Ba-Dum-Bum Goes Your Heart!

Have you ever wondered what makes your ticker tick? Josh and Chuck take you back to high school biology for a stroll through the ins and outs of the little pump that keeps everything from your lowly pinky toe to your mighty brain going strong. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

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• 0:04Josh Clark?

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• 1:33Speaker 00

  Welcome to Stuff You Should Know, a production of iHeart Radio.

• 1:43Josh Clark?

  Hey, and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here too. And this is time for your anatomy lessons. So sit down and shut up.

• 1:54Speaker 02

  Oh, man. Teachers of the days of old.

• 1:58Josh Clark?

  For real. I've got my yardstick.

• 2:00Speaker 02

  Yeah.

• 2:01Josh Clark?

  I've got my necklace of garlic, all the stuff the teachers used to have.

• 2:07Speaker 02

  You got your dunce cap?

• 2:09Josh Clark?

  Yeah. I can't imagine that, wearing that, like, how humiliating.

• 2:15Speaker 02

  Agreed.

• 2:17Josh Clark?

  Speaking of humiliating in school, I have a quick anecdote. When I was in second grade, I went to a Catholic school and there was a woman who taught. She was not a nun, she was a civilian. And she would look in your desk, you know, you had those desks that like the top would open, you kept your stuff inside.

• 2:35Speaker 02

  Yeah.

• 2:35Josh Clark?

  Okay. So she would go and look through people's desk, kids' desks while we were at recess. And then when we came back in, she'd walk slowly up and down the aisles. And then she would stop at whoever's desk she found messiest. She'd tell them to get up. She'd dump their desk over onto the floor and tell them to clean it up because it wasn't organized.

• 2:56Speaker 02

  Wow.

• 2:57Josh Clark?

  And then they had to do that. And then she'd just start the lesson.

• 3:00Speaker 02

  Did you ever get the treatment?

• 3:03Josh Clark?

  I don't know. If I did, it was so traumatic, I blocked it out, but I don't remember ever getting it. But it was like, it was one of those things where you just, like, it made the whole class feel awful for that person. You know what I mean?

• 3:15Speaker 02

  Oh, my God. That's terrible.

• 3:16Josh Clark?

  So suffice to say, I ended up in public school, starting in third grade.

• 3:20Speaker 02

  Oh, well, good for you.

• 3:22Josh Clark?

  So anyway, onto the heart, right?

• 3:25Speaker 02

  That's right. And we're talking about the, the human heart.

• 3:29Josh Clark?

  I have a question for you.

• 3:32Josh Clark?

  Chuck, have you ever held a beating human heart in your hand?

• 3:39Speaker 02

  I have not, but I gotta say, like, reading over this stuff and studying this made me feel, um, good in a way and bad in a way, like, good that there's such a genius thing as the human heart. But it kind of scared in a way that like, everything revolves around this little fist sized pump, working really, really hard for many, many decades.

• 4:05Josh Clark?

  Yeah, for a long time. I mean, what is it, like 40 million beats a year?

• 4:10Speaker 02

  Wow, something like that. I mean, we got those stats.

• 4:12Josh Clark?

  Yeah. And I mean, like, there's a, there's a lot of work. Well, yeah, I think we'll cover it at some point, but there's a lot of work that goes into your heart beating. But I mean, man, it's, it's pretty vital. If the heart shuts down, the whole body goes, basically.

• 4:25Speaker 02

  Yeah. And is the heart, uh, is it the only thing in your body that's like moving? Like, I know blood moves and cells and things, but is, it's the only thing that has real movement, right? Or I guess your lungs move when you breathe in and out.

• 4:39Josh Clark?

  Yeah, but yeah.

• 4:41Speaker 02

  But that, that's not even the same.

• 4:42Josh Clark?

  It seems a little different, like moves on its own, I guess, is, is what you're saying, right?

• 4:47Speaker 02

  Yeah, just, I don't know. The design, it seems like a design flaw.

• 4:52Josh Clark?

  That it has to move?

• 4:54Speaker 02

  No, just like, here's, here's your whole body. You got everything, uh, this does this, this does that. And the thing that operates at all is this little thing in the middle that, that's supposed to beat with great regularity.

• 5:04Josh Clark?

  Yeah, but it does. And it's amazing. And we are going to explain today how it works because I did not know how it worked. And now that we've done this research, I'm like, I understand how the heart works. And it's actually not that complicated, really, even though it is pretty much miraculous.

• 5:22Speaker 02

  No. And, you know, at the end of the day, it is just a little pump. And like any pump that you buy or use, like, you know, pumps work continuously, uh, if, if they're plugged in or whatever. And they can break down, they can get clogged up and they can need repair. And the heart is really, literally no different.

• 5:42Josh Clark?

  Yes. And it can, like you said, it does need repair. In fact, heart disease, um, is I think the leading cause of death in the U.S. We talked about that in the cancer episode, I think.

• 5:52Speaker 02

  Yeah, it still is.

• 5:53Josh Clark?

  The stat I found is that 2,500 Americans die of heart disease each day. That's a death every 34 seconds. And it sounds much smaller, but proportionately, I think these are on par. In the UK, 170 people die a day of heart disease. In Australia, it's 120 and in Canada, it's 288. So that's, that's a lot of people. But weirdly, the death rate, I don't want to say weirdly, the death rate from, um, heart attacks has gone down. And you're like, well, great, Americans are getting healthier. No, that's not true at all. It's just that we've gotten better at life-saving technology and techniques.

• 6:38Josh Clark?

  And so we're able to save people from dying from a heart attack more easily. But there's more people that live with chronic heart conditions after they're saved from dying from their heart attack than there used to be.

• 6:49Speaker 02

  Yeah, for sure. And, you know, the one piece of non-medical advice concerning this I will give is, uh, you know, like, once you get into your 40s, I'm a big believer in just knowing stuff and preemptive measures. Uh, I recommend people go in early, then earlier than you think you should for a heart screening, even if you, if you're in great shape, just to see what's going on in there, see how you're doing, because there are far too many stories of people that were like, I thought I was in great shape and then I had the widow maker. And I didn't know I had plaque blockage. I had a, a friend I went to college with that was like, oh, I feel funny. I think I should drive myself to the emergency room and, which was great, but like, got

• 7:33Speaker 02

  there and died in the parking lot of the hospital. So you hear brutal stories like that. So, uh, that stuff can happen and not to scare anyone, but like, you know, get some preemptive tests done, just to kind of see where you're at, is my advice.

• 7:47Josh Clark?

  I got tests done. It wasn't preemptive. I was actually scared to death. My dad has AFib. So I've heard that if that runs in your family, it's very likely that you're going to develop AFib.

• 7:59Speaker 02

  Yeah.

• 8:00Josh Clark?

  And I had started to get like fluttering, like palpitations, like I felt like my heart was doing a somersault once in a while. So I was like, man, I sent myself in, I got a full workup from a cardiologist for two weeks, um, got the X-ray, had the telemetry, all that stuff. And when I went in for my results, he was like, there's nothing wrong with your heart. He said, I don't even see anything coming down the pike to be worried about. And I was, I almost started crying. I was so relieved. And I went back to smoking after that.

• 8:31Speaker 02

  No, you didn't. The world breathed a sigh of relief. Oh, you did go back to smoking?

• 8:36Josh Clark?

  No, no, I said, no, I didn't.

• 8:38Speaker 02

  Oh, okay. I thought this one might've been like a long time ago. But yes, everybody on, on planet Earth was relieved to hear that. And

• 8:44Josh Clark?

  So sweet.

• 8:45Speaker 02

  I, I did the same thing and got my arterial score. And this was back when I was in much, much worse shape. And, uh, it was lower. And I, I think I've even said this before, the doctor, I'm not sure if it made me feel better or not. And he was like, frankly, I thought it would be higher.

• 9:03Speaker 02

  But it wasn't zero, which isn't great, but since then, things are going better. So hopefully I've at least staved off that, that kind of thing for a little while longer.

• 9:12Josh Clark?

  That's great, man. It feels good, doesn't it?

• 9:14Speaker 02

  Yeah, I mean, we all want to live, right?

• 9:17Josh Clark?

  Yeah, pretty much. I would say the vast majority.

• 9:21Speaker 02

  All right. So let's talk about the heart itself as a, as a physical object. It is hollow and it is cone shaped. And I think most people know this, it's a muscle. And it's between the lungs and behind the sternum, about two thirds of which is on the left side of your body's midline and about a third to the right. With the apex, the little pointy end pointing down and to the left.

• 9:46Josh Clark?

  Down and to the left.

• 9:47Speaker 02

  I knew you were going to say that.

• 9:49Josh Clark?

  Yeah, I've always heard you make a fist. And it's actually about the size of your heart. I've heard your fist is relatively, relative to your heart size.

• 9:58Speaker 02

  Yeah.

• 10:00Josh Clark?

  Anyway, you put it in the middle of your chest and tilt it to your left. And that's basically you're, you're right over your heart right then.

• 10:07Speaker 02

  Yeah, that apex is about five inches long, about three and a half inches wide.

• 10:13Speaker 02

  Two and a half inches from front to back, which makes it relatively fist size. And a man's heart is generally bigger at about 10.5 ounces compared to the average woman's heart, which is about nine ounces. And like I said, I think it's a small thing. It's 0.5% of your total body weight. So a lot is riding on that little fist sized dude.

• 10:34Josh Clark?

  For sure. It's got three layers in this. I mean, we're describing like one of the most, one of like the, the top organs in your body.

• 10:44Speaker 02

  One of the best inventions.

• 10:46Josh Clark?

  Yeah, relatively small, relatively simple. It's got only three layers. The first layer, the smooth inside lining of the heart or the Billy Dee Williams layer is called the endocardium.

• 10:58Speaker 02

  That's right.

• 10:59Josh Clark?

  The middle layer is called the mitocardium or the Jan Brady layer. And then there's a fluid filled sack that surrounds it. It's called the pericardium or the jiggly poo.

• 11:13Speaker 02

  How long did you spend on that?

• 11:15Josh Clark?

  It just came out of me, but it was, it's, it's written down for sure. It's not off the cuff.

• 11:20Speaker 02

  Okay, I got you. So there are four chambers to the heart. You have the right atrium. That is, and what we're describing here is literally the function of the heart. So the right atrium is the starting point, and that's when you have oxygen poor blood that your body has used up that arrives to the little recycling plant.

• 11:41Josh Clark?

  Yep. You've got the right ventricle that's below the atrium. And that's where that oxygen poor blood gets pumped out to your lungs to go get re enriched, right?

• 11:52Speaker 02

  That's right.

• 11:53Josh Clark?

  And then let's talk about the left atrium, Chuck.

• 11:55Speaker 02

  That's right. That's where the lungs deliver that good blood, that oxygenated blood back to the heart. And then bring us home, baby.

• 12:03Josh Clark?

  You've got the left ventricle below the left atrium, and that's where the oxygen rich blood gets pumped back out to the body for use. Right? The left ventricle is far and away the biggest of them because it's really got to work to pump.

• 12:17Speaker 02

  Yeah. So that left side handles the oxygen rich blood, right side, the oxygen poor blood. And it's just with the heart and the lungs, it's just a little mini recycling center in your body.

• 12:28Josh Clark?

  Yeah. Another thing to remember is the atria is incoming, the ventricles is outgoing. That's it.

• 12:36Speaker 02

  That's right. And these chambers work by way of one-way valves at the exits. And that, that's to keep blood from going back the other way. So that chamber is going to contract. The valve at that exit is going to open up. And when it's done contracting, that valve is going to close because reentry is not allowed.

• 12:54Josh Clark?

  Yeah, it's like a backflow preventer on your irrigation system.

• 12:58Speaker 02

  Yeah.

• 12:59Josh Clark?

  So like I said, the left ventricle, it's thicker, it's bigger, I think. And it's because it's responsible for getting that blood out there to your body. And it's got to overcome your general blood pressure to really get it moving, right?

• 13:14Speaker 02

  That's right.

• 13:15Josh Clark?

  So I feel like we can just kind of describe what happens with the heartbeat, right? Cause everybody says it's like lub dub, lub dub, right?

• 13:24Speaker 02

  Yeah.

• 13:24Josh Clark?

  What I thought is that that's the sound of the heart contracting. That's not the case. The lub and the dub are the sounds of those one-way valves closing. When one of the, one of the sets of either atria or ventricles is opening and closing, right?

• 13:41Speaker 02

  Yeah.

• 13:41Josh Clark?

  So I, I took some peyote last night to have a reading quest to figure out how to best describe this. And I'd like to share what I came up with.

• 13:49Speaker 02

  Yeah, let's hear it.

• 13:51Josh Clark?

  So this talking coyote explained it to me as

• 13:53Speaker 02

  Wonderful.

• 13:54Josh Clark?

  You take two fists, right? You put one on top of the other.

• 13:58Speaker 02

  Okay.

• 13:59Josh Clark?

  Okay. You open the top and what's going on? The blood, whether it's oxygen rich or oxygen poor, is flowing into the atria. That's in diastole. That's that relaxed state. If you look at your bottom fist, it's still a fist. So what's happening is that your ventricles are contracting. So while the blood's flowing into the atria, the ventricles are pushing oxygen poor and oxygen rich blood out, either to the lungs or the rest of the body. Now do the opposite. Your top makes a fist and your bottom opens up. And what just happened is those atria pumped that blood into your ventricles. And then do it again, and your ventricles are now pumping that blood out.

• 14:42Josh Clark?

  You got lub dub, lub dub, lub dub. It's really fun to do a bunch and that's what your heart does.

• 14:48Speaker 02

  Yeah, a bunch. We mentioned the stats. It's about 72 times a minute is the average heartbeat. At rest, obviously. And throughout a day, that means about a hundred thousand beats in a year. That's about 38 million beats. And if you are lucky enough to reach the youngish age of 70, on average, we're talking about two and a half million beats laid down by the, the master DJ there in the center of your chest.

• 15:14Josh Clark?

  That is really impressive, man.

• 15:16Speaker 02

  Yeah.

• 15:18Josh Clark?

  Did you know also those beats are not steady over your lifetime? That it actually speeds up and then slows down the younger you are?

• 15:27Speaker 02

  I did. It looks like it maxes out at three months old at 140. That's after about 130 beats per minute as a newborn. Then it goes up to the 140. Then at six months settles back to 130. And your body goes, oh, am I newborn again? And then from years one to 12, it goes from 120 to 115. Steadies out at 100 for years, three, four, I'm sorry. Yeah. Three years, four years, and then six years. Did we skip five years?

• 15:57Josh Clark?

  Yeah, it doesn't matter.

• 15:58Speaker 02

  Okay. Year eight, when you're a little eight-year-old, it drops down to 90. And at 12, when you're truly don't care about what's going on in the world, it's all the way down to 85 and you can tell. And then in your adult years, about 60 to 100 beats per minute, depending on, you know, what's going on.

• 16:17Josh Clark?

  Yeah. And I said, why? And it turns out it's because the little hearts of babies and younger kids proportionate to their body are smaller than the adult heart is to an adult body. And so they have to pump more often to get that, that blood out as they're growing. And they also have a higher metabolism too.

• 16:35Speaker 02

  Well, that means a baby fist is like proportionally, like the heart is smaller than a baby's fist, I guess then, right?

• 16:43Josh Clark?

  Yes.

• 16:44Speaker 02

  Amazing. All right. Should we take a break?

• 16:47Josh Clark?

  Yes.

• 16:47Speaker 02

  All right. We'll be right back.

• 17:04Josh Clark?

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• 20:34Speaker 02

  All right, everyone, we're back and let's talk about blood flow a little bit because your circulatory system is a big part, you know, of course, we said the heart is the pump, but it's got to be connected to stuff to take all the blood to every place in your body that needs it. And there are, I mean, this all smacks so much of like elementary school biology and stuff, but and anatomy, but I kind of love it.

• 20:55Josh Clark?

  I do, too.

• 20:55Speaker 02

  The three kinds of blood vessels, of course, are the veins, arteries and capillaries. And the veins carry that oxygen necessary blood back to the heart, like that depleted blood. And the arteries carry that oxygen-rich blood to the rest of the body. Veins go in, arteries go out.

• 21:13Josh Clark?

  Yeah. And then you're like, well, what the heck do the capillaries do? They carry blood between the veins and the arteries. And I guess at some point, some of the veins are like, hey, I need some more nutrients. Give it to me from the arteries or something like that. I guess it's just for homeostasis purposes. That's the best I could come up with.

• 21:35Speaker 02

  I have a question. Like, I know the arteries are the big fellas and that their walls like have muscle tissue because they actually like pump.

• 21:43Josh Clark?

  Yeah.

• 21:44Speaker 02

  Are capillaries, do they not have little muscle systems? Does the blood just kind of running through them because of the force of entering and exiting?

• 21:51Josh Clark?

  That's my understanding.

• 21:53Speaker 02

  Okay, that's what I thought.

• 21:54Josh Clark?

  And then veins use valve systems, from what I saw, rather than muscle tissue.

• 21:59Speaker 02

  All right. I love it.

• 22:00Josh Clark?

  Yeah, it is. The biggest I saw that a artery is, is about as wide as a nickel is round, two centimeters. That's a big old artery.

• 22:13Speaker 02

  Two centimeters. Okay. Yeah, I got you.

• 22:15Josh Clark?

  Yeah. Imagine holding a nickel in your palm.

• 22:18Speaker 02

  It's been a while.

• 22:18Josh Clark?

  Now imagine that, it really has. Now imagine that is an artery just coming at you, like a cross section of an artery.

• 22:25Speaker 02

  I got you. Pretty intimidating.

• 22:28Josh Clark?

  Yeah.

• 22:29Speaker 02

  It is. So that blood, as we mentioned earlier, comes in through the right side, through two veins, the superior vena cava, oh, man, elementary school city, and the inferior vena cava. And that, the aorta is that main artery of the body that gets all the blood that the heart is pumped out and then distributed, distributes it through the various, I guess, vein channels.

• 22:53Josh Clark?

  Were you learning about the superior and inferior vena cava in, in elementary school? Because I definitely was not.

• 23:01Speaker 02

  I felt like I did, but maybe not, now that you mention it.

• 23:05Josh Clark?

  I mean, we didn't get anywhere near there. I think we learned that we have a heart and that's as far as we got.

• 23:12Speaker 02

  I also ran up through seventh grade in elementary school because we didn't have middle school. So maybe that's a differentiator.

• 23:19Josh Clark?

  You didn't have middle school. So eighth grade began, high school? Wow.

• 23:24Speaker 02

  Yeah, after, right after I left, they built a middle school in our district for the first time. And so my story was always that in eighth, ninth and 10th grade, I was the youngest person in high school because they kept sending that next grade to middle school. Which at the time, now it's like, who cares? But at the time, you just wanted to be older than somebody.

• 23:49Josh Clark?

  No, I know.

• 23:50Speaker 02

  In this school. So three years straight, it was like, oh, now they're taking the eighth graders. Now they're taking the ninth graders.

• 23:55Josh Clark?

  That's the pits, man.

• 23:56Speaker 02

  Yeah. So, yeah, I think by seventh grade, we were learning about this stuff.

• 23:59Josh Clark?

  I don't remember that at all. But, okay, I believe you. I'm saying I don't, I don't remember. I think I just learned about the superior and inferior vena cava.

• 24:08Speaker 02

  In college.

• 24:08Josh Clark?

  No, researching this.

• 24:10Speaker 02

  Okay.

• 24:12Josh Clark?

  Okay. So these are your blood vessels and they're moving a lot of blood.

• 24:18Speaker 02

  How much?

• 24:18Josh Clark?

  Appropriately. Get this. The heart pumps an average of about 2.4 ounces of blood every time it beats. It's a pretty decent amount of blood. And I said, well, how, how much blood is it? 70 milliliters. And I was like, I don't understand how much that is at all. In airplane mini liquor bottles, it's about one and a half of those in blood every time your heart beats.

• 24:43Speaker 02

  Yeah, I'd like to tell people that when Josh takes an article and changes like parts of it to then send to me, there's always fun little things like that. And there's always lots of very funny, inappropriate cursing. I don't think I've ever mentioned how much I enjoy that, by the way.

• 24:59Josh Clark?

  Oh, thanks, man. I enjoy yours as well.

• 25:01Speaker 02

  Yeah, they're only for my eyes, but it's always funny when I come across it.

• 25:05Josh Clark?

  Thanks. It means a lot.

• 25:07Speaker 02

  Yeah, maybe one day we'll just read it out loud and see what people think.

• 25:11Josh Clark?

  I don't know about that.

• 25:13Speaker 02

  All right. So one and a half airplane bottles, airplane liquor bottles worth, at 72 beats a minute, that's about 1.3 gallons or five liters of blood pumped per minute. And about 1,900 gallons or 7,200 liters of blood pumped per day, man. And that is a tiny little 10 ounce pump doing all that work.

• 25:33Josh Clark?

  Yeah, that's 14,400 mini airline liquor bottles per day.

• 25:38Speaker 02

  Wow, is it really?

• 25:39Josh Clark?

  It actually, like, that means more to me than 1,900 gallons. That's a lot. Not because I'm like, oh, I love drinking.

• 25:46Speaker 02

  Right.

• 25:46Josh Clark?

  Like, that is a lot of blood that just moves through your body every day. And bear in mind, everyone, you don't have 14,400 mini liquor bottles worth of blood in you. It just gets circulated that often.

• 26:00Speaker 02

  Right, exactly. Good point.

• 26:01Josh Clark?

  Yeah. That was for the three year olds. I think everybody else already knew that and it kind of went without saying.

• 26:08Speaker 02

  So how does this thing beat? I think most people probably know in a very basic way that it's electrical impulses that cause the heart to beat. But more specifically, it's a group of cells that have the really uncanny ability to generate that activity by themselves.

• 26:29Josh Clark?

  Really super cool. You know how like when you put salt on a dead frog's legs and they twitch?

• 26:36Speaker 02

  I didn't know that, actually.

• 26:37Josh Clark?

  Oh, you didn't? It's like, it's like, you, you should go online and check it out. It's very weird. But what's happening is you just added an electrolyte, which is an, essentially an electricity-bearing element onto a muscle and muscle tissue responds to electricity-bearing elements. And with the heart specifically, you've got what are called pacemaker cells that are located in what are called nodes, where basically they take in those electrolytes that you hear about with hydration and all that. Sodium, potassium, calcium, chlorine, magnesium. And these pacemaker cells in the nodes are able to take those elements and strip them into charged ions, which they shoot at the

• 27:18Josh Clark?

  heart. And this electrical activity just cascades over the heart and that causes the muscle tissue to contract and then release once the electrical impulse is passed over it.

• 27:28Speaker 02

  That is incredible. And you're also saying that this whole electrolyte thing isn't a big scam.

• 27:36Josh Clark?

  No, it really isn't. Because if you're just drinking water and it's just water and you're hydrating like that, it, I mean, it helps. You actually do need water plenty. But there comes a point in time where you're actually diluting your blood and you need those electrolytes to balance that out. So I think we're probably being oversold electrolytes because I don't remember having any problems with it until 2022, when they started advertising it. But you do need electrolytes, for sure.

• 28:08Speaker 02

  Yeah, you know, when I've mentioned that survival show alone that I watch and you're allowed to bring like, a certain amount of things with you that of your own choosing that are obviously approved. And occasionally, I feel like once every two seasons or so, somebody brings a block of salt.

• 28:24Josh Clark?

  Oh, yeah, a whole block? Geez.

• 28:26Speaker 02

  Yep, brings a block of salt and for two reasons. One, to help provide electrolytes when they're like, obviously getting like super dehydrated out there in the wild. But the other kind of obvious more fun reason is to, to give a little bit of flavor to some of that garbage that they have to eat.

• 28:41Josh Clark?

  Yeah, I'll bet.

• 28:42Speaker 02

  It's not a bad idea, though, I don't think, like the salt block.

• 28:46Josh Clark?

  No, not at all. I know deer like to lick salt blocks. So I was wondering if anyone ever brought it to like attract a deer that they killed and ate.

• 28:54Speaker 02

  I have not seen that. I think the salt is too valuable to like chunk it off and just leave out there for anyone to have.

• 28:59Josh Clark?

  Gotcha.

• 29:00Speaker 02

  Yeah, that'd be my guess.

• 29:02Josh Clark?

  But yeah, so they're, they're hydrating with electrolytes then, at least with sodium.

• 29:07Speaker 02

  Totally.

• 29:08Josh Clark?

  So what's also nuts about this is that this electrical cascade is produced more than once per second. I think your heart beats in less than a second every time. It's like 0.8 seconds total where the whole thing goes through its jam.

• 29:26Speaker 02

  Yeah. I mean, if it's 72 times a minute, even Josh Math like figures, can figure that out.

• 29:31Josh Clark?

  That had not dawned on me until this now.

• 29:34Speaker 02

  Yeah. So that electrical impulse travels to the right and left atria first and they contract together. And that's what takes that 0.04 seconds. And then there's a little bit of a delay because those ventricles have to fill back up with the blood, with the good stuff. And then that electrical impulse then goes to the right and left ventricle. They contract at the same time. And that's it. If you, if you have issues with this... Electrical impulse, like getting it right and timing it right, then you're going to need a pacemaker. We'll talk about like artificial pacemaker soon, but like your body has like, that's, it's a natural pacemaker, basically. Like any of that electrical tissue in the heart can be a pacemaker.

• 30:17Josh Clark?

  Right.

• 30:17Speaker 02

  But the one you really want working is the, the, the main one, which is the sinoatrial node. And that is the, that's the real pacemaker. And if that one doesn't work quite right, then other ones can step up and do the job.

• 30:30Josh Clark?

  Yeah, but it's not ideal. You want your, your sinoatrial node functioning correctly, like you said, but in lieu of it, there's other ones like the arterioventricular node, which usually receives electrical impulses from the sinoatrial node. But if, if the SA is not able to do it, the AN can step up and be like, I'll, I'll see what I can do. The pulse though is weaker and it's not as, as rhythmic, I guess, is when it's working properly. It's, but it, you're happy that the atrioventricular node is doing its thing because if not, you drop dead.

• 31:09Speaker 02

  Yeah, that's right. Uh, but that, that's what can produce a arrhythmia, right? Which is an irregular heartbeat.

• 31:16Josh Clark?

  Yes, that's one of the things that can do it for sure. If your sinoatrial node is not working, yes, you have an irregular heartbeat for sure.

• 31:23Speaker 02

  What did your doctor say since you were in like, that your heart was in great shape, what the heart flutters were? Because I used to get those occasionally too.

• 31:30Josh Clark?

  He said that it was nothing. He said it was literally nothing. It just happens sometimes and it doesn't mean anything. He said it doesn't have anything to do with anything. It just happens. It's not a sign of something that's wrong with you or something coming down the road. He said it's just nothing.

• 31:46Speaker 02

  And then he farted and put a cigarette out and kicked you out the front door.

• 31:50Josh Clark?

  Took a shot of scotch first.

• 31:53Speaker 02

  All right. Well, that's good to know because that has happened to me occasionally too. And it's a little disconcerting when you have like, your heart will like race for a couple of seconds. You're like, what the, what the heck was that?

• 32:00Josh Clark?

  Yeah. I mean, it definitely is very unnerving. So I'm, I'm glad it drove me to the, to go get a workup because it was nice to hear, I'm all right.

• 32:09Speaker 02

  That's good. Uh, so there, you know, those pacemaker cells are the one that, that do the money work, uh, but other nerves can change the rate that those cells fire, how, maybe how strong that heart is going to be contracting. Uh, and those are all part of the autonomic nervous system.

• 32:26Josh Clark?

  Yeah. Our old friend fight or flight, uh, is essentially what the reason why your heart starts pounding when you're in fight or flight mode is because your sympathetic nervous system has talked to your sinoatrial node and said, hey, man, step it up. We want more heartbeats and we want stronger contractions than ever before. Cause this guy's about to have to run because there's jungle cat coming. Don't ask me how, because I realize we're in Georgia, but there's a jungle cat coming.

• 32:52Speaker 02

  Totally. Uh, and those, um, all that activity is going to produce an electrical wave. And when you go to get a EKG, an electrocardiogram, that is what it's measuring. Like those are the electrical waves that the EKG can spit out on that piece of paper.

• 33:08Josh Clark?

  Yes. The first wave is called the P wave. And like this is, this is when you're looking at an EKG and it goes, like the lines just go up and down really quick. There's like, it's not just chaotic, like it looks to me. Like one of those is called the P wave. This is when the electrical activity spreads over the atria and they contract. The QRS complex is where the electrical activity spreads over the ventricles. And then when the ventricles relax, that produces on the EKG, a T wave.

• 33:39Speaker 02

  That's right. And if your doctor ever goes to look at your EKG and then goes, huh, and then turns it upside down and then looks at it, then you should fart and put out your cigarette and run out of his office.

• 33:52Josh Clark?

  Yeah. Maybe get a second opinion.

• 33:54Speaker 02

  All right. Should we take a break?

• 33:55Josh Clark?

  Yeah. Let's let everybody hear us try to sell them something.

• 33:59Speaker 02

  All right. We'll be right back.

• 34:17Josh Clark?

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• 34:26Speaker 02

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• 34:39Josh Clark?

  Or discover Toyota's off-road lineup, including the iconic 4Runner and Land Cruiser, designed to go beyond the everyday. And with Toyota's proven reputation for quality and reliability, plus hybrid power on many models, you can get more for every mile and drive for less along the way.

• 34:55Speaker 02

  That's right. And long after you leave the lot, your Toyota keeps delivering with great resale value. So you could trade in for more when you're ready for your next Toyota. From a great deal today to a great value tomorrow, a Toyota is right for you. Shop toyota.com for deals and details, or stop by your local Toyota dealer today. Toyota, let's go places.

• 35:17Josh Clark?

  Gives me more when they have the power to give more. They can inspire more discovery, give more confidence and unwrap more of who you are. So this Black Friday, give a gift that goes beyond the box. The Dell XPS 13 laptop.

• 35:30Speaker 02

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• 35:44Josh Clark?

  Yeah. Plus it's built with a durable aluminum chassis, weighing just 2.2 pounds and Intel Core processors. So it's fast, reliable and portable enough to keep up wherever you go. And while shopping, you'll also find great perks like Dell Rewards, fast free shipping, premium support and financing with flexible payment options. Plus you can find great deals on monitors and accessories. That means you can score a whole new setup now for less. Visit dell.com to explore the possibilities with XPS.

• 36:13Speaker 02

  And this Black Friday sale is one that you're not going to want to miss. Just head to dell.com/deals. That's dell.com/deals.

• 36:26Speaker 02

  Hey everybody. If you've been thinking about securing your home, there's no better time to protect it with SimpliSafe. Right now you can save 70% on a new system, their biggest savings of the year. You've heard us talk about SimpliSafe before and you know it's designed to keep threats away from the door and your loved ones safe in the first place. If you thought about SimpliSafe at all, now is the time to finally secure your home.

• 36:45Josh Clark?

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• 37:02Speaker 02

  That's right. And SimpliSafe has an offer for our listeners now with their biggest savings of the year, 70% off your new system with professional monitoring when you visit simplisafe.com/stuff. That's simplisafe.com/stuff. And when you order, write in the code STUFF at checkout. It tells them we sent you and it really helps the show. SimpliSafe, ahead of crime, in real time.

• 37:40Josh Clark?

  Okay, everybody, we're back. And, um, as miraculous and amazing and actually kind of hashtag basic as the heart is, it can get messed up, as you know. And one of the chief ways that it gets messed up is from us messing it up with the stuff that we eat because cholesterol, fats, lipids even, can get caught up in your arteries. And when they get caught up, they kind of hang in there and they build up what's called plaque. And then the, the, I guess, condition where your arteries are clogged with plaque is called arteriosclerosis. And that is an early part of heart disease.

• 38:19Speaker 02

  Yeah. So if you have a partial blockage in a coronary artery, uh, you're just obviously not going to get enough supply of blood. Uh, it's, you know, usually this is something you might notice when you exert yourself. So, uh, you might feel like a chest pain or something like that. That's because you have a literal lack of blood and oxygen to that part of the heart muscle right there. And that's called angina. And it's no good.

• 38:42Josh Clark?

  No, it's, it isn't. Um, I don't think I've ever heard the words chest pain without thinking of that guy on the Life Alert ad going, I'm having chest pain. Remember him?

• 38:53Speaker 02

  Classic.

• 38:53Josh Clark?

  He was second in, um, fame only to the lady who came after him. He said, I've fallen and I can't get up. Same ad.

• 39:01Speaker 02

  What if those were your grandparents?

• 39:03Josh Clark?

  Like, uh, the actors were?

• 39:05Speaker 02

  Yeah, yeah. Like they, they happened to be a married couple and they booked them together because it was just easy. And those were your literal grandparents.

• 39:12Josh Clark?

  I probably tell a lot of people.

• 39:14Speaker 02

  That'd be so much fun. Do it again, grandma. Or she does that and she, we're like, oh, you're the funniest. And she's like, really fallen and can't get up.

• 39:23Josh Clark?

  It'd really help. Yeah. That'd be a great outgoing, um, voicemail message. If your grandma, if that was your grandma.

• 39:29Speaker 02

  Totally.

• 39:31Josh Clark?

  Josh can't come to the phone now because he's fallen and can't get up.

• 39:37Speaker 02

  So angina is where we left off, I think.

• 39:39Josh Clark?

  Yes. So you've got angina, which can actually get worse. The more angina you have, you can have unstable angina. When the coronary artery is completely blocked, I'm guessing any one of them can really do this to you. You're getting starved of blood and oxygen in your heart muscle. It needs both of those things because the heart doesn't just pump blood, it uses blood too, right? So it'll take a little from me as well. You got more angina, you can actually have a heart attack from that. And I know you found some good information about the difference between like heart attack and cardiac arrest and all that stuff. And I say you lay it on everybody, Chuck.

• 40:16Speaker 02

  Yeah, you know, I knew there was a difference because I think a lot of people use heart attack,

• 40:23Speaker 02

  heart failure and cardiac arrest kind of interchangeably, but they're, but they're not the same thing. So what, what is it again?

• 40:31Josh Clark?

  Oh, okay. I'll lay it on. So a heart attack is a circulation problem because blood flow to part of the heart is blocked. You're having a heart attack. Cardiac arrest, I thought that was the exact same. That's an electrical malfunction where the heart just suddenly stops beating. And then heart failure is actually a chronic condition where the heart muscle is just too weak, or it gets too stiff from things like heart attacks. It stiffens, almost scars after those to effectively pump the blood. So there you have it. You'll never have to have anybody explain it to you again.

• 41:03Speaker 02

  Yeah. And if I'm not mistaken, cardiac arrest is the one that's more dangerous. Like if you see a TV show or a movie, or God forbid, if this has happened to someone in your life, and someone's like, I'm having a heart attack and like, they die a couple of minutes later. I think that's usually cardiac arrest. Whereas a heart attack is like, hey, I'm having a heart attack and like, I need to get into the car now and drive to the hospital. And that can happen.

• 41:28Josh Clark?

  Okay, gotcha. So, so you're saying cardiac arrest is deadlier than a heart attack?

• 41:33Speaker 02

  Yeah.

• 41:33Josh Clark?

  It's just people are misusing terms?

• 41:35Speaker 02

  I think so, because I think cardiac arrest is the one that like where you can be dead minutes later.

• 41:40Josh Clark?

  Well, one of the best things you can do in your entire life is to correct someone who's dying of a heart attack or cardiac arrest as they're going down.

• 41:51Speaker 02

  Actually.

• 41:54Josh Clark?

  Oh, boy. So let's move on to atrial fibrillation. This one is a big one to me because like I said, my dad has it. And I remember hearing he had, it's called Afib for those of us in the know. I was like, oh my God, that sounds awful. Apparently it's not. There's not actually a problem with Afib in and of itself. It's just a type of arrhythmia where the heart just doesn't follow. It beats to, it moves to the beat of its own drum, not the standard one. And there's nothing wrong with having Afib, but Afib can lay the groundwork for all sorts of other heart problems. That's the problem with Afib.

• 42:30Speaker 02

  Yeah, like you may not show any symptoms. They may, or you may get symptoms later. You may not know you have Afib at all for like a very, very long time. And like you said, it's, you know, it will increase the risk of maybe heart failure or stroke. It, because it's, you know, basically because it's marching to the beat of its own drummer, it's circulating your blood in a way that's different. So if it's so different that thrombosis or like blood clotting can occur, that could happen and a blood clot can break off and block like a brain artery. And that's where a stroke comes from.

• 43:07Josh Clark?

  Yeah, that's nay good, for sure. So yeah, you want to steer clear of Afib. You want to screen for it too, especially if it's in your family.

• 43:15Speaker 02

  Yeah.

• 43:16Josh Clark?

  And then there's congenital heart disease, which simply means that you have a heart condition that you were born with. I think the most common, it's the most common type of birth defect. And I think one of the most common types of congenital heart disease is holes in the heart, septal defects. I didn't see if they actually are the most common, but that's the one I've always heard the most. So I guess anecdotally speaking, it's the most common.

• 43:43Speaker 02

  Yeah. So if you have a brand new baby and they say that they have, were born with congenital heart disease, they need to change that name up a little bit, or hopefully they break it to you in a different way.

• 43:54Josh Clark?

  Sure.

• 43:55Speaker 02

  Than just like laying that down because it can be no big deal at all. Sometimes there's just no treatment required at all.

• 44:02Josh Clark?

  Right. If you do have a heart condition, especially if your heart's just not quite beating in a rhythm that's, that's making it work as efficiently as possible, there's all sorts of stuff you can do. There's medications. Well, there's medications. There's also pacemakers, which have really come a long way. I think the first pacemaker implant was in 1958. And now it's, I don't want to say routine, but it's, they, they save a lot of lives these days.

• 44:31Speaker 02

  It's pretty routine, I think.

• 44:32Josh Clark?

  Yeah.

• 44:32Speaker 02

  Like I know several people in my life that have pacemakers. They are literal electronic devices that keep your heart beating like it should, or prevent it rather, I guess, from beating abnormally. And it's a, it's a battery. It's got some computer circuitry. It's a little piece of metal and they implant that inside of your body in the upper chest, like kind of near your shoulder.

• 44:56Josh Clark?

  Yeah. And then the wires go through your vein, I think from your leg into your heart. And there's different ones depending on what they're working on. There's single chamber where for some reason, it's specific to parts of the heart. So like a single chamber pacemaker works, helps the right ventricle do its thing. So it's pumping blood out to the lungs. But like you wouldn't put that in like the left ventricle for some reason. I could not find why it's so specific.

• 45:28Speaker 02

  Yeah. And this is the point where we need to just take our hats off and salute humanity.

• 45:34Josh Clark?

  Sure.

• 45:35Speaker 02

  In this case, a guy named Wilson Greatbotch, who is basically recognized as the, as the dude who invented the first pacemaker. And, and you know, I'm sure Wilson had a team of great people that are always undersung. So it's amazing that people are like, hey, if your heart doesn't beat right, maybe we can put a little thing in your body that's, that's like, that lives inside of you successfully.

• 46:00Josh Clark?

  Yeah. I mean, those, so it just basically, if you're, say your sino atrial node isn't just, isn't producing electricity like it's supposed to, this thing does. It goes, oh, here, I'll stand in for you. So yeah, it's pretty, pretty amazing stuff for sure. And it depends on what your heart's doing, that the type of pacemaker is inserted. But we won't necessarily get into that. If you need a pacemaker, I'm pretty sure your doctor can tell you everything you need. You don't need it from us.

• 46:31Speaker 02

  Yeah, that's a good point.

• 46:32Josh Clark?

  But let's say you have a pacemaker and you're like, I've got five to 15 years of battery life. That's what, that's how pacemakers break down. They just drain their battery after a while.

• 46:42Speaker 02

  Yeah.

• 46:43Josh Clark?

  I'm looking for the pacemaker that gathers, that's recharged by motion. You know, those like,

• 46:51Speaker 02

  Oh, yeah, yeah.

• 46:51Josh Clark?

  inventions where like you can dance and you're actually lighting up the dance floor? Why can't you do that with a pacemaker battery? It seems like, seems like something you could do eventually.

• 47:01Speaker 02

  I could see them working on something like that. At least give me the 15 year version.

• 47:06Josh Clark?

  Sure.

• 47:06Speaker 02

  Because every time it's triggered, you know, it's not necessarily running full time. It's triggered to run when you need it, depending on the kind. And it's going to drain that battery a little bit, like you said. So, you know, you can get a temporary pacemaker while you're recovering for a heart attack, maybe to speed up your heart rate. That's not implanted. That's just like, hey, you got out of surgery. So we're going to just keep you on the right track for now with this thing.

• 47:33Josh Clark?

  Yes. I, I want to say like the next step up is the artificial heart, but it feels like that's many, many steps above a pacemaker in severity, inventiveness, all that stuff. But essentially what an artificial heart is, it steps in when your ventricles are no longer capable of pumping blood well enough to get it to your lungs or through the rest of your circulatory system. So what they do is they go in and cut out your ventricles and they put in an artificial heart, which is basically those two new artificial ventricles to do that job for you. And what you do, you have like wires coming out of your body and they're connected to an outside driver. And

• 48:17Josh Clark?

  This in and of itself is just amazing because

• 48:20Speaker 02

  Yeah.

• 48:20Josh Clark?

  Up until, I guess, I don't remember when the first, yeah, the first one took place in 1982. Up to that, if you needed a heart, you were on a heart transplant list and there's not nearly enough heart donors to, to meet the supply needed. So a lot of people died waiting for a heart transplant. The artificial heart's meant to step in and say, hey, how about we use this to keep you alive until you can get that donor heart? Um, that's, that's what the artificial heart is as it stands. What they're working toward is what's called a total artificial heart, which is exactly what it sounds like. Rather than getting a donor's heart, someone else's heart put into your chest,

• 49:02Josh Clark?

  you would get this total artificial heart put into your chest and that's all you'd ever need. It's like a artificial donor heart.

• 49:09Speaker 02

  Yeah, it's incredible looking. I remember when I was a kid, I mean, this, the first one was in 1982. Like you said, I was 11 and when I saw the name, the patient's name, Dr. Barney Clark, it was like, oh, boom. Yeah, that was him. Like it was such a big deal in the news. Like even a little 11 year old that like normally wouldn't care about this kind of thing. It's like implanted in my brain. Uh, a guy, a doctor named William Deveries implanted the Jarvik 7 and that was the first like successful design and you know, it looks like a, a heart. Uh, sadly Barney Clark only lived for about 112 days. And as you might expect, it was like complications from like, um,

• 49:50Speaker 02

  the wires and stuff, like it, it wasn't the, the, the artificial heart itself failed. It was just complications from the surrounding things it's connected to.

• 49:59Josh Clark?

  I think four other people got Jarvik 7 implants. Um, and at least one of them did die because the, the machine wasn't working correctly. And I saw

• 50:09Speaker 02

  Oh, really?

• 50:10Josh Clark?

  That those, those wires that were coming out of you, that's connected to the thing that's powering all of it. The original Jarvik 7, that power unit was the size and weight of a, of a full-size refrigerator.

• 50:23Speaker 02

  Oh, my gosh.

• 50:23Josh Clark?

  So if you had an artificial heart, you weren't leaving the hospital anytime soon. And I don't think anybody who had a Jarvik 7 did. But I did see, did you see the, um, story of Leif Stenberg?

• 50:34Speaker 02

  No.

• 50:35Josh Clark?

  So Leif Stenberg was one of the recipients of the Jarvik 7. And I guess they found out after they implanted it that he was actually a Swedish crime boss. And he got an artificial heart and lived for 212 days. And during that time,

• 50:48Speaker 02

  Yeah.

• 50:49Josh Clark?

  His lawyers argued that he, um, could not be tried for crimes that he was, um, facing. And, um, they argued it because under Swedish law, you die once your heart stops beating. And they're like, his heart already stopped beating. He's got an artificial one. So therefore he's legally dead and can't face prosecution.

• 51:09Speaker 02

  That's right.

• 51:10Josh Clark?

  Isn't that nuts?

• 51:11Speaker 02

  I read that over when you sent it. That, that's, uh, that's some legal trickery.

• 51:15Josh Clark?

  It is from our Swedish friends.

• 51:17Speaker 02

  Uh, you know, obviously, um, the first idea would be like, hey, let's make something that looks and like, um, acts and behaves just like a heart. Cause that seems like the most logical thing to do.

• 51:29Josh Clark?

  Sure.

• 51:29Speaker 02

  But as time goes on, as with most things, people come along and say, maybe it should be like simpler. Maybe we can design a streamlined thing that doesn't need to have like, uh, doesn't need to like behave exactly like your traditional heart. And that's what they're doing. That's the stuff they're working on now where, um, it's like a continuous flow with a couple of chambers.

• 51:51Josh Clark?

  Right.

• 51:51Speaker 02

  So like it has a rotor that moves blood constantly instead of like relying on this thing to pump like an actual heart. And it makes just less moving parts, more simplified. It makes a lot more sense, I think.

• 52:02Josh Clark?

  Totally. It's way more stripped down, way, way less parts. So yeah, the idea of wear and tear is much different than what it is with all the other artificial heart designs. So

• 52:12Speaker 02

  Yeah, pretty cool.

• 52:13Josh Clark?

  Yeah. I mean, this, this, I was reading about and people were like, this may be the one, that total artificial heart. That if you go in and you need a heart, they ordered this from the supplier and the supplier sent it to them. And now they're going to put it in your chest and you're going to live X number of years walking around with a knot attached to a fridge.

• 52:30Speaker 02

  Yeah. And they say, you're the first person. And you go, oh, great.

• 52:34Josh Clark?

  I know. Remember we talked about test pilots or test, um, aircraft? And, uh, it was in the, um, Hindenburg episode, I think, where it was like, when you're in the double digits of the, the test, um, aircraft, you do not want to do, you want to wait until at least double or triple digits. Same with an artificial heart.

• 52:53Speaker 02

  Yeah, agreed. Uh, and you know, the last thing I just want to say as far as the PSA is, uh, I feel like heart issues are way more male focused. Uh, you tend to think of like men having a heart attack and men needing this kind of stuff and men having cardiac arrest. But, uh, that's, that's, does a disservice to the fact that, um, plenty of women need this help and care and screenings as well. So, uh, we're, we're talking to everyone here.

• 53:19Josh Clark?

  Yep. Good job, man. That was great.

• 53:22Speaker 02

  Yeah.

• 53:23Josh Clark?

  Uh, well, that's it for heart for now. Um, sorry to disappoint Jerry, who very excitedly said, the band when we told her what we were recording.

• 53:32Speaker 02

  Yeah.

• 53:32Josh Clark?

  Uh, and, uh, since I just said we disappointed Jerry, that means that we've unlocked listener mail.

• 53:40Speaker 02

  Yeah, this is a quick correction of sorts and the short stuff about flappers, you guys. Josh mentioned Clara Bowe was the first it girl. Clara Bowe was in the film It, not the horror film, obviously, and may have been referred to as an it girl. But I believe the very first it girl, as you, uh, guys were talking about was Evelyn Nesbit.

• 54:00Josh Clark?

  Okay.

• 54:01Speaker 02

  Just throwing that out there. Thanks for the great shows. That is from Dave Twiss in Massachusetts.

• 54:06Josh Clark?

  Very nice. Thanks a lot, Dave. Um, yeah, I probably would have guessed Clara Bowe after that. And my God, I would have gotten it wrong again.

• 54:15Speaker 02

  Well, according to this guy.

• 54:17Josh Clark?

  So if you want to be like Dave and tell us something, some fact or correction that may or may not be true, we would love to hear that. You can send it off the email to [email protected].

• 54:31Speaker 00

  Stuff You Should Know is a production of iHeartRadio. For more podcasts, iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.

• 54:47Josh Clark?

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• 55:19Speaker 03

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• 55:48Speaker 04

  This is an iHeart Podcast. Guaranteed Human.