Expert: What I know about … Cardiology
The doctor is in, and he has some lessons of the heart.
Illustrations by Pop Winson
Who: Dr. Wayne Tymchak
Job: Cardiologist and Professor of Medicine
Experience: Dr. Wayne Tymchak spent several years studying at the University of Alberta, followed by even more time training in Edmonton hospitals learning everything there is to know about the human heart. He has held numerous appointments in the field of cardiology and currently holds multiple positions at the Mazankowski Alberta Heart Institute, including facility site chief, director of cardiology and cardiac intensive care unit director. He is also a professor of medicine at the University of Alberta.
A typical day for Tymchak could include everything from biopsies to procedures, clinics, meetings, teaching, time in the catheterization lab and much more. “It’s never the same thing,” says Tymchak. “That’s also what makes it quite exciting.”
How does the human heart function?
The heart is an amazing organ. It has its own intrinsic pacemaker, so to speak, so basically what the heart does is it collects blood from the venous system, drains the blood from our arms, legs, abdominal organs, from our brain and, through the right side of the heart, [the blood] goes through the pulmonary artery circulation, through the lungs, which then oxygenate the blood, which then allows the left side of the heart to pump or eject the blood out to supply the brain, abdominal organs, arms and legs with oxygen.
What are some of the most common tests or procedures relating to the heart?
The electrocardiogram is probably the most basic test that we have. … Number one, it’ll identify – is the [heart] rhythm a normal rhythm? Number two – are there any arrhythmias? Are there extra beats? It can tell us if there’s any chamber enlargement or thickening. It can identify patients who have had previous heart attacks or myocardial infarctions. It can identify acute changes in patients who present with chest pain syndromes. … There’s a whole host of information that the electrocardiogram can give us.
Is it true that heart attacks are more likely to occur in the morning?
Statistically, heart attacks do occur more often in the early morning hours. There tends to be a blood-
pressure surge at that time, there can be a catecholamine [hormones made in the adrenal glands] surge at that time, and it’s sort of well known that this can happen.
Can you tell me a bit about body cooling techniques and the role they play in regards to the heart?
Open heart surgery is performed under a lower-than-[normal] body temperature, and this has been done now for many years with improved outcomes. Aside from the open-heart procedures, we have a very aggressive cooling program in patients who [have experienced] cardiac arrest where there has been an interruption of blood flow to the brain. And, several studies have shown a significant improvement in cooling the body to 33-34 degrees Celsius for a 24-hour period with respect to brain resuscitation and improvement in brain function.
What are some of the technological advancements that have helped the field of cardiology?
When we began performing coronary angioplasty – meaning you pass a wire in a balloon across a block and you open the block up – you had a one-in-20 chance that that vessel would suddenly block off early after the procedure. With the advent of stents, that prevents that particular complication. With the advent of coated stents, which exude medications that actually prevent in-stent restenosis [narrowing of the blood vessel], the number of patients that actually come back with recurrence of symptoms has reduced tremendously.