Howstuffworks "How Your Heart Works"

Search HowStuffWorks and the Web

Computer Stuff Auto Stuff Electronics Stuff Home Stuff Stuffo Health Stuff Money Stuff Travel Stuff People Stuff
Science Stuff

Main > Science > Life Science

Click here to go back to the normal view!

How Your Heart Works

by Dr. Carl Bianco, M.D.

Everyone knows that the heart is a vital organ. We cannot live without our heart. However, when you
get right down to it, the heart is just a pump. A complex and important one, yes, but still just a pump.
As with all other pumps it can become clogged, break down and need repair. This is why it is critical
that we know how the heart works. With a little knowledge about your heart and what is good or bad
for it, you can significantly reduce your risk for heart disease.

Heart disease is the leading cause of death in the U.S. Almost 2,000 Americans die of heart disease
each day. That is 1 death every 44 seconds. The good news is that the death rate from heart disease
has been steadily decreasing. Unfortunately, heart disease still causes sudden death and many
people die before even reaching the hospital.

The heart holds a special place in our collective psyche as well. Of course the heart is synonymous
with love. It has many other associations, too. Here are just a few examples:

have a heart - be merciful

change of heart - change your mind
to know something by heart - memorize something
broken heart - to lose love
heartfelt - deeply felt
have your heart in the right place - to be kind
cry your heart out - to grieve
heavy heart - sadness
http://science.howstuffworks.com/heart.htm/printable (1 of 10)1/30/2003 10:43:00 PM
Howstuffworks "How Your Heart Works"

have your heart set on - to want something badly

Certainly no other bodily organ elicits this kind of response. When was the last time you had a heavy
pancreas?

In this article, we will look at this most important -- and most talked-about -- organ so that you can
understand exactly what makes your heart tick.

Anatomy of the Heart

The heart is a hollow, cone-shaped muscle located between the lungs and behind the sternum
(breastbone). Two-thirds of the heart is located to the left of the midline of the body and 1/3 is to the
right (see Figure 1).

Figure 1
[Please note - Medical illustrations assume that the patient is
facing you so that the right and left correspond to the patient's
right and left. That's why the left and right labels here seem backwards.]

The apex (pointed end) points down and to the left. It is 5 inches (12 cm) long, 3.5 inches (8-9 cm)
wide and 2.5 inches (6 cm) from front to back, and is roughly the size of your fist. The average weight
of a female human heart is 9 ounces and a male's is 10.5 ounces. The heart comprises less than
0.5% of the total body weight.

The heart has 3 layers. The smooth inside lining of the heart is called the endocardium. The middle
layer of heart muscle is called the myocardium. It is surrounded by a fluid filled sac call the
http://science.howstuffworks.com/heart.htm/printable (2 of 10)1/30/2003 10:43:00 PM
Howstuffworks "How Your Heart Works"

pericardium.

Chambers and Valves

The heart is divided into 4 chambers: (see Figure 2)

1. Right Atrium (RA)

2. Right Ventricle (RV)
3. Left Atrium (LA)
4. Left Ventricle (LV)

Figure 2

Each chamber has a sort of one-way valve at its exit that prevents blood from flowing backwards.
When each chamber contracts the valve at its exit opens. When it is finished contracting the valve
closes so that blood does not flow backwards.

4. Tricuspid valve - is at the exit of the Right Atrium.

http://science.howstuffworks.com/heart.htm/printable (3 of 10)1/30/2003 10:43:00 PM

Howstuffworks "How Your Heart Works"

5. Pulmonary valve - is at the exit of the Right Ventricle.

6. Mitral valve - is at the exit of the Left atrium.
7. Aortic valve - is at the exit of the Left Ventricle.

When the heart muscle contracts or beats (called systole) it pumps blood out of the heart. The heart
contracts in two stages. In the first stage the Right and Left Atria contract at the same time, pumping
blood to the Right and Left Ventricles. Then the Ventricles contract together to propel blood out of the
heart. Then the heart muscle relaxes (called diastole) before the next heartbeat. This allows blood to
fill up the heart again.

The right and left sides of the heart have separate functions. The right side of the heart collects
oxygen-poor blood from the body and pumps it to the lungs where it picks up oxygen and releases
carbon dioxide. The left side of the heart then collects oxygen rich blood from the lungs and pumps it
to the body so that the cells throughout your body have the oxygen they need to function properly.

Flow of Blood
All blood enters the right side of the heart through two veins: The Superior Vena Cava (SVC) and
the Inferior Vena Cava (IVC) (see figure 3).

The SVC collects blood from the upper half of the body. The IVC collects blood from the lower half of
the body. Blood leaves the SVC and the IVC and enters the Right Atrium (RA) (3).

When the RA contracts, the blood goes through the Tricuspid Valve (4) and into the Right Ventricle
(RV) (5). When the RV contracts blood is pumped through the Pulmonary Valve (6), into the
Pulmonary Artery (PA) (7) and into the lungs where it picks up oxygen.

http://science.howstuffworks.com/heart.htm/printable (4 of 10)1/30/2003 10:43:00 PM

Howstuffworks "How Your Heart Works"

Figure 3

Why does it happen this way? Because blood returning from the body is relatively poor in oxygen. It
needs to be full of oxygen before being returned to the body. So the right side of the heart pumps
blood to the lungs first to pick up oxygen before going to the left side of the heart where it is returned
to the body full of oxygen.

Blood now returns to the heart from the lungs by way of the Pulmonary Veins (8) and goes into the
Left Atrium (LA) (9). When the LA contracts, blood travels through the Mitral Valve (10) and into the
Left Ventricle (LV) (11). The LV is a very important chamber that pumps blood through the Aortic
Valve (12) and into the Aorta (13). The Aorta is the main artery of the body. It receives all the blood
that the heart has pumped out and distributes it to the rest of the body. The LV has a thicker muscle
than any other heart chamber because it must pump blood to the rest of the body against much
higher pressure in the general circulation (blood pressure).

Here is a recap of what we just discussed. Blood from the body flows:

http://science.howstuffworks.com/heart.htm/printable (5 of 10)1/30/2003 10:43:00 PM

Howstuffworks "How Your Heart Works"

to the Superior and Inferior Vena Cava,

then to the Right Atrium
through the Tricuspid Valve
to the Right Ventricle
through the Pulmonic Valve
to the Pulmonary Artery
to the Lungs

The blood picks up oxygen in the lungs, and then flows from the lungs:

to the Pulmonary Veins

to the Left Atrium
through the Mitral valve
to the Left Ventricle
through the Aortic Valve
to the Aorta
to the body

Electrical System
Have you ever wondered what makes your heart beat? How does it do it automatically, hour after
hour, day after day?

The answer lies in a special group of cells that have the ability to generate electrical activity on their
own. These cells separate charged particles. Then they spontaneously leak certain charged particles
into the cells. This produces electrical impuses in the pacemaker cells which spread over the heart,
causing it to contract. These cells do this more than once per second to produce a normal heart beat
of 72 beats per minute.

The natural pacemaker of the heart is called the Sinoatrial node (SA node). It is located in the Right
Atrium. The heart also contains specialized fibers that conduct the electrical impulse from the
pacemaker (SA node) to the rest of the heart (see Figure 4).

Figure 4

The electrical impulse leaves the SA node (1) and travels to the right and left Atria, causing them to
contract together. This takes .04 seconds. There is now a natural delay to allow the Atria to contract
and the Ventricles to fill up with blood. The electrical impulse has now traveled to the

http://science.howstuffworks.com/heart.htm/printable (6 of 10)1/30/2003 10:43:00 PM

Howstuffworks "How Your Heart Works"

Atrioventricular Node (AV node) (2). The electrical impulse now goes to the Bundle of His (3),
then it divides into the Right and Left Bundle Branches (4) where it rapidly spreads using Purkinje
Fibers (5) to the muscles of the Right and Left Ventricle, causing them to contract at the same time.

Any of the electrical tissue in the heart has the ability to be a pacemaker. However, the SA node
generates an electric impulse faster than the other tissue so it is normally in control. If the SA node
should fail, the other parts of the electrical system can take over, although usually at a slower rate.

Although the pacemaker cells create the electrical impulse that causes the heart to beat, other nerves
can change the rate at which the pacemaker cells fire and the how strongly the heart contracts.
These nerves are part of the Autonomic Nervous System. The Autonomic Nervous System has 2
parts - The Sympathetic Nervous System and the Parasympathetic Nervous System. The
Sympathetic Nerves increase the heart rate and increase the force of contraction. The
Parasympathetic Nerves do the opposite.

All this activity produces electrical waves we can measure. The measurement is typically represented
as a graph called an Electrocardiogram (EKG). Here is an example of three heartbeats from an EKG
(Figure 5):

Figure 5

Each part of the tracing has a lettered name:

1. P wave - coincides with the spread of electrical activity over the Atria and the beginning of it's
contraction.
2. QRS complex - coincides with the spread of electrical activity over the ventricles and the
beginning of it's contraction.
3. T wave - coincides with the recovery phase of the ventricles.

Electrical system abnormalities can range from minor premature beats (skipped beats) that do not
require treatment, to slow or irregular beats that require an artificial pacemaker.

Blood Supply
Coronary arteries are the ones that we try to keep clear by eating a healthy diet. If Coronary arteries
are blocked a heart attack results.

The heart, just like any other organ, requires blood to supply it with oxygen and other nutrients so that
http://science.howstuffworks.com/heart.htm/printable (7 of 10)1/30/2003 10:43:00 PM
Howstuffworks "How Your Heart Works"

it can do its work. The heart does not extract oxygen and other nutrients from the blood flowing inside
it -- it gets its blood from coronary arteries that eventually carry blood within the heart muscle.
Approximately 4-5% of the blood output of the heart goes to the coronary arteries (7 ounces/
minute or 225 ml/min).

There are two main coronary arteries (figure 6) - The Left Main Coronary artery (1) and the Right
Coronary Artery (2) which arise from the Aorta. The Left Main Coronary Artery divides into the Left
Anterior Descending Branch (3) and the Left Circumflex Arteries (4). Each artery supplies blood
to different parts of the heart muscle and the electrical system.

Figure 6

The heart also has veins that collect oxygen-poor blood from the heart muscle. Most of the major
veins of the heart (great cardiac vein, small cardiac vein, middle cardiac vein, posterior vein of the
Left Ventricle, and oblique vein of the Left Atrium) drain into the coronary sinus which opens into the
Right Atrium.

Coronary artery disease is caused by a blockage in one of the coronary arteries. When a coronary
artery is partially blocked, that artery cannot supply enough blood to the heart muscle to meet its
needs during exertion. When someone with coronary artery disease exerts himself or herself, it
causes chest pain. This is due to lack of blood and oxygen to that part of the heart muscle and is
called angina. If the obstruction worsens (more frequent angina episodes, with less exertion) a
condition called unstable angina can occur. A heart attack happens when a coronary artery is
completely blocked and no blood or oxygen is getting to the heart muscle served by that artery. This
also causes chest pain and causes death to the heart muscle served by that artery.

Interesting Heart Facts

What causes the sound your heart makes?
When someone listens to your heart with a stethoscope the sound is often described as - lub-dub lub-
dub. The 1st heart sound (lub) is caused by the acceleration and deceleration of blood and vibration
of the heart at the time of the closure of the Tricuspid and Mitral Valves. The 2nd heart sound (dub) is
caused by the same acceleration and deceleration of blood and vibrations at the time of closure of
the Pulmonic and Aortic Valves.

How many times does you heart beat?

The average heartbeat is 72 times per minute. In the course of one day it beats over 100,000 times.
In one year the heart beats almost 38 million times, and by the time you are 70 years old, on
average, it beats 2.5 billion times!
http://science.howstuffworks.com/heart.htm/printable (8 of 10)1/30/2003 10:43:00 PM
Howstuffworks "How Your Heart Works"

Does your heart rate change as we age?

Everyone's pulse (average heart rate per minute) changes as we age. Here is a chart of average
pulse at different ages:

Age Pulse
Newborn 130
3 months 140
6 months 130
1 year 120
2 years 115
3 years 100
4 years 100
6 years 100
8 years 90
12 years 85
adult 60 - 100

How much blood does your heart pump?

An average heart pumps 2.4 ounces (70 milliliters) per heartbeat. An average heartbeat is 72 beats
per minute. Therefore an average heart pumps 1.3 gallons (5 Liters) per minute. In other words it
pumps 1,900 gallons (7,200 Liters) per day, almost 700,000 gallons (2,628,000 Liters) per year, or 48
million gallons (184,086,000 liters) by the time someone is 70 years old. That's not bad for a 10
ounce pump!

For more information on the human heart and related topics, check out the links on the next page.

Lots More Information

Related HowStuffWorks Articles

How Your Lungs Work

How Heart Attacks and Angina Work
How Congestive Heart Failure Works
http://science.howstuffworks.com/heart.htm/printable (9 of 10)1/30/2003 10:43:00 PM
Howstuffworks "How Your Heart Works"

How Diagnosing Heart Disease Works

How Aspirin Works
How Blood Works
How AIDS Works
How Cells Work
How does a blood pressure gauge (sphygmomanometer) work? What is blood pressure?
What is open heart surgery and a bypass operation?
How do human blood types work?

More Great Links

American Heart Association

The Heart: An Online Exploration
National Heart, Lung, and Blood Institute (NHLBI)
HeartInfo.org
Cardiosource

About the Author

Dr. Carl Bianco, M.D. is an Emergency Physician practicing at Dorchester General Hospital in
Cambridge, MD, located on the Eastern Shore of Maryland. Dr. Bianco attended Medical school at
Georgetown University School of Medicine and he received his undergraduate degree from
Georgetown University majoring in nursing and pre-med. He Completed an internship and residency
in Emergency Medicine at Akron City Hospital in Akron, Ohio.

Home Store Newsletter Search Advertising Privacy Contact About Help

1998 - 2005 HowStuffWorks, Inc.

http://science.howstuffworks.com/heart.htm/printable (10 of 10)1/30/2003 10:43:00 PM