2017517 HeartandCirculatorySystem

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HeartandCirculatorySystem
Witheachheartbeat,bloodissentthroughoutourbodies,carryingoxygenandnutrientstoeverycell.Every
day,theapproximately10pints(5liters)ofbloodinyourbodytravelmanytimesthroughabout60,000miles
(96,560kilometers)ofbloodvesselsthatbranchandcross,linkingthecellsofourorgansandbodyparts.

AbouttheHeartandCirculatorySystem
Thecirculatorysystemiscomposedoftheheartandbloodvessels,includingarteries,veins,andcapillaries.Our
bodiesactuallyhavetwocirculatorysystems:Thepulmonarycirculationisashortloopfromthehearttothe
lungsandbackagain,andthesystemiccirculation(thesystemweusuallythinkofasourcirculatorysystem)
sendsbloodfromthehearttoalltheotherpartsofourbodiesandbackagain.

Theheartisthekeyorganinthecirculatorysystem.Asahollow,muscularpump,itsmainfunctionistopropel
bloodthroughoutthebody.Itusuallybeatsfrom60to100timesperminute,butcangomuchfasterwhen
necessary.Itbeatsabout100,000timesaday,morethan30milliontimesperyear,andabout2.5billiontimes
ina70yearlifetime.

Theheartgetsmessagesfromthebodythattellitwhentopumpmoreorlessblooddependingonan
individual'sneeds.Whenwe'resleeping,itpumpsjustenoughtoprovidefortheloweramountsofoxygen
neededbyourbodiesatrest.Whenwe'reexercisingorfrightened,theheartpumpsfastertoincreasethe
deliveryofoxygen.

Thehearthasfourchambersthatareenclosedbythick,muscularwalls.Itliesbetweenthelungsandjusttothe
leftofthemiddleofthechestcavity.Thebottompartoftheheartisdividedintotwochamberscalledtheright
andleftventricles,whichpumpbloodoutoftheheart.Awallcalledtheinterventricularseptumdividesthe
ventricles.

Theupperpartoftheheartismadeupoftheothertwochambersoftheheart,therightandleftatria.Theright
andleftatriareceivethebloodenteringtheheart.Awallcalledtheinteratrialseptumdividestherightandleft
atria,whichareseparatedfromtheventriclesbytheatrioventricularvalves.Thetricuspidvalveseparatesthe
rightatriumfromtherightventricle,andthemitralvalveseparatestheleftatriumandtheleftventricle.

Twoothercardiacvalvesseparatetheventriclesandthelargebloodvesselsthatcarrybloodleavingtheheart.
Thesearethepulmonicvalve,whichseparatestherightventriclefromthepulmonaryarteryleadingtothe
lungs,andtheaorticvalve,whichseparatestheleftventriclefromtheaorta,thebody'slargestbloodvessel.

Arteriescarrybloodawayfromtheheart.Theyarethethickestbloodvessels,withmuscularwallsthatcontract
tokeepthebloodmovingawayfromtheheartandthroughthebody.Inthesystemiccirculation,oxygenrich
bloodispumpedfromtheheartintotheaorta.Thishugearterycurvesupandbackfromtheleftventricle,then
headsdowninfrontofthespinalcolumnintotheabdomen.Twocoronaryarteriesbranchoffatthebeginningof
theaortaanddivideintoanetworkofsmallerarteriesthatprovideoxygenandnourishmenttothemusclesof
theheart.

Unliketheaorta,thebody'sothermainartery,thepulmonaryartery,carriesoxygenpoorblood.Fromtheright
ventricle,thepulmonaryarterydividesintorightandleftbranches,onthewaytothelungswherebloodpicks
upoxygen.

Arterialwallshavethreelayers:

1.Theendotheliumisontheinsideandprovidesasmoothliningforbloodtoflowoverasitmoves
throughtheartery.

2.Themediaisthemiddlepartoftheartery,madeupofalayerofmuscleandelastictissue.

3.Theadventitiaisthetoughcoveringthatprotectstheoutsideoftheartery.

Astheygetfartherfromtheheart,thearteriesbranchoutintoarterioles,whicharesmallerandlesselastic.

Veinscarrybloodbacktotheheart.They'renotasmuscularasarteries,buttheycontainvalvesthatprevent
bloodfromflowingbackward.Veinshavethesamethreelayersthatarteriesdo,butarethinnerandless

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2017517 HeartandCirculatorySystem
flexible.Thetwolargestveinsarethesuperiorandinferiorvenacavae.Thetermssuperiorandinferiordon't
meanthatoneveinisbetterthantheother,butthatthey'relocatedaboveandbelowtheheart.

Anetworkoftinycapillariesconnectsthearteriesandveins.Thoughtiny,thecapillariesareoneofthemost
importantpartsofthecirculatorysystembecauseit'sthroughthemthatnutrientsandoxygenaredeliveredto
thecells.Inaddition,wasteproductssuchascarbondioxidearealsoremovedbythecapillaries.

WhattheHeartandCirculatorySystemDo
Thecirculatorysystemworkscloselywithothersystemsinourbodies.Itsuppliesoxygenandnutrientstoour
bodiesbyworkingwiththerespiratorysystem.Atthesametime,thecirculatorysystemhelpscarrywasteand
carbondioxideoutofthebody.

Hormonesproducedbytheendocrinesystemarealsotransportedthroughthebloodinthecirculatory
system.Asthebody'schemicalmessengers,hormonestransferinformationandinstructionsfromonesetof
cellstoanother.Forexample,oneofthehormonesproducedbythehearthelpscontrolthekidneys'releaseof
saltfromthebody.

Onecompleteheartbeatmakesupacardiaccycle,whichconsistsoftwophases:

1.Inthefirstphase,theventriclescontract(thisiscalledsystole),sendingbloodintothepulmonaryand
systemiccirculation.Topreventtheflowofbloodbackwardsintotheatriaduringsystole,the
atrioventricularvalvesclose,creatingthefirstsound(thelub).Whentheventriclesfinishcontracting,the
aorticandpulmonaryvalvesclosetopreventbloodfromflowingbackintotheventricles.Thisiswhat
createsthesecondsound(thedub).

2.Thentheventriclesrelax(thisiscalleddiastole)andfillwithbloodfromtheatria,whichmakesupthe
secondphaseofthecardiaccycle.

Auniqueelectricalconductionsystemintheheartcausesittobeatinitsregularrhythm.ThesinoatrialorSA
node,asmallareaoftissueinthewalloftherightatrium,sendsoutanelectricalsignaltostartthecontracting
oftheheartmuscle.Thisnodeiscalledthepacemakeroftheheartbecauseitsetstherateoftheheartbeatand
causestherestofthehearttocontractinitsrhythm.

Theseelectricalimpulsescausetheatriatocontractfirst,andthentraveldowntotheatrioventricularorAV
node,whichactsasakindofrelaystation.Fromheretheelectricalsignaltravelsthroughtherightandleft
ventricles,causingthemtocontractandforcingbloodoutintothemajorarteries.

Inthesystemiccirculation,bloodtravelsoutoftheleftventricle,totheaorta,toeveryorganandtissueinthe
body,andthenbacktotherightatrium.Thearteries,capillaries,andveinsofthesystemiccirculatorysystem
arethechannelsthroughwhichthislongjourneytakesplace.

Onceinthearteries,bloodflowstosmallerarteriolesandthentocapillaries.Whileinthecapillaries,the
bloodstreamdeliversoxygenandnutrientstothebody'scellsandpicksupwastematerials.Bloodthengoes
backthroughthecapillariesintovenules,andthentolargerveinsuntilitreachesthevenacavae.

Bloodfromtheheadandarmsreturnstotheheartthroughthesuperiorvenacava,andbloodfromthelower
partsofthebodyreturnsthroughtheinferiorvenacava.Bothvenacavaedeliverthisoxygendepletedblood
intotherightatrium.Fromherethebloodexitstofilltherightventricle,readytobepumpedintothepulmonary
circulationformoreoxygen.

Inthepulmonarycirculation,bloodlowinoxygenbuthighincarbondioxideispumpedouttherightventricle
intothepulmonaryartery,whichbranchesoffintwodirections.Therightbranchgoestotherightlung,andvice
versa.

Inthelungs,thebranchesdividefurtherintocapillaries.Bloodflowsmoreslowlythroughthesetinyvessels,
allowingtimeforgasestobeexchangedbetweenthecapillarywallsandthemillionsofalveoli,thetinyairsacs
inthelungs.

Duringtheprocesscalledoxygenation,oxygenistakenupbythebloodstream.Oxygenlocksontoamolecule
calledhemoglobinintheredbloodcells.Thenewlyoxygenatedbloodleavesthelungsthroughthepulmonary
veinsandheadsbacktotheheart.Itenterstheheartintheleftatrium,thenfillstheleftventriclesoitcanbe
pumpedintothesystemiccirculation.

ProblemsoftheHeartandCirculatorySystem
Problemswiththecardiovascularsystemarecommonmorethan64millionAmericanshavesometypeof
cardiacproblem.Butcardiovascularproblemsdon'tjustaffectolderpeoplemanyheartandcirculatory
systemproblemsaffectchildrenandteens,too.

Heartandcirculatoryproblemsaregroupedintotwocategories:congenital(problemspresentatbirth)and
acquired(problemsdevelopedsometimeafterbirth).

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2017517 HeartandCirculatorySystem
Congenitalheartdefects.Theseabnormalitiesintheheart'sstructurearepresentatbirth.Approximately8
outofevery1,000newbornshavecongenitalheartdefectsrangingfrommildtosevere.Thesedefectsoccur
whilethefetusisdevelopinginthemother'suterusandit'snotusuallyknownwhytheyoccur.Somecongenital
heartdefectsarecausedbygeneticdisorders,butmostarenot.Whatallcongenitalheartdefectshavein
common,however,isthattheyinvolveabnormalorincompletedevelopmentoftheheart.

Acommonsignofacongenitalheartdefectisaheartmurmuranabnormalsound(likeablowingor
whooshingsound)that'sheardwhenlisteningtotheheart.Usuallyaheartmurmurisdetectedbyadoctor
who'slisteningtotheheartwithastethoscopeduringaroutineexam.Murmursareverycommoninchildren
andcanbeinnocentmurmursfoundinanotherwisehealthyheart.Othermurmurscanbecausedby
congenitalheartdefectsorotherheartconditions.

Arrhythmia.Cardiacarrhythmias,alsocalleddysrhythmiasorrhythmdisorders,areproblemsintherhythmof
theheartbeat.Theymaybecausedbyacongenitalheartdefectortheymaybeacquiredlater.Anarrhythmia
maycausetheheart'srhythmtobeirregular,abnormallyfast,orabnormallyslow.Arrhythmiascanoccurat
anyageandmaybediscoveredduringaroutinephysicalexamination.Dependingonthetypeofrhythm
disorder,anarrhythmiamaybetreatedwithmedication,surgery,orpacemakers.Somearrhythmiasarenot
harmful.

Cardiomyopathy.Thischronicdiseasecausestheheartmuscle(themyocardium)tobecomeweakened.
Usually,itfirstaffectsthelowerchambersoftheheart,theventricles,andthenprogressesanddamagesthe
musclecellsandeventhetissuessurroundingtheheart.Initsmostsevereforms,itcanleadtoheartfailure
andevendeath.Cardiomyopathyisthe#1reasonforhearttransplantsinchildren.

Coronaryarterydisease.Themostcommonheartdisorderinadults,coronaryarterydiseaseiscausedby
atherosclerosis.Depositsoffat,calcium,anddeadcells,calledatheroscleroticplaques,formontheinnerwalls
ofthecoronaryarteries(thebloodvesselsthatsupplytheheart)andinterferewiththesmoothflowofblood.
Bloodflowtotheheartmusclemayevenstopifathrombus,orclot,formsinacoronaryvessel,whichmay
causeaheartattack.Inaheartattack(ormyocardialinfarction),theheartmusclebecomesdamagedbylack
ofoxygen,andunlessbloodflowreturnswithinminutes,muscledamageincreasesandtheheart'sabilityto
pumpbloodiscompromised.Iftheclotcanbedissolvedwithinafewhours,damagetotheheartcanbe
reduced.Heartattacksarerareinkidsandteens.

Hypercholesterolemia(highcholesterol).Cholesterolisawaxysubstancethat'sfoundinthebody'scells,in
theblood,andinsomefoods.Havingtoomuchcholesterolintheblood,alsoknownashypercholesterolemia,is
amajorriskfactorforheartdiseaseandcanleadtoaheartattack.

Cholesteroliscarriedinthebloodstreambylipoproteins.Twokindslowdensitylipoproteins(LDL)andhigh
densitylipoproteins(HDL)arethemostimportant.HighlevelsofLDLcholesterol(thebadcholesterol)
increaseaperson'sriskforheartdiseaseandstroke,whereashighlevelsofHDLcholesterol(thegood
cholesterol)canprotectagainstthese.

Abloodtestcanmeasureifsomeone'scholesterolistoohigh.Achild'stotalcholesterollevelisborderlineifit's
170to199mg/dL,andit'sconsideredhighifit'sabove200mg/dL.

About10%ofteensbetween12and19havehighcholesterollevelsthatputthematincreasedriskof
cardiovasculardisease.

Highbloodpressure(hypertension).Overtime,highbloodpressurecandamagetheheart,arteries,and
otherbodyorgans.Symptomscanincludeheadache,nosebleeds,dizziness,andlightheadedness.Infants,kids,
andteenscanhavehighbloodpressure,whichmaybecausedbygeneticfactors,excessbodyweight,diet,
lackofexercise,anddiseasessuchasheartdiseaseorkidneydisease.

Kawasakidisease.Alsoknownasmucocutaneouslymphnodesyndrome,Kawasakidiseaseaffectsthe
mucousmembranes(theliningofthemouthandbreathingpassages),theskin,andthelymphnodes(partof
theimmunesystem).Itcanalsoleadtovasculitis,aninflammationofthebloodvessels.Thiscanaffectall
majorarteriesinthebodyincludingthecoronaryarteries.Whencoronaryarteriesbecomeinflamed,achild
candevelopaneurysms,whichareweakenedandbulgingspotsonthewallsofarteries.Thisincreasestherisk
ofabloodclotforminginthisweakenedarea,whichcanblocktheartery,possiblyleadingtoaheartattack.In
additiontothecoronaryarteries,theheartmuscle,lining,valves,ortheoutermembranethatsurroundsthe
heartcanbecomeinflamed.Arrhythmiasorabnormalfunctioningofsomeheartvalvescanoccur.Kawasaki
diseasehassurpassedrheumaticfeverastheleadingcauseofacquiredheartdiseaseinchildrenintheUnited
States.

Rheumaticheartdisease.Usuallythecomplicationofanuntreatedstrepthroatinfection,rheumaticfevercan
leadtopermanentheartdamageandevendeath.Mostcommoninkidsbetween5and15yearsofage,it
beginswhenantibodiesthebodyproducestofightthestrepinfectionbegintoattackotherpartsofthebody.
Theyreacttotissuesintheheartvalvesasthoughtheywerethestrepbacteriaandcausetheheartvalvesto
thickenandscar.Inflammationandweakeningoftheheartmusclemayalsooccur.Usually,whenstrepthroat
infectionsarepromptlytreatedwithantibiotics,thisconditioncanbeavoided.

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2017517 HeartandCirculatorySystem
Stroke.Strokesoccurwhenthebloodsupplytothebrainiscutofforwhenabloodvesselinthebrainbursts
andspillsbloodintoanareaofthebrain,causingdamagetobraincells.Childrenorinfantswhohave
experiencedstrokemaybesuddenlynumborweak,especiallyononesideofthebody,andtheymay
experienceasuddensevereheadache,nauseaorvomiting,anddifficultyseeing,speaking,walking,ormoving.
Duringchildhood,strokesarerare.

Gettingplentyofexercise,eatinganutritiousdiet,maintainingahealthyweight,andgettingregularmedical
checkupsarethebestwaystohelpkeepthehearthealthyandavoidlongtermproblemslikehighblood
pressure,highcholesterol,andheartdisease.

Reviewedby:YaminiDurani,MD
Datereviewed:January2013

Note:AllinformationonKidsHealthisforeducationalpurposesonly.Forspecificmedicaladvice,diagnoses,and
treatment,consultyourdoctor.

19952017TheNemoursFoundation.Allrightsreserved.

ImagesprovidedbyTheNemoursFoundation,iStock,GettyImages,Corbis,Veer,SciencePhotoLibrary,
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