Download How the heart works

Session 1
Checklist
How the heart works
The aim of the session is to understand:
What the heart is.
How a normal heart works.
What the heart does.
What circulation is.
The information you need
to get across is:
Session time:
20 minutes
You will need
10 minutes
Training card 1
Visual card 1
What is the heart?
The heart is a muscle that pumps blood around the body. It’s about the size of
your fist and is in the middle of your chest and tilted slightly to the left.
How does a normal heart work?
The right side of the heart:
receives blood from the body and pumps it to the lungs. The blood picks up
fresh oxygen and releases carbon dioxide, and then flows back to the heart.
The left side of the heart:
receives the oxygen-rich blood from the lungs, and pumps it out through the
aorta to the rest of the body.
Summary sheet 1
USB
What does the heart do?
The right side and the left side of the heart work together, to circulate blood
around your body. Circulation of the blood is essential because:
the blood takes nourishment to the body’s tissues and organs
it sends waste materials to the lungs and kidneys, which then get rid of these
from the body.
Each day, your heart beats about 100,000 times and pumps the equivalent of
about 23,000 litres (5,000 gallons) of blood.
How your heart
works poster
What is circulation?
Circulation is the movement of blood around the body, pumped by the heart. This
system is called the cardiovascular system. It contains about five litres (eight pints)
of blood, which your heart is continuously recirculating. Your heart pumps blood
through 97,000km (60, 273 miles) of veins, arteries and blood vessels.
Pre-session preparation
Print out Summary sheet 1
Activities
USB
Key activity: Recap heart discussion
10 minutes
(small groups/pairs) Open the How your heart works poster and ensure the group can see it clearly.
Using the information and illustrations on the poster, ask each small group/pair
to discuss the following points:
About the heart
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1. Where is your heart in your body?
It is in the middle of your chest and tilted slightly to the left.
2. How big is it?
Your heart is about the size of your fist.
3. What job does your heart do?
The heart is the muscle that pumps the blood around your body through a series of blood vessels.
Blood needs to be continuously supplied to every organ in your body.
Blood carries essential oxygen to the tissues and carries away unwanted waste products.
4. How hard does it have to work each day?
Each day, your heart beats about 100,000 times and pumps the equivalent of about 23,000 litres
(5,000 gallons) of blood through 97,000km (60,273 miles) of veins, arteries and blood vessels.
After the discussion ask someone from each small group/pair to share one of their answers with the whole group.
At the end of the session
Hand out Summary sheet 1
USB
Background information
Although you now have all the basic information you need to deliver Session 1, here’s some more detail
you might find useful.
The superior vena cava and inferior vena cava carry deoxygenated (dark red) blood, which has
circulated around the body, into the right side of the heart.
The heart muscle then pumps the blood through the pulmonary artery to the lungs where it picks up
a fresh supply of oxygen.
At the same time, the left side of the heart receives its newly oxygenated (bright red) blood from the
lungs through the pulmonary veins, and pumps it to the rest of the body through the aorta – the
body’s main artery.
There are four valves in your heart. These are situated between the upper and lower chambers of your
heart, in the entrance of the pulmonary artery and the entrance of the aorta. The valves open and close
to allow blood to flow in one direction only.
Both the right and left sides of the heart each have a thin-walled, upper small chamber, called an
atrium, which helps to pump blood into the thicker walled chambers called ventricles.
The heart muscle receives its own blood supply through the left and right coronary arteries, which
arise from the aorta above the aortic valve, and the circumflex artery which branches off the left
coronary artery, and spread out over the surface of the heart. After supplying the heart muscle, the
blood drains back into the right side of the heart via the coronary veins.
For more information
bhf.org.uk
BHF Heart Helpline: 0300 330 3311 for information and support on anything related to heart health.
This service is available in English only.
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Session 2
Checklist
What is coronary
heart disease?
The aim of the session is to understand:
What coronary heart disease is.
How coronary heart disease affects different communities.
How you can reduce your risk of developing it.
The information you need
to get across is:
10 minutes
Session time:
20 minutes
You will need
Training card 2
Visual card 2
What is coronary heart disease?
Coronary heart disease is a condition where the coronary arteries (that supply
blood and oxygen to the heart) become narrowed or hardened by a gradual
build-up of fatty material in their walls. This is called atherosclerosis and the fatty
material is called atheroma.
In time, the artery may become so narrow that it cannot deliver enough oxygenrich blood to the heart muscle when it needs it – such as when you are exercising.
The pain and discomfort that you feel as a result is called angina.
Summary sheet 2
USB
If the atheroma becomes unstable, it may break off and form a blood clot. If the
blood clot blocks the coronary artery, the heart muscle is starved of blood and
oxygen, and may become permanently damaged. This is known as a heart attack
(myocardial infarction).
Cardiovascular disease is also called heart and circulatory disease. It means
all diseases of the heart and circulation, including coronary heart disease (angina
and heart attack) and stroke. Cardiovascular disease is the most common cause
of death in the UK and causes more than one in every three deaths1.
The good news is that, by making simple lifestyle changes, you can reduce your
risk of getting coronary heart disease. If you already have heart disease, furring
up of the arteries isn’t reversible, but the risk of further heart problems can be
reduced by making these changes.
Why are South Asian communities more at risk?
South Asian people living in the UK are up to twice as likely to die from
cardiovascular disease before the age of 69 than the rest of the UK population2.
Pakistani men and women, and Bangladeshi men have a higher risk than other
South Asian groups2.
People of South Asian origin also have a higher rate of premature death from
stroke than the general UK population. And the rates for those born in West
Africa and the Caribbean are even higher2.
About the heart
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How can you reduce your risk of coronary heart disease?
There are several things you can do to help prevent coronary heart disease, including:
stopping smoking
controlling your blood pressure
becoming more physically active
eating a healthy, balanced diet
reducing your cholesterol
if you drink alcohol, keeping within the recommended levels
losing weight (if you need to) and maintaining a healthy weight
trying to prevent or control diabetes
learning to deal with stress.
Pre-session preparation
Print out Summary sheet 2
USB
Activities
Key activity: Coronary heart disease discussion
(whole group) 10 minutes
Discuss coronary heart disease with the group. Ask them to answer the following questions:
1. What do you think happens to the arteries over time?
Over a period of many years, the walls of your arteries can gradually become ‘furred up’ with fatty
deposits (atheroma). If the arteries get too narrow, the blood supply to your heart can be restricted or
even blocked. This is coronary heart disease.
2. At what age do you think this starts happening?
Although coronary heart disease mainly affects older people, the process starts when you are young.
3. Do you think this process is reversible?
The furring up of the arteries is not reversible. However, you can slow the process down by making
some healthy lifestyle changes.
4. What do you think you can do to reduce your risk of coronary heart disease?
stop smoking
control your blood pressure
become more physically active
eat a healthy, balanced diet
reduce your cholesterol
if you drink alcohol, keep within the recommended levels
maintain a healthy weight
try to prevent diabetes, by making simple lifestyle changes
learn to deal with stress.
At the end of the session
Hand out Summary sheet 2
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USB
Background information
Although you now have all the basic information you need to deliver Session 2, here’s some more detail
you might find useful.
Your risk of getting coronary heart disease or having a stroke depends on how many risk factors you
have, and how strong each risk factor is – for example, how high your blood pressure or cholesterol level is.
Research shows that making changes to your lifestyle can have a major effect on reducing your risk.
Knowing about risk factors – how they affect your health and how they increase your risk – can help you
make the necessary lifestyle changes and help you feel more in control of your heart health.
These do not have to be big changes; small changes can make a big difference.
Each person’s risk is individual to them. Although two people may appear to have the same risk factors,
the impact of the risk factors may not be the same.
For up-to-date statistics on coronary heart disease please visit www.heartstats.org
For more information
bhf.org.uk
BHF Heart Helpline: 0300 330 3311 – for information and support on anything
related to heart health. This service is available in English only.
BHF DVDs:
Living to prevent heart disease (aimed at South Asians, with soundtracks in English and five South
Asian languages)
Risking it (English soundtrack and subtitles)
To order these free resources, call the BHF Orderline on 0870 600 6566.
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Session 3
Checklist
Symptoms of coronary heart
disease and heart attack
Session time:
40 minutes
(+ optional
extra 10 minutes)
You will need
Training card 3
Visual card 3
The aim of the session is to understand:
What the symptoms of coronary heart disease are.
What a heart attack is.
What the common symptoms of a heart attack are.
The importance of calling 999 immediately if you think
you are, or someone else is, having a heart attack.
What a cardiac arrest is.
The information you need
to get across is:
10 minutes
What are the symptoms of coronary heart disease?
The symptoms of coronary heart disease vary for each individual. Some people
may be breathless when they try to do normal everyday things, others may have
chest pain (angina). No two people are the same.
Summary sheet 3
USB
Angina is a type of coronary heart disease. If you suffer from angina you can help
to prevent your condition becoming worse by looking at your lifestyle and making
simple changes. Having angina does not necessarily mean that you will have a
heart attack, but it does increase your risk. If you experience chest pain for the
first time or your angina symptoms are different from what you are used to, then
you could be having a heart attack. And, you should call 999 immediately.
What is a heart attack?
Watch your own
heart attack film
A heart attack happens when a blood clot completely blocks one of the coronary
arteries that supply the heart. As a result of this, a part of the heart muscle does
not get an adequate blood supply. This can permanently damage the heart
muscle. Some people also develop a life-threatening irregular heartbeat, which
can lead to sudden death. Most heart attacks happen as the result of coronary
heart disease.
What are the common symptoms of a heart attack?
The symptoms of a heart attack can vary from one person to another. Some
common symptoms include:
chest pain or discomfort which may spread to the arms, neck, jaw, stomach or back
a dull pain, ache or ‘heavy’ feeling in your chest
chest pain or discomfort which feels like indigestion but which also makes you
feel generally unwell
feeling sick, sweaty, breathless, lightheaded, dizzy or generally unwell, as well as
having chest pain or discomfort.
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About the heart
Why is it important to call 999 immediately if you think you are having
a heart attack?
During a heart attack, the sudden loss of blood supply to the heart muscle causes two problems:
It damages your heart. Once the blood supply is interrupted your heart muscle will start to die. If a large part
of your heart muscle dies, it can lead to heart failure and greatly reduce your quality of life in the future.
It increases the risk of having a life-threatening irregular heartbeat, which may lead to a cardiac arrest.
What is a cardiac arrest?
This is when someone’s heart stops pumping. Unless they receive basic life-support (chest compressions and
rescue breaths) quickly, they will die.
One in three people who have a heart attack will die before they reach hospital. That’s why it’s so important to
call 999 immediately.
Heartstart UK
Ideally, everyone should know what to do if someone has a heart attack or a cardiac arrest. About three in
every four cardiac arrests happen away from hospital and there may be nobody around to help.
Heartstart UK is an initiative coordinated by the BHF to teach members of the public what to do in a
life-threatening emergency – simple skills that save lives. It only takes two hours to learn the skills, which
may some day save a life.
To find out more about Heartstart UK, or to find a course near you, call the BHF Heart Helpline
on 0300 330 3311.
Pre-session preparation
Print out Summary sheet 3
USB
Activities
Key activity: Symptoms of a heart attack discussion
(whole group) 10 minutes
Ask the group to recall the symptoms of a heart attack. Write their answers on a flipchart. Finish with the
statements that if you, or anyone around you, experience any of these symptoms, don’t ignore them. Call
999 immediately. The longer you wait for medical assistance, the lower your chance of survival.
Common symptoms include:
chest pain or discomfort which may spread to the arms, neck, jaw, stomach or back
a dull pain, ache or ‘heavy’ feeling in your chest
chest pain or discomfort which feels like indigestion but which also makes you feel generally unwell
feeling sick, sweaty, breathless, lightheaded, dizzy or generally unwell, as well as having chest pain or discomfort.
Key activity: Barriers to calling 999 discussion
(small groups/pairs) 20 minutes
People often delay calling for an ambulance when experiencing chest pain or other symptoms of a heart
attack. As this delay can lead to permanent damage to the heart, or death, ask the groups or pairs to answer
the following questions:
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1. Why do you think people delay calling 999 when they are having chest pain or other symptoms of a
heart attack?
There are many reasons, including:
uncertainty about the symptoms
not wishing to make a fuss
refusing to believe that it could be happening to them.
Remind them that, the longer you wait to call, the greater the risk of permanent damage to the heart
muscle, and the greater the risk of dying. Calling for an ambulance is vital if you think you are having a
heart attack.
2. What might stop you calling 999 if you were experiencing chest pain or other symptoms?
Examples might be:
Worry about a language barrier between you and the 999 operator. (You do not need to worry about
this as translators are available.)
You thought you would call your GP first. (Calling your GP will cost you precious time – always call 999 if
experiencing chest pain or other symptoms of a heart attack.)
You thought that the symptoms were caused by something else.
After the discussion
Ask the groups/pairs to nominate a spokesperson to share a couple of their answers with the whole group.
Write their suggestions on a flipchart.
Make a clear statement – that you should call 999 immediately if you think you are, or someone else is,
having a heart attack. The emergency services would rather hear from you and discover that it is a false
alarm than not hear from you at all.
Additional activity: Short film – Watch your own heart attack
(whole group) (optional extra 10 minutes)
If you have time, show the group the two-minute film, Watch your own heart attack, which shows what it is like
to have a heart attack. (You can watch it at www.2minutes.org.uk).
Afterwards, discuss how the film makes them feel and whether it would help them recognise the symptoms
if they, or someone else, experienced them. Emphasise that:
this only shows some common symptoms and
they shouldn’t ignore symptoms which are more subtle, or different to those in the film.
At the end of the session
Hand out Summary sheet 3
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USB
Background information
Although you now have all the basic information you need to deliver Session 3, here’s some more detail
you might find useful.
Symptoms of a heart attack
It’s important to remember that the symptoms of a heart attack can vary from one person to another.
They can be mild, severe, or somewhere in between. No two heart attacks are the same. Symptoms
can range from a severe pain in the centre of the chest, to having mild chest discomfort that makes
you feel generally unwell. In many cases, chest pain or tightness are accompanied by a range of other
symptoms. Some people may not experience chest pain at all but feel pain in other areas such as their
jaw, back or shoulder.
Treatments for heart attack
The most common treatments for people with acute coronary syndrome (heart attack or unstable angina)
are thrombolysis or a coronary angioplasty with stents.
Thrombolysis helps to dissolve the clot that is blocking the artery, and helps to restore the blood
supply to the heart muscle. Ideally the injection should be given as soon as possible. That’s why, if you
think you may be having a heart attack, it is important to call 999 immediately, so that the blood supply
to your heart muscle can be restored as quickly as possible.
Coronary angioplasty with stent is a treatment to widen the narrowed artery. When angioplasty is
done as an emergency, it is called primary angioplasty.
Women and heart disease
Coronary heart disease (CHD) kills three times more women than breast cancer and there are over
one million women in the UK living with CHD.
Women are less aware than men about their risk of CHD and often ignore, or do not know, the
symptoms of a heart attack. They are also slower to call 999 for help, dramatically reducing their
chances of survival.
They are less likely to seek help from their GP so are often more unwell and difficult to treat.
Some women may think of coronary heart disease as a male problem, as women tend to get heart
disease later in life than men.
Women may be protected by female hormones until the menopause. It’s true that fewer women than
men get coronary heart disease before the age of 50, but by the time women reach their 60s the gap
between men and women narrows.
Women are also less likely to attend cardiac rehab programmes, making recovery difficult and
increasing the risk of future events.
Women should be encouraged to:
- recognise the risk factors for coronary heart disease and the signs and symptoms
- have a cardiovascular risk assessment, particularly after the menopause, and
- be aware of their blood pressure.
For more information
bhf.org.uk
BHF Heart Helpline: 0300 330 3311 – for information and support on anything
related to heart health. This service is available in English only.
BHF booklets:
Heart attack (in English)
Coronary angioplasty (in English)
Women and heart disease (in English)
To order these free resources, call the BHF Orderline on 0870 600 6566.
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