muscular organ that pumps blood to all parts of the body. The rhythmic beating of the heart is a ceaseless activity, lasting from before birth to the end of life.

Anatomy and Function

The human heart is a pear-shaped structure about the size of a fist. It lies obliquely within the chest cavity just left of center, with the apex pointing downward. The heart is constructed of a special kind of muscle called myocardium or cardiac muscle, and is enclosed in a double-layered, membranous sac known as the pericardium. A wall of muscle divides the heart into two cavities: the left cavity pumps blood throughout the body, while the right cavity pumps blood only through the lungs. Each cavity is in turn divided into two chambers, the upper ones called atria, the lower ones ventricles. Venous blood from the body, containing large amounts of carbon dioxide, returns to the right atrium. It enters the right ventricle, which contracts, pumping blood through the pulmonary artery to the lungs. Oxygenated blood returns from the lungs to the left atrium and enters the left ventricle, which contracts, forcing the blood into the aorta, from which it is distributed throughout the body. In addition, the heart employs a separate vascular system to obtain blood for its own nourishment. Two major coronary arteries regulate this blood supply.

Cardiac Cycle

Blood flows through the heart in one direction only. It is prevented from backing up by a series of valves at various openings: the tricuspid valve between the right atrium and right ventricle; the bicuspid, or mitral, valve between the left atrium and left ventricle; and the semilunar valves in the aorta and the pulmonary artery. Each heartbeat, or cardiac cycle, is divided into two phases. In the first phase, a short period of ventricular contraction known as the systole, the tricuspid and mitral valves snap shut, producing the familiar "lub" sound heard in the physician's stethoscope. In the second phase, a slightly longer period of ventricular relaxation known as the diastole, the pulmonary and aortic valves close up, producing the characteristic "dub" sound. Both sides of the heart contract, empty, relax, and fill simultaneously; therefore, only one systole and one diastole are felt. The normal heart has a rate of 72 beats per minute, but in infants the rate may be as high as 120 beats, and in children about 90 beats, per minute. Each heartbeat is stimulated by an electrical impulse that originates in a small strip of heart tissue known as the sinoatrial (S-A) node, or pacemaker.

Advances in Cardiology

One of the important advances in cardiology is the artificial pacemaker used to electrically initiate a normal heartbeat when the patient's own pacemaker is defective (see arrhythmia); it may be surgically implanted in the patient's body. Similarly, an internal defibrillator may be implanted to deliver an electrical shock to the heart in order to stop certain forms of rapid heart rhythm disturbances. Another familiar tool of the cardiologist is the electrocardiograph (EKG), which is used to detect abnormalities that are not evident from a physical examination (see electrocardiography).

One of the most important advances in heart surgery during the 1960s was the transplantation of the healthy heart immediately after the death of an individual (the donor) to a recipient suffering from incurable heart disease (see transplantation, medical). In the 1980s new advances in the design and construction of an artificial heart—both the entire organ and such parts as the valves and large blood vessels—showed some promise in treating cardiovascular disease (see heart, artificial), but the limited success that has characterized artificial heart implantation thus far has led many experts to question the efficacy of such measures. Although the artificial heart has often been used as a temporary measure until a permanent human donor heart can be located, a number of recipients have not fared well, even for a limited duration. In addition, it is often unclear how long the recipient will have to wait for a donor. Proponents of the artificial heart hope that technological advances will allow the permanent replacement of human hearts with artificial ones.

See circulatory system; heart disease.

The Columbia Encyclopedia, Sixth Edition Copyright© 2004, Columbia University Press. Licensed from Lernout & Hauspie Speech Products N.V. All rights reserved.

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