Dr. Vincent Figueredo
Appearances
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
People who are at risk should be on low dose aspirin. And those are people who have evidence of coronary artery disease, have had events such as a heart attack or unstable angina that led to a stent being placed in or bypass surgery. Someone with a lot of risk factors, a smoker with diabetes and high cholesterol, I would recommend that they be on a baby aspirin.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
But in general, we don't recommend it for healthy people without a lot of risk factors or evidence of coronary artery disease.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Well, the good part is the aspirin keeps the blood from clotting, keeps the platelets from causing a blood clot. When a person has cholesterol plaque buildup in their coronary arteries, those plaques can crack open. And when they do, the platelets attack because it's a rupture, it's an opening, and they want to prevent it from opening further. And
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
That leads to a blood clot and aspirin prevents that from happening. The downside is aspirin can irritate the lining of the stomach and can result in GI bleeds.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
We used to say that in the past. More recent studies have suggested that the risk can outweigh the benefit in people who do not have high risk for heart disease.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Yes, people can die from a broken heart. There's two examples of that. One is... something that we call broken heart syndrome. It's also called stress-induced cardiomyopathy. What happens is there's a sudden overwhelming event and an emotional event. Say you see your child playing soccer and they are hit and they're unconscious or you see someone get hit by a car or
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
You're informed that your sister died, and this sudden emotional event causes a huge surge in epinephrine or adrenaline in your body, and it can actually damage the bottom of the heart and induce what looks like a heart attack, even though the person's coronary arteries are perfectly fine. We call this broken heart syndrome. People do die from it. I'll tell you another example.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
If your soccer team loses a penalty shootout in the World Cup final or in the Super Bowl, your team loses on a last second pass. A lot of those people can develop broken heart syndrome or stress induced cardiomyopathy. Fortunately, most of them recover, but some do die. The second example is more chronic.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
A good example is the couple, the 85-year-old couple that's been married since they were 16 years old, and one of them passes away. It's amazing how most of the spouses of those people pass away within the year. And it's probably due to the depression and the sadness of missing that lifelong partner. And we typically see those people go into hospice within months after the other has passed away.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And then they pass on as well.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
It's advancing rapidly. At the beginning of the 20th century, we finally figured out what a heart attack was, but the only treatment was morphine, bedrest, and a priest. By the end of the 20th century, we're doing bypass surgeries, coronary stents, pacemakers. We can now repair and insert new heart valves with a catheter instead of open heart surgery.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
We're implanting artificial heart assist devices in people with broken hearts to bridge them to transplant or to allow their heart to heal. We're replacing broken hearts with a completely artificial robotic heart. We have one person who's lived over seven years with an artificial heart. Soon, we're going to be doing xenotransplantations.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
That's transplanting the heart of another animal into a human Many animal hearts have been tried, probably the most likely, and it makes me laugh, is the pig heart is most closely associated with the human heart. And in fact, a recent recipient lived several months with a gene modified pig heart.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
So given the shortage of human donor hearts around the world, I can see in 10 years, xenotransplantation occurring. We're now starting to grow heart muscle to replace lost heart cells. We're not salamanders. We can't reproduce heart cells in our body. But with stem cell studies, we're learning how to rebuild lost heart muscle. Maybe someday we'll be able to rebuild a whole heart.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
We're developing vaccines to prevent future heart disease, looking at people's genetic makeup and determining whether they should get that vaccine early in life. We're using 3D printing to create, for instance, a perfect heart valve match to a patient. Someday maybe we'll do a 3D printing of an actual whole heart to replace someone's broken heart.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Actually holding a heart in my hand, it felt like a super strong tennis ball. This is not a floppy organ. This thing is solid. And when you're holding a beating heart in your hand, the strength that you feel is just mind-boggling.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Well, you know, if you go back to millennia ago, ancient ancestors, for them, they understood that that beating heart meant life. It would beat faster with fear and love. And when someone died, it would beat no more and the body would cool. So they thought, well, this beating organ in the middle of our body, it's our heat, it's our furnace, it's what supplies our heat.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And it must be where our emotions are. Because if we're angry or scared or if we're in love or excited our heart responds to us and so that must be where our emotions are and and where our being or our soul is and and that would that held true for you know millennia right up until the renaissance
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Yeah. Basically, since the Renaissance, you're right. We just view the heart physiologically as a blood pump and nothing more. And yet metaphorically, we continue to use it when we talk about our emotions, our love, our memory. It's interesting, you know, think about the grandmother sees her grandchild running to her. Where does she cross her arms over her heart?
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Where do you point to on your body when you say me? You point to your chest. When we're on emails and doing texting, we use heart emojis. There's 41 heart emojis. There's only one brain emoji. When we're on Instagram or X, if we like something, we push the heart. If we're at the restaurant, we look for the heart symbol for heart-healthy food. So the symbolic heart is pervasive in our society.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And, you know, if you ask people, you know, where is your love of family and your love of God, they're going to say in their heart. And yet if you ask them, what does the heart do, they say it just pumps blood.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And in fact, there's a term for that. It's called interoception. And that's feeling things within your body. And the most common one would be the heartbeat. And that can have positive ramifications and negative ramifications. When people feel irregular rhythms in their body, it induces panic attacks and anxiety. But when they feel that nice, harmonious, regular, coherent beat, it calms them.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And the heart actually sends signals to the brain to calm yourself.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
It's a spectacular pump. It has special muscle cells that besides being able to conduct an electrical signal are spread out in three different orientations. So they're horizontal, vertical, and at an angle. And so when a heart pumps, it's not like a balloon deflating. It's more like you're twisting a wet rag to get all of the fluid out of it.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And what's amazing is it's pumping one and a half gallons every minute. over 2,000 gallons every day, and over 58 million gallons over regular life. And that's equivalent to turning on a kitchen sink full blast for 45 years.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
So a couple fascinating things about the heart that I've learned over the years was, one, actually holding things. a heart in my hand uh it felt like a super strong tennis ball this is not a floppy organ this thing is solid and and when you're holding a beating heart in your hand the the this the strength that you feel is just mind boggling.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
A heart in an athlete can increase seven times its baseline output. So if the heart is beating one and a half gallons a minute, a sprinter could increase that seven times to get blood to the muscles, for instance, in the legs.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
It depends on how much time takes place. So if a heart stops within a minute, you have a very good chance of getting that heart going again. But the longer it takes before someone tries to start it, the more likely it will not come back. And that's
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Again, not getting into the science, but electrolyte shifts within the membranes of the heart that just won't allow you to start the heart beating again.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
It means that the heart pump is not functioning normally. And there's generally two types of heart failure. One is a poor pump. So the pump is no longer working well. That's systolic heart failure. Or the pump has become too stiff. and can't relax, that's called diastolic heart failure. Both are dangerous, both need to be treated or people will not survive. Sometimes they can be temporary.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
It could be due to an infection or some toxic substance and we can reverse a lot of those. Sometimes it's due to coronary artery disease with poor blood flow and after say bypass surgery, we can get some return of heart function. But basically it's heart failure means the pump is not working. The result is fluid accumulates in the body, in the lungs, in the legs, in the belly.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
And if that progresses, eventually a person won't survive.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Unfortunately, yes, it is. Heart disease has basically been the number one killer, especially in the U.S., since pretty much 1900, with the exception of the years of the Spanish flu. And it really peaked around the 1950s and 60s when everybody was smoking with education, treatment of blood pressure, cholesterol.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
and a decrease in prevalence of smoking, heart disease has gone down, yet it still remains the number one killer worldwide of both men and women. When someone has a heart attack or begins to have a heart attack, up to half of them can experience sudden death, and that can happen long before a person reaches the emergency room. So obviously, the point is, let's not get to that point.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Let's not have the heart attack. Let's prevent it.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
No, Bob probably hasn't been fine since he was a teenager. If you look at autopsy studies of, for instance, young soldiers during the Vietnam and Korean wars, it's remarkable how much coronary artery disease cholesterol plaque they have already built up.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
This starts with just these cholesterol fatty streaks as early as our teens and continues to build through our life such that there's cholesterol plaque buildup and calcification of our coronary arteries by the time, you know, Bob is 60 years old.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
On top of that, you have other risk factors such as high blood pressure known as the silent killer because you don't feel it until it causes you to have a heart attack or stroke. And high cholesterol. A lot of people go through life not going to the doctor and not having these things treated. And so, you know, it really isn't a surprise that Bob suddenly fell dead yesterday.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
Yes, it is. Family history is extremely important. We generally ask about first degree relatives, mother, father, sister, brother, whether the men had heart disease before 55 or the women had heart disease before 65. And if they weren't smokers and they did have heart events, then that definitely needs to be taken into account when we risk stratify patients.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
So we'll be more attentive to their cholesterol levels, their blood pressure levels. We can now order tests like a coronary calcium score, which is a quick CAT scan, to see if they already do have cholesterol buildup in their arteries that they weren't aware of, and then we would treat them more vigorously.
Something You Should Know
The Amazing Things Your Heart Does & The Power You Have to Change Lives
no there are um people in their 90s and hundreds whose coronary arteries are completely clean really we always say good good family genes but yeah there there there are people uh that uh go into their 60s 70s 80s 90s hundreds without significant coronary artery disease generally those people led a very healthy life and they had a good family history