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Depression and Heart Disease

Heart disease and heart attacks | Miscellaneous | Heatlh & Medicine | Khan Academy

I think most of us know what the heart does in our body. It pumps the blood and in particular it takes in the blood from the rest of the body. That is blue over here in this diagram, because that blood does not have carried oxygen And it pumps that blood to the lungs where the blood gets oxygenated. And then it comes back from the lungs, depicted as red blood, now that it has oxygen in it. And then that oxygenated blood is pumped to the rest of the body. And I think also, most of us have the general idea that when people talk about heart disease or heart attacks, which we learn, are two different things, related but different things, that has something to do with the clogging of arteries. so when I was a kid and I first learnt about the clogging of arteries. and I knew enough that the heart is all about pumping blood to the body. I assumed the artery that people were talking about these big arteries that were coming away from the heart to the rest of the body that somehow these things got clogged up. so let me draw that, different colour you can see so this was my ….this is what I thought people were talking about when they were saying clogging of the arteries and maybe when they got clogged enough, the stopped blood flow to the rest of the body somehow and that would actually kill the person. I want to make it very clear right now. Those are not the arteries that people are talking about getting clogged, when people talk about heart disease or heart attacks. The arteries that they are talking about are the arteries that actually provide blood to the heart. Remember the heart itself is a muscle. It itself needs oxygen. So you have these arteries right over here, the red tubes. Those are arteries. and then the blue ones are veins. They’re taking the de-oxygenated blood away from the tissue of the heart. And these are called coronary arteries. And this one over here at least from the point of view of me or you looks like it’s on the right. Or from the point of view of the person whose heart it is, it’s on the left. This right over here is called the left coronary artery or LCA. And this right over here in red is called the right coronary arteries or the RCA. And so when people talk about arteries getting blocked or getting clogged, they’re talking about the coronary arteries. They’re talking about the things that supply blood to the heart. So let’s zoom in on one of them….Maybe we can zoom in right over here, that part of the artery. That’s the tube….clear where I am zooming in. I am zooming in right over here. So over time, I am not going into the details how this happened. It is subject for another video. You can have these plaques build up along the walls of the artery. So over time if a person doesn’t have the right diet, or maybe they just have a predisposition to it, you can have these things called plaques form on the walls of the arteries. And the plaques, the material inside of them are lipids, so things like fat, cholesterol and also dead white blood cells, which is this kind of messy substance right over here. This is what we call a plaque. And the formation of these plaques that obstruct the actual blood vessel, that actually obstruct the artery. We call it…..make it clear you see that. This is kind of tube over here. Let me draw the blood So this formation of these plaques we call atherosclerosis. So you can imagine if you have these things build up, it’s narrowing the actual vessel that’s supplying blood downstream from that obstruction. So it would be destructing the blood flow downstream right over there. In that general process we talk about the restriction of blood flow, that is ischemia that’s happening. So ischemia is deprivation of blood flow and oxygen downstream from this right over there. That’s what we call coronary artery disease, or heart disease. So this causes coronary artery disease, which is sometimes called heart disease. Coronary heart disease would be redundant, because coronary is already referring to the heart. This is also sometimes called heart disease. And so you can imagine if downstream the muscle tissue is not getting all the oxygen it needs, especially maybe when this person, whoever’s heart this is, when they are exerting themselves, they need more oxygen. The heart needs to pump a little harder. If downstream the cells are not getting all of the oxygen they need, you can imagine that the heart maybe not able to provide all of the functions, whoever’s heart this is, that they needed to do. And when that happens that’s called heart failure. So heart disease is one of the causes of heart failure. Now I want to be clear, heart failure does not mean that the heart is stopping. That the heart is stopped and the person is dead, it literally just means that the heart is failing to do what it should be doing. It’s failing to provide the needs of that person. So it’s not pumping hard enough or well enough to provide adequate function for that person. The other symptom that actually might occur when someone has coronary heart disease, where they have obstruction or this ischemia or this deprivation of oxygen downstream from this obstruction, is that they might experience this kind of strangling chest pain That’s called angina pectoris or sometimes angina. Very few people say the pectoris part. Sometimes you hear people say oh angina. Angina pectoris, which is really chest pain, angina literally comes from meaning this kind of strangling feeling, and pectoris is in the chest. This is strangling feeling in the chest. This is a symptom of heart disease. Now this is already not a situation you want to get into because already your body is not able to function as well as it maybe could be, as maybe it could. Sometimes as I might describe here is a plaque. Some plaques are actually unstable. These plaques just grow and grow and grow. It makes probably heart disease worse and worse, heart failure worse, and angina pectoris worse. These plaques are unstable. It can actually rupture. You can imagine all these blood flows, as plaque grows, the blood flows become a little turbulent around these plaques. It has to go really fast through this narrow section. It comes out turbulent on the inside and creates these friction and all the rest. At some point, you can imagine this plaque is unstable. It could actually rupture. Let me draw ruptured plaque over here….let me draw the same one….I am gonna draw the ruptured. Now this plaque has rupture. It got so big. Maybe the turbulent blood flow helped stimulate this and whatever else. For whatever reason, it ruptures. When it ruptures, now it sudden i am doing a simplification of the process right over here. Now the content of this plaque: the lipid, the cholesterol, the fat, the dead white blood cell. Now it sudden is exposed to the blood flow. in particular to the clotting factor in the blood. This is highly thrombogenic material. Thrombogenic, very fancy word. That just means, that tends to cause blood clot. Thrombosis is a blood clot. What happened is, as soon as this type of things happened, it can literally happen in seconds or in minutes. All the sudden you could have these clotting factors form a clot right over here right at the actual plaque. As this happens, it starts to really really really obstruct the blood vessel. Sometimes it can even completely obstruct the blood vessel. When it happens, you are significantly depleting the blood flow going downstream from there. You might even be shutting it off. When you do that, the cells downstream will no longer get oxygen. They will die. This right over here, is called an infarction. an infarct is actually a dead heart tissue. You can imagine when heart tissue begins to die, this is even worse than what we were describing with coronary heart disease. Not only coronary heart disease just is not getting enough oxygen, now they are actually dead. They are turning into dead tissue. This process of completely or almost completely depriving cells of oxygen so that they die, this is a heart attack. Let me completely obstruct this artery to make the point clear. this right over here is a heart attack. This is the primary cause of heart attack. It’s less likely but sometimes a plaque could also go downstream, kind of form a thromboembolism. It would be this thrombogenic material, the clots around it. It would actually go and block the artery further downstream and be embolism. That can also block the artery and cause tissue to die. But the main cause is this intense clotting that can occur pretty quickly and completely obstruct the artery. There is one last word i want to touch sometimes mixed in with all the other words, that is cardiac arrest. That’s because sometimes we use them in the same context. one thing can lead to another. Heart attack is not cardiac arrest. Cardiac arrest is the actual dying of the heart. What I just described in a heart attack, people can have a heart attack. They will have some part of their muscle tissue die. Some part infarct, that’s what they called myocardial infarction. Myocardial means the tissue of heart or the muscle of the heart that’s dying. Sometimes it is called myocardial infarction. That is not cardiac arrest. Cause you can have some of your heart tissue die and you can survive. Your heart would be impaired. But you will continue to live. Cardiac arrest is literally your heart stopping. This would obviously cause someone to die. If you have a bad enough heart attack, if you have enough of the tissue get starved of oxygen so that it dies, infarction occurs. Then it could lead to cardiac arrest. It always won’t lead to cardiac arrest. Frankly, heart attack is not the only thing that can cause cardiac arrest. I also want to once again differentiate cardiac arrest from heart failure, because they sound the same, sound like heart is failing. Cardiac arrest is heart stopping. Heart failure is essentially just saying that heart can not provide all of the needs for the body.

92 thoughts on “Heart disease and heart attacks | Miscellaneous | Heatlh & Medicine | Khan Academy

  1. thank you Khan! Your enthusiasm inspises me learn sсience. So many themes on your channel, so many answers in your videos. Keep up the good work!!!

    P.S. I think that it would perfect if will make subtitles on other languages.

  2. The artery pointed as LCA in this video is actually the left anterior descending artery (also called LAD) to be presice. LAD is a branch of left coronary artery (LCA). LCA is only a short artery that bifurcates and gives rise to the LAD and so called LCX (left circumflex artery).

  3. @gemini88miller similar how? it's possible that they would feel similar pain wise, but cramps aren't caused by any of the same problems that cause heart attacks

  4. So the question is why only the arteries in the heart have this problems, why not my leg, hand , itc
    why only the heart ???

  5. ….Excuse my ignorance, but if this can happen to your heart, why can't it happen to anything? Such as a thumb attack? Does plaque not form anywhere else?

  6. @apricotsnms516 Im guessing that these clogs don't form instantly. Most of the blood goes through the heart, so most of the excess fat clings to the side of the arteries, causing it to build up over time. Very little blood goes to the thumb, so it's rare that that will happen. Although, there are attacks on other parts of the bodies. A stroke, for example, is a brain 'attack'.

  7. @lesleyhenriquez How is that possible? the guy you mentioned must have been Obese. I'm 31 and i am slightly overweight. So far, no heart problems.

  8. @Superbighenful Khan will not do that. He knows that English is the superior language. LOL NOOO SUBTITLES. make the non english people translate it themselves.

  9. @apricotsnms516
    It does. If it happens in the brain, it can lead to a stroke. It will also happens elsewhere. I don't know if it's called like that in english, but there's something called "smoker's leg" (more generally "peripheral vascular disease"), which can even make amputation of limbs necessary.

  10. can you do more videos on "pulmonary vein stenosis" or rather a video … especially in infants… please , thank you

  11. @Superbighenful actually, right now the khan academy folks are working on translating all the videos into tons of different languages. Check out Khanacademy . org 🙂

  12. I love medical science so much that I'm pursuing a career in the medical field! This was such an intriguing video on the heart. Thank you, Sal.

  13. Mmmm, thrombogenic material. I learned a new word today. I am so used to hearing the term thrombosis. Thank you for this.

  14. @khanacademy Is the infarction the heart attack or do heart attacks happen after an infarction when the heart is put under excess stress e.g. during exercise?

  15. nitpicky, but the coronary arteries talked about at around three minutes are the LAD (left anterior descending artery, also known as anterior interventricular artery) and the right marginal artery. These are branches of the left and right coronary arteries.

  16. Your site came to replace 9gag for me. Thank you. Also, your voice is surprisingly clear. English is not my first language and I can still understand you perfecly.

  17. Hi Willow,
    arteries deliver blood away from the "chambers," the large interior spaces, of the heart. The coronary arteries DO go to the heart, but they supply the walls of the heart. They do not deliver blood back into the chambers. However, there are also veins, shown in blue on the image, which will drain the walls of the heart and send that blood back into the chambers. Hope that makes more sense for you.

  18. Some of the yellow is fat tissue. It's normal to have some, but some unhealthy hearts will have a lot more.

  19. I have chest pains and i went to the dorcrs and I dont have heart diseiase or heart failures what do I have

  20. Does this happen to other muscles as well as the heart or does plaque only build up in the coronary arteries? Can you have a bicep infarction for example?

  21. Nice video about Heart Disease. I just watch this video carefully. Thanks for sharing this video. Heart patients will be Inspired from this video and the help provided here is really great. Hope you will keep uploading more awesome videos in the future too to let us know more details on Heart Disease and Heart Attacks.

    Follow @ Meschinohealth(dot)com

  22. I love you. Your videos > 298393 pages of reading in the textbook. very clear and helpful, keep up the work for all of us fellow college and university students

  23. Perhaps the most interesting research coming out on prevention of heart disease is the study published two weeks ago by the journal CIRCULATION of the American Heart Association. This 10 year NIH funded study found a 48% reduction of heart disease in people who were taught Transcendental Meditation. The control group used the standard education program. This finding was even more significant when looking at those who were most regular with their twice a day practice–66% in that group.

  24. High intensity ultrasound fixes the heart. Search for ‘HIUS jonathan thomason heart’ on how to use high intensity ultrasound to clear coronary heart disease

  25. Hey so I know it's really hard to get noticed on youtube today but I really hope that people would give my channel a chance. I make educational videos that are similar to these. You don't even have to subscribe if you don't want to but all I ask is for you to take a look at my channel please!

  26. Just watched Heart Disease and Heart Attacks. Does Khan Academy have any videos on Surgical Treatment of Heart Disease and Post-Op pharmaceutical options?

  27. My heart got a pain and it felt like a tearing.
    What does this mean im worried it has happend before no short of breath or anything else

  28. Here's something I read on the news : Tea loosens the arteries with helps fight for the prevention of atherosclerosis. This isn't like a 100% cure, but I though it was cool.

  29. Hi, please, I need your help to spread the word. Thank you in adavnce!

  30. Please…..The title of this video is "heart disease and heart attack", not "parts of the heart"…..You have to go straight to the point.

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  32. My close friends had nasty problems with her heart that often used to go crazy style and made her land in a mess. She did try some medicines but all failed. So she went on to the net and discovered Planet Ayurveda and received her Heart Care Pack that made her heartbeat in a perfect and normal way. Now she doesn't tire that easily and works for around 12 to 14 hours each day.

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