Director, Emergency Services, Bikur Cholim Hospital
One of our correspondents asks: How much sleep is required?
This varies according to the individual. Some people can
function on very little and others need more. The average is
seven hours, but babies and teenage girls are the ones who
sleep the most. Sleep quality goes down as one ages, so many
elderly people need help going to sleep or they sleep in the
middle of the day to make up for losses at night.
I was also asked if weight lifting reduces cholesterol more
than walking. The answer is no. Weight lifting will increase
muscle mass — even in females — and will build
strength but not endurance. Nor is it the type of exercise
that helps the heart.
Weight loss reduces high blood pressure. I am asked if it
makes a difference if it is through exercise or dieting. No,
it doesn't, but exercise will build a healthy heart. So try
to do both.
I am asked to speak about heart murmurs. This is simply a
noise that comes from the blood moving over a defective
valve. There are four valves in the heart. The ones on the
left side of the heart are called the mitral and aortic
valves. The former is the valve between the upper chamber of
the heart and the second is the valve at the outlet of the
heart to the rest of the body. These two are the most
commonly affected by disease, and the disease usually comes
in two forms: a valve that does not close completely or a
valve that becomes stuck and doesn't open completely. The
former is called regurgitation, the latter stenosis. They
make characteristic noise on exam and obviously can affect
the functioning of the body by the way the blood is
distributed.
If there is a leaky valve, some of the blood will fall back
into the heart and not get circulated. If there is a sticky
valve, only a small portion of blood will leave the heart,
and backup may occur. Valves can be broken open, or even
completely replaced by valves made of metal or of animal
— most commonly pig. This second kind of valve —
while made from pigs — require no blood thinning, so
they may be safer.
Young women often have benign murmurs. Also, bad valves can
get infected, and this is not a good situation. Valves can be
best evaluated through an echocardiagram or cardiac
catheterization.
Write me in care of the Yated.
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