risk assessment, visit geisinger.org/heartrisk.</p></shirttailMeta></div>

Keep those critical heart valves clean