The individual has..
- Chest pain
- Shortness of breath
- Fainting or dizziness
- Rapid weight gain
- Swelling/pain in the abdomen
- Swelling of the legs and ankles (fluid accumulation when blood begins leaking out of blood vessels)
- Increasing fatigue
- Awakening short of breath/ needing more pillows
Chest X - Ray
- Helps with recognizing if there is a buildup of blood in the lungs
- Could see if the heart is enlarged (what happens with end-stage heart failure)
- Low blood counts (anemia) = can cause symptoms like end-stage heart failure or contribute to this
- Abnormal levels of Sodium, Potassium, Magnesium and other electrolyte levels
- B-type natriuetic peptide (BNP) measured (hormone that increases by failing heart; increases when the heart failure worsens)
- One of the most important tests in diagnosing patients
- shows the beating of the heart and the functions (acts like an ultrasound)
- Could help determine the cause of the failure and gives an accurate measurement of the left ventricle ejection percentage
- Multiple-gated acquisition scanning (MUGA scan) -> mildly radioactive dye injected in the vein, travels to the heart and takes pictures of the right and left ventricles; pumping performance can be determined from this (not used very often)
MRI (magnetic resonance imaging)
- magnetic fields provide pictures of the hearts structure to pump blood to the body
- if Gadolinium used (special MRI contrast agent) can provide information about inflammation, injury and blood flow
tests to condition
Heart transplants are the only option when the heart can hardly pump blood and there is nothing to be done to repair the damage. This is also only used for patients that are not elderly and who do not have any other medical conditions that would disrupt the transplant. This will correct the condition because the patient will receive a completely new heart getting rid of the entire problem allowing for the body to go back to normal.
heart transplant: step by step process
After you have taken off all jewelry and changed into a hospital gown...
- An IV line will be in your arm
- catheters will be placed in blood vessels in your neck and wrist to monitor heart and blood pressure
- Foley catheter will be placed in bladder to drain urine
- Tube in your mouth or nose to your stomach to drain stomach fluids
- Chest hair may be shaved
- Placed under anesthesia and a breathing tube will be placed in your mouth to your lungs (attached to a ventilator that will breath for you during the surgery)
- Incision down the center of your chest from just below the Adam's apple to just above the navel
- The sternum will be cut in half and spread apart so they could reach your heart
- Tubes will be put into your chest so blood can be pumped through your body by a cardiopulmonary bypass machine while heart is stopped and replaced
- When all blood has been diverted into the bypass machine, the doctor will take out the heart
- The new heart is sewed into place and the doctor will connect the blood vessels carefully so there are no leaks
- After the heart is fully connected to blood vessels the blood circulating in the bypass machine is allowed into the heart and the tubes to the bypass machine are removed
- Surgeon will shock the heart with small paddles to restart the new heart
- Once beating the whole team will watch making sure it is beating properly and that there are no leaks
- Wires may be put into the heart and can be attacked to the pacemaker outside the body to pace the new heart if needed during the beginning of the recovery period
- Sternum is rejoined together and sewed together with small wires
- Skin over sternum sewed and they will use sutures or surgical staples to close the incision
- Tubes will be put in your chest to drain blood/ fluids from around the heart; they are connected to a suction device to drain fluids while it heals
- Lastly a sterile bandage/ dressing is applied
- YOU HAVE A NEW HEART AND SURVIVED!!!
Brittney's Story of her transplant
Brittney, born October 26, 1990 had a rare life-threatening heart condition called hypoplastic left heart syndrome, the left side of her heart did not develop correctly and there is no cure and nothing to do. Doctors told her parents she only had a few days to live. Her parents did not give up and looked for answers, which her mom found in a People Magazine about a baby who received a heart transplant which was not very common then.
She was taken to Loma Linda University Medical Center in California. 26 days later a baby boy died in an accident and the parents "had the courage to see past their grief to donate his heart to me (Brittney)." Now, no one could tell she almost died and happens to be on the track and field team, not thinking much about her heartbeat. She competed in the Transplant Games all over the world and wins many medals and sent many of them to the family whose baby son died as a thank you for saving her life.
Brittney wants to become a psychologist to help families with the struggles that affect them every day.
She says, "Every time I take my transplant medication, I know I'm a little different - and a lot luckier - than many. I got a second chance, and I want to mean something. So when my friends are hanging out at the mall, my mom and I are often somewhere giving a presentation about the importance of organ donation...It's hard to believe that someone had to die in order for me to live. I think about that a lot. And I'm trying to make that gift mean something bigger. I hope I succeed."
Medications needed after heart transplant surgery:
Immunosuppressants -> decrease the activity of the immune system so it won't attack the new heart
Many times the immune system will never completely accept the donated heart, patients will be taking these for the rest of their lives
Immunosuppressants decrease the body's protection against infection so you may also get antibacertial, antiviral and antifungal medications
- Wearing sunscreen
- No tobacco products
- Healthy diet
The average life expectancy was 9.16 years after a heart transplant, but if the individual does what the doctor prescribes then they will live longer and healthier than what they would have had without a new heart.
- There are about 5,000 heart transplants preformed worldwide each year
- There are about 2,000 heart transplants preformed in the United States
- At any given time there are about 3,000 people waiting for a heart transplant
Leading medical centers for heart transplants:
- Aurora St. Luke's Medical Center (Milwaukee) - 7th largest robotic heart center in the world and a 1 month survival rate of 100%
- Duke Univeristy Hospital (Durham, N.C) - recognized by the HHS as the nation's largest heart transplant programs
- Indiana University Health Academic Health Center (Indianapolis) - full-service transplant center and have been preforming heart transplants since 1982
- Sutter Medical Center (Sacramento, California) - full-service cardiovascular center that had the first successful open-heart surgery, heart transplant, pediatric open-heart surgery and endoscopic vein harvesting procedure in Sacramento area
- Texas Heart Institute at Baylor St. Luke's Medical Center (Houston) - staff of 180 preformed more than 118,800 open heart operations, 258,000 cardiac catheterizations and 1,270 heart transplants