Science A Essay: Heart FailureZahra AzahariOrgan failure is a condition where an essential system in the body fails to perform its intended function (MedicineNet, Inc., “Definition of Organ Failure.
“). An example of a major organ that is susceptible to failure is the heart. The heart is an organ in the center of the body’s circulatory system. It “provides the pressure that forces the blood through arteries, capillaries and veins” (Pickering, 90).
In cases of heart failure, the heart muscle cannot fulfill the body’s need for blood as it cannot pump effectively (Harvard University, “Heart Failure.”). There are many causes of heart failure, namely coronary artery disease (CAD), heart attack, cardiomyopathy. In the case of a coronary artery disease, the patient’s arteries are blocked by plaque (U.
S. Department of Health & Human Services, “Coronary Heart Disease”). The diagram below illustrates the buildup of plaque in the artery, resulting in a blocked blood flow. Heart attacks most commonly occur as a result of CAD, while cardiomyopathy is a disease that causes the heart muscle to become “enlarged, thick, or rigid” (U.S.
Department of Health & Human Services, “Coronary Heart Disease”). There are numerous symptoms and problems associated with heart failure, as shown in the diagram on the left. For instance, as a result of heart failure, the lungs will experience congestion due to the buildup of excess fluids in the area. This is caused by the blood flow backing up into the lungs, as the heart cannot receive blood and pump it normally (UPMC, “Heart Failure: What Happens to the Body”). The patient may find it difficult to do physical activity as they will oftentimes be short of breath and have excessive coughing. Additionally, the kidneys will also be impacted.
To adapt to the changes of blood flow, the body will only send oxygenated blood to the more important brain and the heart, and not the kidneys. This results in the kidney being unable to effectively filter the body’s excess water and cause the excess water to settle in the ankles, feet, and legs. This also known as swelling, or edema (UPMC, “Heart Failure: What Happens to the Body”). Overall, since the heart is a major organ in the body, there will be many consequences in the case of failure. Scientific research has lead to many solutions for this issue, such as heart transplant. This is the necessary procedure for patients of end-stage heart failure–their condition is so severe they need a new heart. Heart transplants consist of three operations: harvesting the heart from the donor, removing the heart, and finally, inserting the heart in the patient (Fishbein, “Heart Transplant Surgery: Artificial Hearts, Costs, Rejection”).
The diagram demonstrates the procedure, and which arteries and veins will be temporarily disconnected from the heart during the surgery until the donor heart is in place. During this stage, the patient will be put under general anaesthesia. It is an open heart surgery, where the patient’s diseased heart must be taken out and replaced with the healthy donor heart. The surgeon will sew the donor heart into the patient (University of Rochester Medical Center, “Heart Transplantation Procedure”). After the surgery, the patient must take medicines named “immunosuppressants” for the rest of their life, as the body’s immune system will initially reject the heart, recognizing it as a foreign object. (University of Rochester Medical Center, “Heart Transplantation Procedure”). For a heart transplant, the patient will need a donor heart. The donor of a heart must be declared “brain-dead” prior to transplantation.
The National Kidney Foundation defines brain death as “death based on the absence of all neurologic function”. A person who is brain-dead is essentially dead, however, their other organs can still function with the help of ventilator, a machine that can “breathe” for the patient. Therefore, as the heart can still beat, it can be donated to someone who needs a new, healthy heart (National Kidney Foundation, “Brain Death”). According to Ahmet Kilic, et al., in the article “Donor Selection in Heart Transplantation”, “the two central and unifying concepts in the selection of a donor heart for transplantation are (I) the quality of the donor heart and (II) the matching of the donor heart to the recipient’s individual needs”. Because of this, waiting times for a donor heart usually take a long time — “often more than six months” (The Regents of The University of California, “FAQ: Heart Transplant”).
Not only do the hearts need to be donated by someone that is brain-dead, the heart must suit the patient.As with any other solution, there are advantages and disadvantages to having a heart transplant. Evidently, the prime advantage of having a heart transplant is that it is the only solution for someone who is suffering from end-stage heart failure. In cases where pre-surgery medicines and minor surgeries have failed, the patient may have to get a new heart (U.S.
Department of Health and Human Services, “Heart Failure”). In short, it has the potential to save the life of a severely ill person. The survival rate for one year afterwards is approximately 85 to 90 percent, with an annual death rate of around 4 percent after (Eisen, “Patient Education: Heart Transplantation (Beyond the Basics)”). Nevertheless, there are consequences; the body’s immune system may reject the new heart and react negatively. As a result, the patient must take post surgery medicines all their lives to change the immune system’s response to the new heart (Fishbein, “Heart Transplant Surgery: Artificial Hearts, Costs, Rejection”).
Heart transplant recipients “have an average of one to three episodes of rejection in the first year after transplantation” (Eisen, “Patient Education: Heart Transplantation (Beyond the Basics)”). There is also the threat of infection, as the post surgery medicines weaken the immune system so it does not attack the new heart. In the first year 22 percent of deaths occur because of infections while 18 percent of deaths are because of acute (sudden) rejection (Eisen, “Patient Education: Heart Transplantation (Beyond the Basics)”).
Additionally, as mentioned before, the waiting times for a suitable donor heart can extend to six months or more, and the waiting period may be costly due to medicine and hospital fees, if necessary. There are multiple implications of heart failure, particularly from the cultural aspect. A few religions do not support organ transplant