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The Practical Guide to Your Heart and Heart Surgery ABOUT THE AUTHORS Larry W. Stephenson, M.D., is the Ford-Webber professor of surgery and chief of the Division of Cardiothoracic Surgery for Wayne State University in Detroit, Michigan. He is also chief of Cardiothoracic Surgery at the Detroit Medical Center and Harper Hospital. Besides having a busy clinical practice, he has authored or co-authored more than 270 scientific articles and book chapters and three medical books. Dr. Stephenson was born in Appleton, Wisconsin, and attended college and medical school at Marquette University in Milwaukee. He completed his general surgical residency at the University of Alabama, where he also did a cardiovascular research fellowship. Next he did his cardio- thoracic surgical residency at the University of Pennsylvania, where he stayed on the faculty. Previously, he was a cardiothoracic surgeon at the Children’s Hospital of Philadelphia and at the Hospital of the University of Pennsylvania. While at the University of Pennsylvania, he rose through the faculty ranks to professor of surgery and was awarded the prestigious J. William White Professorship in Surgery. Dr. Stephenson is a retired colonel, U.S. Army Medical Corps, with more than 20 years of service in the U.S. Army Reserves. He has held numerous command positions and was on active duty at Walter Reed Army Medical Center in Washington, D.C., during Operation Desert Storm. Jeffrey L. Rodengen, president and CEO of Write Stuff Enterprises, Inc., is the author of the acclaimed and award- winning Legend series of coffee-table books. With more than 40 books to his name, he is the country’s foremost biographer of American industry and technology, including comprehensive works on such global organizations as Pfizer, Inc, Boston Scientific Corp., Cessna Aircraft Co., Advanced Micro Devices, Inc., The Stanley Works, Chris-Craft Industries, Inc., and Ashland Inc. Throughout his remarkable career, Jeff has inter- viewed thousands of scientists, CEOs, business and national leaders, and celebrities. Before beginning his career in publish- ing, Rodengen enjoyed a 15-year career in Hollywood as a writ- er, producer and director. He has written or produced nearly 30 films, network television specials (including six for Arnold Schwarzenegger), Las Vegas revues and Broadway pro- ductions. Jeff has degrees in psychology and post-graduate degrees in engineering. He lives in Fort Lauderdale with his wife Karine, award-winning photographer, and their twin children. The Practical Guide to Your Heart and Heart Surgery Larry W. Stephenson, M.D. with Jeffrey L. Rodengen Edited by Jon VanZile Design and layout by Sandy Cruz In Remembrance Write Stuff Enterprises, Inc. 1001 South Andrews Avenue, Second Floor Fort Lauderdale, FL 33316 1-800-900-Book (1-800-900-2665) (954) 462-6657 www.writestuffbooks.com C. Walton Lillehei, M.D., Ph.D. www.stateoftheheartbook.com October 23, 1918–July 5, 1999 Heart Surgery Pioneer Copyright © 1999 by Write Stuff Enterprises, Inc. All rights reserved. No part of this book may be reproduced or trans- “I would like to think that mitted in any form by any means, electronic or mechanical, I’ve left the world of cardiovascular surgery including photocopying and recording, or by any informa- better than when I found it. tion storage or retrieval system, without permission in writ- That would be a suitable epitaph.” ing from the publisher. — C. Walton Lillehei, 1995 Publisher’s Cataloging in Publication Notice to Readers Rodengen, Jeffrey L. The practice of medicine, medical science State of the heart /Jeffrey L. Rodengen. and medical research is rapidly changing, espe- — 2nd ed. cially as it relates to the heart. Information result- p. cm. ing from medical research, clinical experience Includes bibliographical references and index. and specific circumstances as well as opinions of ISBN 0-945903-26-X — hardbound cover authorities that may differ require that the read- ISBN 0-945903-63-4 — softbound cover er use judgement and other sources when mak- ing any decision based upon the content of State 1. Heart — Diseases — Popular works. of the Heart. 2. Cardiologists — Interviews. I. Title. The publisher and authors have made every effort to ensure that the information contained in RC682.R64 1999 616.1’2 State of the Heart is complete, accurate and in QBI98-928 accord with medical standards at the time of pub- lication. However, neither the publisher, authors nor any other contributor to this publication can Library of Congress warrant, especially in light of the rapid changes in Catalog Card Number 98-61623 medical science, that the material contained is in all respects accurate and complete and they do ISBN 0-945903-26-X Hardbound Cover not take any responsbility for any use or misuse ISBN 0-945903-63-4 Softbound Cover of the information contained herein. The reader is therefore advised to discuss the Completely produced in the information contained in State of the Heart with United States of America medical authorities and to confirm any informa- 10 9 8 7 6 5 4 3 2 1 tion with other available sources. iv TABLE OF CONTENTS Reader’s Tip: The icon denotes a section that is of historical significance in the development of heart surgery. Foreword by C. Everett Koop, M.D. .x Acknowledgements . .xii Contributors . .xiv Chapter One: The Dawn of Open Heart Surgery . .16 The Early Days . .17 The Heart-Lung Machine . .18 The Roller Pump (Dr. Michael DeBakey) . .20 The Dodrill Pump . .21 Cross-Circulation . .21 C. Walton Lillehei’s Legacy . .22 John Kirklin’s Heart-Lung Machine . .24 Denton Cooley: Inventor and Pioneer Surgeon . 28 Nikolay Amosov: Heart Surgeon and Public Servant in the U.S.S.R. 30 Chapter Two: The Normal Heart . 32 The Right Side of the Heart . 33 The Heart As a Muscle . 34 The Left Side of the Heart . 36 Blood Pressure . 36 The Blood . 37 The Electrical Conduction System . 38 The Cardiac Cycle . 38 The Coronary Arteries . 39 What You Should Know About Your Heart During Pregnancy . 40 by Dr. Pamela Gordon Chapter Three: Staying Healthy . 44 Smoking . 45 High Blood Pressure . 45 High Cholesterol . 45 Vitamin E and the Heart . 47 Exercise . 48 Stress . 48 Diabetes . 49 Nutrition for a Healthy Heart by Dr. Morrison Bethea . 49 v STATE OF THE HEART Wine, Alcohol, and the Heart by Dr. R. Curtis Ellison . 52 Antibiotic Protection for Dental Surgery . 57 Chapter Four: Signs and Symptoms of Heart Problems . 58 History and Physical Exam . 59 Chest Pain . 59 Angina Pectoris . 60 Heart Attack . 61 Difficulty Breathing . 61 Coughing Up Blood . 62 Fatigue . .62 Swelling . .62 Pleural Effusion . .63 Fainting . .64 Vasovagal Fainting and Dizziness . .64 Palpitations . .65 Skin Color . .66 Shock . .67 Changes in Vision, Strength & Speech . .67 Leg Pain . .67 Your Visit to the Cardiologist by Dr. John O’Connell . .68 Chapter Five: Diagnosing a Problem . .72 Electrocardiogram . .73 Exercise Stress Test . .73 Ambulatory Electrocardiographic Monitoring . .74 Echocardiography . .74 Exercise Echocardiogram . .75 The Chest X-Ray . .76 Chest Computed Tomography . .76 Magnetic Resonance Imaging (MRI) . .77 Nuclear Perfusion Tests . .77 Pyrophosphate Technetium-99m Scanning . ..
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