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单词 with all one's heart
释义

with all one's heart


Translations

heart

(haːt) noun1. the organ which pumps blood through the body. How fast does a person's heart beat?; (also adjective) heart disease; a heart specialist. 心臟 心脏2. the central part. I live in the heart of the city; in the heart of the forest; the heart of a lettuce; Let's get straight to the heart of the matter/problem. 中心 中心3. the part of the body where one's feelings, especially of love, conscience etc are imagined to arise. She has a kind heart; You know in your heart that you ought to go; She has no heart (= She is not kind). 心腸 心肠4. courage and enthusiasm. The soldiers were beginning to lose heart. 勇氣與熱誠 勇气5. a symbol supposed to represent the shape of the heart; a white dress with little pink hearts on it; heart-shaped. 心形 心形的东西6. one of the playing-cards of the suit hearts, which have red symbols of this shape on them. (撲克牌)紅心 (纸牌)红桃 -heartedkind-hearted; hard-hearted; broken-hearted. .有..心的(如:好心的、無情的、傷心的) 有...心(肠)的 ˈhearten verb to encourage or cheer up. We were greatly heartened by the good news. 鼓勵,振奮 鼓励ˈheartless adjective cruel; very unkind. a heartless remark. 冷酷的,無情的 无情的ˈheartlessly adverb 冷酷地 冷酷地ˈheartlessness noun 冷酷 冷酷hearts noun plural (sometimes treated as noun singular) one of the four card suits. the two of hearts. 紅心(撲克牌四種花色之一) 一组红桃样的纸牌ˈhearty adjective1. very friendly. a hearty welcome. 親切的 衷心的2. enthusiastic. a hearty cheer. 熱誠的 热诚的3. very cheerful; too cheerful. a hearty person/laugh. 開心的,歡喜無比的 热烈的4. (of meals) large. He ate a hearty breakfast. 豐盛的 丰盛的5. (of a person's appetite) large. 胃口好的 胃口好的ˈheartily adverb 由衷地 衷心地,热心地 ˈheartiness noun 熱誠、開心 诚实,热心,衷心 ˈheartache noun (a feeling of) great sadness. 痛心 痛心heart attack a sudden failure of the heart to function correctly, sometimes causing death. My father has had a slight heart attack. 心臟病發作 心脏病发作ˈheartbeat noun (the sound of) the regular movement of the heart. 心跳 心跳,心搏 ˈheartbreak noun (something which causes) great sorrow. I have suffered many heartbreaks in my life. 心碎,難忍的悲傷 心碎,极度伤心,伤心事 ˈheartbroken adjective feeling very great sorrow. a heartbroken widow. 令人心碎的 极度伤心的ˈheartburn noun a burning feeling in the chest caused by indigestion. She suffers from heartburn after meals. 心口灼痛 胃灼热heart failure the sudden stopping of the heart's beating. the old man died of heart failure. 心臟衰竭 心力衰竭ˈheartfelt adjective sincere. heartfelt thanks. 衷心的 衷心的ˌheart-to-ˈheart adjective open and sincere, usually in private. I'm going to have a heart-to-heart talk with him. 開誠佈公的 率直的,贴心的 noun an open and sincere talk, usually in private. After our heart-to-heart I felt more cheerful. 開誠佈公的對話 交心,坦率的对话 ˈheart-warming adjective causing a person to feel pleasure. It was heart-warming to see the happiness of the children. 溫暖人心的,溫馨感人的 暖人心房的at heart really; basically. He seems rather stern but he is at heart a very kind man. 事實上,基本上 基本上break someone's heart to cause someone great sorrow. If you leave her, it'll break her heart. 讓人心碎,傷透人心 使心碎by heart from memory; by memorizing. The children know their multiplication tables by heart; Actors must learn their speeches (off) by heart. 憑記憶 依靠记忆的from the bottom of one's heart very sincerely. She thanked him from the bottom of her heart. 由衷地 衷心地have a change of heart to change a decision etc, usually to a better, kinder one. He's had a change of heart – he's going to help us after all. 改變主意(通常改成較好) 改变主意have a heart! show some pity!. 發發慈悲! 发发慈悲!have at heart to have a concern for or interest in. He has the interest of his workers at heart. 對...關心或,感興趣 在内心里对...关心或感兴趣heart and soul with all one's attention and energy. She devoted herself heart and soul to caring for her husband. 全心全意 全心全意lose heart to become discouraged. 喪失勇氣 丧失勇气not have the heart to not to want or be unkind enough to (do something unpleasant). I don't have the heart to tell him that everyone laughed at his suggestions. 不忍心 不忍心set one's heart on / have one's heart set on to want very much. He had set his heart on winning the prize; He had his heart set on winning. 極想要 下决心做某事take heart to become encouraged or more confident. 鼓起勇氣或信心 鼓起勇气take to heart1. to be made very sad or upset by. You mustn't take his unkind remarks to heart. 因...感到難過或不快 为…伤心,为某事耿耿于怀 2. to pay attention to. He's taken my criticism to heart – his work has improved. 把...聽進去 认真对待to one's heart's content as much as one wants. She could play in the big garden to her heart's content. 隨心所欲地 随心所欲地with all one's heart very willingly or sincerely. I hope with all my heart that you will be happy. 心甘情願地,由衷地 全心全意地,十分愿意地

with all one's heart


with all (one's) heart

With one's sincerest feelings. I will love you with all my heart until the day we die. I just wanted to tell you, with all my heart, how proud I am of you.See also: all, heart

with all one's heart

With great willingness or pleasure; also, with the deepest feeling or devotion. For example, I wish you well with all my heart. [Late 1400s] See also: all, heart
EncyclopediaSeeheartMedicalSeeSTRUCTURES OF THE HEART: (A) anterior view of the heart (B) frontal section of the heartSTRUCTURES OF THE HEART: (A) anterior view of the heart (B) frontal section of the heartA hollow, muscular organ, the pump of the circulatory system. Its wall has three layers: the outer epicardium, a serous membrane; the middle myocardium, made of cardiac muscle; and the inner endocardium, endothelium that lines the chambers and covers the valves. The heart is enclosed in the pericardium, a fibroserous sac; the potential space between the parietal pericardium and the epicardium is called the pericardial cavity, which contains serous fluid to prevent friction as the heart beats. See: illustration; circulation, coronary for illus.; cardiomyopathy, hypertrophic

Chambers

The upper right and left atria are thin-walled receiving chambers separated by the interatrial septum. The lower right and left ventricles are thick-walled pumping chambers separated by the interventricular septum; normally the right side has no communication with the left. The right side receives deoxygenated blood via the venae cavae from the body and pumps it to the lungs; the left side receives oxygenated blood from the lungs and pumps it via the aorta and arteries to the body. Contraction of the heart chambers is called systole; relaxation with accompanying filling with blood is called diastole. The sequence of events that occurs in a single heartbeat is called the cardiac cycle, with atrial systole followed by ventricular systole. For a heart rate of 70 beats per minute, each cycle lasts about 0.85 sec.

Valves

In the healthy state, all four cardiac valves prevent backflow of blood. The atrioventricular valves are at the openings between each atrium and ventricle; the tricuspid valve, between the right atrium and ventricle; and the bicuspid or mitral valve, between the left atrium and ventricle. The pulmonary semilunar valve is at the opening of the right ventricle into the pulmonary artery; the aortic semilunar valve is at the opening of the left ventricle into the aorta.

Function

In adults, the cardiac output varies from 5 L/min at rest to as much as 20 L/min during vigorous exercise. At the rate of 72 times each minute, the adult human heart beats 104,000 times a day, 38,000,000 times a year. Every stroke forces approx. 5 cu in (82 ml) of blood out into the body, amounting to 500,000 cu in (8193 L) a day. In terms of work, this is the equivalent of raising 1 ton (907 kg) to a height of 41 ft (12.5 m) every 24 hr.

Blood Supply

The myocardium receives its blood supply from the coronary arteries that arise from the ascending aorta. Blood from the myocardium drains into several cardiac veins.

Nerve Supply

The heart initiates its own beat, usually from 60 to 80 beats per minute, but the rate may be changed by impulses from the cardiac centers in the medulla oblongata. Accelerator impulses are carried by sympathetic nerves. Preganglionic neurons in the thoracic spinal cord synapse with postganglionic neurons in the cervical ganglia of the sympathetic trunk; their axons continue to the heart. Sympathetic impulses are transmitted to the sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, and myocardium of the ventricles and increase heart rate and force of contraction. Inhibitory impulses are carried by the vagus nerves (parasympathetic). Preganglionic neurons (vagus) originating in the medulla synapse with postganglionic neurons in terminal ganglia in the wall of the heart. Parasympathetic impulses are transmitted to the SA and AV nodes and decrease the heart rate. Sensory nerves from the heart serve for the sensation of pain, which is caused by an insufficient supply of oxygen to the myocardium. The vagus and glossopharyngeal are the sensory nerves for reflex changes in heart rate. These nerves arise from pressoreceptors or chemoreceptors in the aortic arch and carotid sinus, respectively.

Auscultation

Listening to the heart with a stethoscope reveals the intensity, quality, and rhythm of the heart sounds and detects any adventitious sounds (e.g., murmurs or pericardial friction). The two separate sounds heard by the use of a stethoscope over the heart have been represented by the syllables “lubb, ” “dupp.” The first sound (systolic), which is prolonged and dull, results from the contraction of the ventricle, tension of the atrioventricular valves, and the impact of the heart against the chest wall and is synchronous with the apex beat and carotid pulse. The first sound is followed by a short pause, and then the second sound (diastolic) is heard, resulting from the closure of the aortic and pulmonary valves. This sound is short and high pitched. After the second sound there is a longer pause before the first is heard again. A very useful technique for listening to the variation in sounds between one area and another is to move the stethoscope in small steps from site to site.

Procedure

The patient should be recumbent when the examination begins. After all possible signs have been elicited, the examination should be repeated with the patient sitting, standing, or leaning forward, and any variations from this change of position should be noted. Auscultation is performed first while the patient is breathing naturally, next while he holds the breath in both deep inspiration and expiration, and finally while the patient takes three or four forced inspirations. By listening over the entire thoracic cavity, the examiner should try to localize the points at which heart sounds, both normal and abnormal, are heard with the greatest intensity. The examination should proceed from below upward and from left to right.

The normal location of valves should be noted for auscultation. The aortic valve is in the third intercostal space, close to the left side of the sternum; the pulmonary valve is in front of the aorta, behind the junction of the third costal cartilage with the sternum, on the left side. The tricuspid valve is located behind the middle of the sternum about the level of the fourth costal cartilage. Finally, the mitral valve is behind the third intercostal space about 1 in (2.5 cm) to the left of the sternum.

Both heart sounds either are heard better or are actually accentuated in increased heart action from any cause, normal or abnormal (e.g., anemia, vigorous exercise, cardiac hypertrophy, thin chest walls, and lung consolidation as found in pneumonia). Accentuation of the aortic second sound results from hypertrophy of the left ventricle, increased arterial resistance (as in arteriosclerosis with hypertension), or aortic aneurysm. Accentuation of the pulmonary second sound results from pulmonary obstruction (as in emphysema, pneumonia, or hypertrophy of the right ventricle). Both heart sounds are poorly heard or are actually decreased in intensity in general obesity, general debility, degeneration or dilatation of the heart, pericardial or pleural effusion, and emphysema.

The reduplication of heart sounds is probably due to a lack of synchronous action in the valves of both sides of the heart. It results from many conditions but notably from increased resistance in the systemic or the pulmonary circulation (as in arteriosclerosis and emphysema). It is also frequently noted in mitral stenosis and pericarditis.

A murmur (an abnormal sound heard over the heart or blood vessels) may result from obstruction or regurgitation at the valves following endocarditis; dilatation of the ventricle or relaxation of its walls rendering the valves relatively insufficient; aneurysm; a change in the blood constituents (as in anemia); roughening of the pericardial surfaces (as in pericarditis); and irregular action of the heart. Murmurs produced within the heart are called endocardial; those outside, exocardial; those produced in aneurysms, bruits; those produced by anemia, hemic murmurs.

Hemic murmurs, which are soft and blowing and usually systolic, are heard best over the pulmonary valves. They are associated with symptoms of anemia.

An aneurysmal murmur (bruit) is usually loud and booming, systolic, and heard best over the aorta or base of the heart. It is often associated with an abnormal area of dullness and pulsation and with symptoms resulting from pressure on neighboring structures.

Pericardial friction sounds are superficial, rough, and creaking, to and fro in tempo, and not transmitted beyond the precordium. These sounds may be modified by the pressure of the stethoscope.

Murmur intensity and configuration: The intensity (loudness) of murmurs may be graded from I to VI as follows: (1) Grade I–faint, audible only with intense listening in a quiet environment; (2) Grade II–quiet but immediately audible; (3) Grade III–moderately loud; (4) Grade IV–quite loud; a thrill (like the purring of a cat) usually felt over the heart; (5) Grade V–loud enough to be heard with the stethoscope not completely in contact with the chest wall; and (6) Grade VI–loud enough to be heard with the stethoscope close to but not actually touching the chest.

The configuration of sound intensity of a murmur may begin low and rise in intensity (crescendo) or be relatively loud and then decrease in intensity (decrescendo) or some combination of those features or may exhibit the same intensity from beginning to end.

Palpation

This process not only determines position, force, extent, and rhythm of the apex beat but also detects any fremitus or thrill. A thrill is a vibratory sensation like that when the hand is placed on the back of a purring cat. Thrills at the base of the heart may result from valvular lesions, atheroma of the aorta, aneurysm, and roughened pericardial surfaces (as in pericarditis). A presystolic thrill at the apex is almost pathognomonic of mitral stenosis. In children especially, a precordial bulge, substernal thrust, or apical heave suggests cardiac enlargement.

Percussion

This procedure determines the shape and extent of cardiac dullness. The normal area of superficial or absolute percussion dullness (the part uncovered by the lung) is detected by light percussion and extends from the fourth left costosternal junction to the apex beat; from the apex beat to the juncture of the xiphoid cartilage with the sternum; and thence up the left border of the sternum. The normal area of deep percussion dullness (the heart projected on the chest wall) is detected by firm percussion and extends from the third left costosternal articulation to the apex beat; from the apex beat to the junction of the xiphoid cartilage with the sternum; and thence up the right border of sternum to the third rib. The lower level of cardiac dullness fuses with the liver dullness and can rarely be determined. The area of cardiac dullness is increased in hypertrophy and dilation of the heart and in pericardial effusion; it is diminished in emphysema, pneumothorax, and pneumocardium.

abdominal heart

A heart displaced into the abdominal cavity.

armored heart

An obsolete term for calcific pericarditis.

artificial heart

A mechanical device that pumps blood to augment or replace a failing heart. It may be located inside the body (intracorporeally) or outside it (extracorporeally). See: heart-lung machine

athlete's heart

Enlargement of the heart (cardiomegaly), with slowing of the heart rate (bradycardia) as a result of prolonged physical training, e.g., the aerobic exercise of running. This is not known to be a predisposing factor for any form of heart disease. Synonym: athletic bradycardia.

beriberi heart

Heart failure caused by thiamine (vitamin B1) deficiency (e.g., in patients with chronic alcoholism or malnutrition).

boatshaped heart

A heart in which one ventricle is dilated and hypertrophied as a result of aortic regurgitation.

bony heart

A heart with calcified patches in its walls and pericardium (e.g., in patients with hyperparathyroidism).

cervical heart

A heart displaced into the neck.

fibroid heart

An obsolete term for scarring of the myocardium (e.g., after myocardial infarction).

irritable heart

An obsolete term for neurocirculatory asthenia or effort syndrome, characterized by breathlessness, palpitation, weakness, and exhaustion.

left heart

The left atrium and ventricle. The left atrium receives oxygenated blood from the lungs; the left ventricle pumps this blood into the systemic circulation.

right heart

The right atrium and ventricle. The right atrium receives deoxygenated blood from the body; the right ventricle pumps this blood to the lungs.

soldier's heart

An obsolete term for panic attack.

heart

The twin-sided, four-chambered controlled muscular pump that, by means of regular rhythmical tightening (contractions) of the chambers and the action of valves, maintains the twin circulations of blood to the lungs and to the rest of the body. The right side of the heart pumps blood through the lungs and back to the left side. The left side pumps the blood returning from the lungs through all parts of the body and back to the right side.
HeartFig. 189 Heart . Nerve centres in the mammalian heart.

heart

the muscular pump of the BLOOD CIRCULATORY SYSTEM. In those invertebrates that possess a heart (e.g. ARTHROPODS, ANNELIDS, MOLLUSCS, ECHINODERMS) the heart is composed of several chambers and lies dorsal to the gut. In vertebrates the heart is made of special CARDIAC MUSCLE and lies in a ventral position surrounded by the PERICARDIUM. The five classes of vertebrates show an increasing complexity of structure, from the simple S-shaped heart with one ATRIUM and one VENTRICLE (2) found in fish, through the amphibians and most reptiles where the heart is divided into two atria but retains a single ventricle, and on to the birds and mammals where the heart shows complex separation into two sides with two atria and two ventricles. The main features of the human heart are:
  1. the right side pumps blood around the pulmonary (lung) circulation for oxygenation, the left side pumping blood around the systemic (body) circulation where it becomes deoxygenated.
  2. blood from the body enters the right atrium via the superior vena cava (upper body) and inferior vena cava (lower body). A coronary sinus also drains into the right atrium bringing blood from the heart itself. The right atrium squeezes blood through the atrioventricular (AV) opening into the muscular right ventricle. finally, blood is ejected into the single opening of the pulmonary artery which splits to go to the two lungs.
  3. blood enters the left atrium from four pulmonary veins and passes through the left AV opening into the left ventricle. This has a much thicker wall than the right ventricle, reflecting its requirement for greater power. Blood leaves the left ventricle by one great vessel, the AORTA, which supplies all parts of the body, including the heart.
  4. flow of blood through the heart is in one direction only, due to the presence of various valves. Back-flow from ventricles to atria is prevented by AV valves, the tricuspid valve on the right side with three flaps, and the BICUSPID (3) valve on the left side with two flaps, both valves held in place by cords of connective tissue, the ‘chordae tendinae’. Back-flow from arteries to the ventricles is prevented by semilunar valves.
  5. various nerve areas connected with contraction are located in the heart (see HEART, CARDIAC CYCLE): (i) the sinoatrial node (SAN) or ‘pacemaker’ located in the wall of the right atrium near the entry of the venae cavae; (ii) the atrioventricular node (AVN) at the junction of all four heart chambers; (iii) the atrioventricular bundle, or bundle of His, running down the interventricular septum from the AVN; and (iv) a network of Purkinje tissue and other fibres spreading out from the bundle of His across the walls of both ventricles. See Fig. 189 .

Other nerve areas are situated in or near the heart: (i) baroreceptors in the walls of the heart, in the aortic arch, the carotid sinus, venae cavae and pulmonary veins where they enter the atria. Such sensory receptors are stimulated by stretching of the structure in which they are found, resulting in a decrease in blood pressure. (ii) chemoreceptors sensitive to blood CO2 levels are found in the AORTIC BODY and CAROTID BODY.

heart

(hahrt) [TA] Hollow muscular organ that receives blood from veins and propels it into the arteries. In mammals, divided by a musculomembranous septum into two halves-right or venous and left or arterial-each of which consists of a receiving chamber (atrium) and an ejecting chamber (ventricle). [A.S. heorte]

Patient discussion about heart

Q. how does it feel to heart promblems answer to my question then talk to meA. Heart problems may manifest as sensation of the heartbeats (called palpitations, as with rhythm problems), chest pain (usually a feeling of tightness or pressure in the chest rather than frank pain), or difficulty breathing (called dyspnea).
Other manifestations may include fainting (called syncope) either spontaneously or after exercise, edema (swelling) of the legs and various other non specific complaints.
The manifestations depend, of course, on the specific disease and the various characteristics of the patient (age, sex etc.)
You may read more here:
www.nlm.nih.gov/medlineplus/heartdiseases.html

Q. What happens to my heart when I exercise? My senior told me that exercise is good for health and especially for heart. What happens to my heart when I exercise? A. the heart is a muscle that constructs and pump blood through our body. like any muscle it can get bigger and stronger. doing exercise is putting pressure on the heart and the heart start to react by growing.

Q. Is garlic helpful in heart ailments? I have heard that garlic is very good for cardiac health and using in curries or cooked with foods will be helpful. I have also heard that it has anti-inflammatory substances and also helps in weight loss. Is garlic helpful in heart ailments?A. It acts as antioxidant and reduces the amount of free radicals in your body. It’s helpful once taken raw. But the raw garlic can cause bad breadth and blistering of skin and diarrhea. So, there should be a reduced intake of raw garlic. It’s better to have garlic in a cooked up form like in curries or with vegetables. This will also give the desired benefits of garlic and the side effect of over consumption of garlic will also be reduced.
http://www.youtube.com/watch?v=_jOrw1eB-uc&eurl=http://www.imedix.com/health_community/vng-A24JmWJY_iceland_heart_protection_formula?q=heart&feature=player_embedded

More discussions about heart
">heart of the heart" href="javascript:eml2('davisTab', 'h09.jpg')">STRUCTURES OF THE HEART: (A) anterior view of the heart (B) frontal section of the heartSTRUCTURES OF THE HEART: (A) anterior view of the heart (B) frontal section of the heartA hollow, muscular organ, the pump of the circulatory system. Its wall has three layers: the outer epicardium, a serous membrane; the middle myocardium, made of cardiac muscle; and the inner endocardium, endothelium that lines the chambers and covers the valves. The heart is enclosed in the pericardium, a fibroserous sac; the potential space between the parietal pericardium and the epicardium is called the pericardial cavity, which contains serous fluid to prevent friction as the heart beats. See: illustration; circulation, coronary for illus.; cardiomyopathy, hypertrophic

Chambers

The upper right and left atria are thin-walled receiving chambers separated by the interatrial septum. The lower right and left ventricles are thick-walled pumping chambers separated by the interventricular septum; normally the right side has no communication with the left. The right side receives deoxygenated blood via the venae cavae from the body and pumps it to the lungs; the left side receives oxygenated blood from the lungs and pumps it via the aorta and arteries to the body. Contraction of the heart chambers is called systole; relaxation with accompanying filling with blood is called diastole. The sequence of events that occurs in a single heartbeat is called the cardiac cycle, with atrial systole followed by ventricular systole. For a heart rate of 70 beats per minute, each cycle lasts about 0.85 sec.

Valves

In the healthy state, all four cardiac valves prevent backflow of blood. The atrioventricular valves are at the openings between each atrium and ventricle; the tricuspid valve, between the right atrium and ventricle; and the bicuspid or mitral valve, between the left atrium and ventricle. The pulmonary semilunar valve is at the opening of the right ventricle into the pulmonary artery; the aortic semilunar valve is at the opening of the left ventricle into the aorta.

Function

In adults, the cardiac output varies from 5 L/min at rest to as much as 20 L/min during vigorous exercise. At the rate of 72 times each minute, the adult human heart beats 104,000 times a day, 38,000,000 times a year. Every stroke forces approx. 5 cu in (82 ml) of blood out into the body, amounting to 500,000 cu in (8193 L) a day. In terms of work, this is the equivalent of raising 1 ton (907 kg) to a height of 41 ft (12.5 m) every 24 hr.

Blood Supply

The myocardium receives its blood supply from the coronary arteries that arise from the ascending aorta. Blood from the myocardium drains into several cardiac veins.

Nerve Supply

The heart initiates its own beat, usually from 60 to 80 beats per minute, but the rate may be changed by impulses from the cardiac centers in the medulla oblongata. Accelerator impulses are carried by sympathetic nerves. Preganglionic neurons in the thoracic spinal cord synapse with postganglionic neurons in the cervical ganglia of the sympathetic trunk; their axons continue to the heart. Sympathetic impulses are transmitted to the sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, and myocardium of the ventricles and increase heart rate and force of contraction. Inhibitory impulses are carried by the vagus nerves (parasympathetic). Preganglionic neurons (vagus) originating in the medulla synapse with postganglionic neurons in terminal ganglia in the wall of the heart. Parasympathetic impulses are transmitted to the SA and AV nodes and decrease the heart rate. Sensory nerves from the heart serve for the sensation of pain, which is caused by an insufficient supply of oxygen to the myocardium. The vagus and glossopharyngeal are the sensory nerves for reflex changes in heart rate. These nerves arise from pressoreceptors or chemoreceptors in the aortic arch and carotid sinus, respectively.

Auscultation

Listening to the heart with a stethoscope reveals the intensity, quality, and rhythm of the heart sounds and detects any adventitious sounds (e.g., murmurs or pericardial friction). The two separate sounds heard by the use of a stethoscope over the heart have been represented by the syllables “lubb, ” “dupp.” The first sound (systolic), which is prolonged and dull, results from the contraction of the ventricle, tension of the atrioventricular valves, and the impact of the heart against the chest wall and is synchronous with the apex beat and carotid pulse. The first sound is followed by a short pause, and then the second sound (diastolic) is heard, resulting from the closure of the aortic and pulmonary valves. This sound is short and high pitched. After the second sound there is a longer pause before the first is heard again. A very useful technique for listening to the variation in sounds between one area and another is to move the stethoscope in small steps from site to site.

Procedure

The patient should be recumbent when the examination begins. After all possible signs have been elicited, the examination should be repeated with the patient sitting, standing, or leaning forward, and any variations from this change of position should be noted. Auscultation is performed first while the patient is breathing naturally, next while he holds the breath in both deep inspiration and expiration, and finally while the patient takes three or four forced inspirations. By listening over the entire thoracic cavity, the examiner should try to localize the points at which heart sounds, both normal and abnormal, are heard with the greatest intensity. The examination should proceed from below upward and from left to right.

The normal location of valves should be noted for auscultation. The aortic valve is in the third intercostal space, close to the left side of the sternum; the pulmonary valve is in front of the aorta, behind the junction of the third costal cartilage with the sternum, on the left side. The tricuspid valve is located behind the middle of the sternum about the level of the fourth costal cartilage. Finally, the mitral valve is behind the third intercostal space about 1 in (2.5 cm) to the left of the sternum.

Both heart sounds either are heard better or are actually accentuated in increased heart action from any cause, normal or abnormal (e.g., anemia, vigorous exercise, cardiac hypertrophy, thin chest walls, and lung consolidation as found in pneumonia). Accentuation of the aortic second sound results from hypertrophy of the left ventricle, increased arterial resistance (as in arteriosclerosis with hypertension), or aortic aneurysm. Accentuation of the pulmonary second sound results from pulmonary obstruction (as in emphysema, pneumonia, or hypertrophy of the right ventricle). Both heart sounds are poorly heard or are actually decreased in intensity in general obesity, general debility, degeneration or dilatation of the heart, pericardial or pleural effusion, and emphysema.

The reduplication of heart sounds is probably due to a lack of synchronous action in the valves of both sides of the heart. It results from many conditions but notably from increased resistance in the systemic or the pulmonary circulation (as in arteriosclerosis and emphysema). It is also frequently noted in mitral stenosis and pericarditis.

A murmur (an abnormal sound heard over the heart or blood vessels) may result from obstruction or regurgitation at the valves following endocarditis; dilatation of the ventricle or relaxation of its walls rendering the valves relatively insufficient; aneurysm; a change in the blood constituents (as in anemia); roughening of the pericardial surfaces (as in pericarditis); and irregular action of the heart. Murmurs produced within the heart are called endocardial; those outside, exocardial; those produced in aneurysms, bruits; those produced by anemia, hemic murmurs.

Hemic murmurs, which are soft and blowing and usually systolic, are heard best over the pulmonary valves. They are associated with symptoms of anemia.

An aneurysmal murmur (bruit) is usually loud and booming, systolic, and heard best over the aorta or base of the heart. It is often associated with an abnormal area of dullness and pulsation and with symptoms resulting from pressure on neighboring structures.

Pericardial friction sounds are superficial, rough, and creaking, to and fro in tempo, and not transmitted beyond the precordium. These sounds may be modified by the pressure of the stethoscope.

Murmur intensity and configuration: The intensity (loudness) of murmurs may be graded from I to VI as follows: (1) Grade I–faint, audible only with intense listening in a quiet environment; (2) Grade II–quiet but immediately audible; (3) Grade III–moderately loud; (4) Grade IV–quite loud; a thrill (like the purring of a cat) usually felt over the heart; (5) Grade V–loud enough to be heard with the stethoscope not completely in contact with the chest wall; and (6) Grade VI–loud enough to be heard with the stethoscope close to but not actually touching the chest.

The configuration of sound intensity of a murmur may begin low and rise in intensity (crescendo) or be relatively loud and then decrease in intensity (decrescendo) or some combination of those features or may exhibit the same intensity from beginning to end.

Palpation

This process not only determines position, force, extent, and rhythm of the apex beat but also detects any fremitus or thrill. A thrill is a vibratory sensation like that when the hand is placed on the back of a purring cat. Thrills at the base of the heart may result from valvular lesions, atheroma of the aorta, aneurysm, and roughened pericardial surfaces (as in pericarditis). A presystolic thrill at the apex is almost pathognomonic of mitral stenosis. In children especially, a precordial bulge, substernal thrust, or apical heave suggests cardiac enlargement.

Percussion

This procedure determines the shape and extent of cardiac dullness. The normal area of superficial or absolute percussion dullness (the part uncovered by the lung) is detected by light percussion and extends from the fourth left costosternal junction to the apex beat; from the apex beat to the juncture of the xiphoid cartilage with the sternum; and thence up the left border of the sternum. The normal area of deep percussion dullness (the heart projected on the chest wall) is detected by firm percussion and extends from the third left costosternal articulation to the apex beat; from the apex beat to the junction of the xiphoid cartilage with the sternum; and thence up the right border of sternum to the third rib. The lower level of cardiac dullness fuses with the liver dullness and can rarely be determined. The area of cardiac dullness is increased in hypertrophy and dilation of the heart and in pericardial effusion; it is diminished in emphysema, pneumothorax, and pneumocardium.

abdominal heart

A heart displaced into the abdominal cavity.

armored heart

An obsolete term for calcific pericarditis.

artificial heart

A mechanical device that pumps blood to augment or replace a failing heart. It may be located inside the body (intracorporeally) or outside it (extracorporeally). See: heart-lung machine

athlete's heart

Enlargement of the heart (cardiomegaly), with slowing of the heart rate (bradycardia) as a result of prolonged physical training, e.g., the aerobic exercise of running. This is not known to be a predisposing factor for any form of heart disease. Synonym: athletic bradycardia.

beriberi heart

Heart failure caused by thiamine (vitamin B1) deficiency (e.g., in patients with chronic alcoholism or malnutrition).

boatshaped heart

A heart in which one ventricle is dilated and hypertrophied as a result of aortic regurgitation.

bony heart

A heart with calcified patches in its walls and pericardium (e.g., in patients with hyperparathyroidism).

cervical heart

A heart displaced into the neck.

fibroid heart

An obsolete term for scarring of the myocardium (e.g., after myocardial infarction).

irritable heart

An obsolete term for neurocirculatory asthenia or effort syndrome, characterized by breathlessness, palpitation, weakness, and exhaustion.

left heart

The left atrium and ventricle. The left atrium receives oxygenated blood from the lungs; the left ventricle pumps this blood into the systemic circulation.

right heart

The right atrium and ventricle. The right atrium receives deoxygenated blood from the body; the right ventricle pumps this blood to the lungs.

soldier's heart

An obsolete term for panic attack.

heart

The twin-sided, four-chambered controlled muscular pump that, by means of regular rhythmical tightening (contractions) of the chambers and the action of valves, maintains the twin circulations of blood to the lungs and to the rest of the body. The right side of the heart pumps blood through the lungs and back to the left side. The left side pumps the blood returning from the lungs through all parts of the body and back to the right side.
HeartFig. 189 Heart . Nerve centres in the mammalian heart.

heart

the muscular pump of the BLOOD CIRCULATORY SYSTEM. In those invertebrates that possess a heart (e.g. ARTHROPODS, ANNELIDS, MOLLUSCS, ECHINODERMS) the heart is composed of several chambers and lies dorsal to the gut. In vertebrates the heart is made of special CARDIAC MUSCLE and lies in a ventral position surrounded by the PERICARDIUM. The five classes of vertebrates show an increasing complexity of structure, from the simple S-shaped heart with one ATRIUM and one VENTRICLE (2) found in fish, through the amphibians and most reptiles where the heart is divided into two atria but retains a single ventricle, and on to the birds and mammals where the heart shows complex separation into two sides with two atria and two ventricles. The main features of the human heart are:
  1. the right side pumps blood around the pulmonary (lung) circulation for oxygenation, the left side pumping blood around the systemic (body) circulation where it becomes deoxygenated.
  2. blood from the body enters the right atrium via the superior vena cava (upper body) and inferior vena cava (lower body). A coronary sinus also drains into the right atrium bringing blood from the heart itself. The right atrium squeezes blood through the atrioventricular (AV) opening into the muscular right ventricle. finally, blood is ejected into the single opening of the pulmonary artery which splits to go to the two lungs.
  3. blood enters the left atrium from four pulmonary veins and passes through the left AV opening into the left ventricle. This has a much thicker wall than the right ventricle, reflecting its requirement for greater power. Blood leaves the left ventricle by one great vessel, the AORTA, which supplies all parts of the body, including the heart.
  4. flow of blood through the heart is in one direction only, due to the presence of various valves. Back-flow from ventricles to atria is prevented by AV valves, the tricuspid valve on the right side with three flaps, and the BICUSPID (3) valve on the left side with two flaps, both valves held in place by cords of connective tissue, the ‘chordae tendinae’. Back-flow from arteries to the ventricles is prevented by semilunar valves.
  5. various nerve areas connected with contraction are located in the heart (see HEART, CARDIAC CYCLE): (i) the sinoatrial node (SAN) or ‘pacemaker’ located in the wall of the right atrium near the entry of the venae cavae; (ii) the atrioventricular node (AVN) at the junction of all four heart chambers; (iii) the atrioventricular bundle, or bundle of His, running down the interventricular septum from the AVN; and (iv) a network of Purkinje tissue and other fibres spreading out from the bundle of His across the walls of both ventricles. See Fig. 189 .

Other nerve areas are situated in or near the heart: (i) baroreceptors in the walls of the heart, in the aortic arch, the carotid sinus, venae cavae and pulmonary veins where they enter the atria. Such sensory receptors are stimulated by stretching of the structure in which they are found, resulting in a decrease in blood pressure. (ii) chemoreceptors sensitive to blood CO2 levels are found in the AORTIC BODY and CAROTID BODY.

heart

(hahrt) [TA] Hollow muscular organ that receives blood from veins and propels it into the arteries. In mammals, divided by a musculomembranous septum into two halves-right or venous and left or arterial-each of which consists of a receiving chamber (atrium) and an ejecting chamber (ventricle). [A.S. heorte]

Patient discussion about heart

Q. how does it feel to heart promblems answer to my question then talk to meA. Heart problems may manifest as sensation of the heartbeats (called palpitations, as with rhythm problems), chest pain (usually a feeling of tightness or pressure in the chest rather than frank pain), or difficulty breathing (called dyspnea).
Other manifestations may include fainting (called syncope) either spontaneously or after exercise, edema (swelling) of the legs and various other non specific complaints.
The manifestations depend, of course, on the specific disease and the various characteristics of the patient (age, sex etc.)
You may read more here:
www.nlm.nih.gov/medlineplus/heartdiseases.html

Q. What happens to my heart when I exercise? My senior told me that exercise is good for health and especially for heart. What happens to my heart when I exercise? A. the heart is a muscle that constructs and pump blood through our body. like any muscle it can get bigger and stronger. doing exercise is putting pressure on the heart and the heart start to react by growing.

Q. Is garlic helpful in heart ailments? I have heard that garlic is very good for cardiac health and using in curries or cooked with foods will be helpful. I have also heard that it has anti-inflammatory substances and also helps in weight loss. Is garlic helpful in heart ailments?A. It acts as antioxidant and reduces the amount of free radicals in your body. It’s helpful once taken raw. But the raw garlic can cause bad breadth and blistering of skin and diarrhea. So, there should be a reduced intake of raw garlic. It’s better to have garlic in a cooked up form like in curries or with vegetables. This will also give the desired benefits of garlic and the side effect of over consumption of garlic will also be reduced.
http://www.youtube.com/watch?v=_jOrw1eB-uc&eurl=http://www.imedix.com/health_community/vng-A24JmWJY_iceland_heart_protection_formula?q=heart&feature=player_embedded

More discussions about heart
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