What is truncus arteriosus. How is it diagnosed. What are the symptoms of truncus arteriosus. What causes this congenital heart defect. How common is truncus arteriosus. What treatment options are available for truncus arteriosus.

What Is Truncus Arteriosus?

Truncus arteriosus is a rare congenital heart defect characterized by a single common blood vessel emerging from the heart, rather than the usual two vessels (the main pulmonary artery and aorta). This condition occurs when the blood vessel fails to separate completely during fetal development, resulting in a connection between the aorta and pulmonary artery.

In a normal heart, the right side pumps oxygen-poor blood to the lungs through the pulmonary artery, while the left side pumps oxygen-rich blood to the body through the aorta. However, in babies with truncus arteriosus, oxygen-poor and oxygen-rich blood mix as they flow to the lungs and the rest of the body. This mixing leads to excessive blood flow to the lungs and forces the heart to work harder to pump blood throughout the body.

Types of Truncus Arteriosus

There are several types of truncus arteriosus, classified based on how the arteries remain connected. The specific type can affect the severity of the condition and the required treatment approach. Additionally, most cases of truncus arteriosus are accompanied by a ventricular septal defect (VSD), which is a hole between the bottom two chambers of the heart (ventricles).

The Truncal Valve

Instead of having separate aortic and pulmonary valves, babies with truncus arteriosus have a single common valve called the truncal valve. This valve controls blood flow out of the heart and is often abnormal. It may be thickened and narrowed, obstructing blood flow as it leaves the heart, or it may leak, causing blood to flow back into the heart across the valve.

How Common Is Truncus Arteriosus?

Truncus arteriosus is a rare congenital heart defect, occurring in less than one out of every 10,000 live births. In the United States, there are approximately 250 cases of truncus arteriosus reported each year. While it can occur in isolation, truncus arteriosus may also be associated with certain genetic disorders.

Despite its rarity, understanding the prevalence of truncus arteriosus is crucial for healthcare providers and researchers. This knowledge helps in allocating resources for diagnosis, treatment, and ongoing care for affected individuals.

What Causes Truncus Arteriosus?

The exact causes of truncus arteriosus, like many congenital heart defects, remain largely unknown. However, researchers have identified several factors that may contribute to its development:

• Genetic factors: Some babies develop truncus arteriosus due to changes in their genes or chromosomes.
• Environmental factors: Certain elements in the mother’s environment during pregnancy may play a role.
• Maternal diet and nutrition: What the mother eats or drinks during pregnancy could potentially influence fetal heart development.
• Medications: Certain medications taken during pregnancy might increase the risk of congenital heart defects.

It’s important to note that in most cases, truncus arteriosus occurs sporadically, without any identifiable cause. Ongoing research aims to uncover more about the underlying mechanisms leading to this and other congenital heart defects.

How Is Truncus Arteriosus Diagnosed?

Truncus arteriosus can be diagnosed during pregnancy or shortly after birth. Early detection is crucial for proper management and treatment of this condition.

Prenatal Diagnosis

During pregnancy, several screening tests can help detect congenital heart defects, including truncus arteriosus:

1. Routine ultrasound: Some heart defects may be visible during a standard prenatal ultrasound.
2. Fetal echocardiogram: If a healthcare provider suspects truncus arteriosus, they may request this more detailed ultrasound of the baby’s heart. This test can reveal structural problems, such as a single large vessel coming from the heart, and assess how the heart is functioning with the defect.

Postnatal Diagnosis

After birth, infants with truncus arteriosus typically show signs of distress within the first few days of life. Common symptoms include:

• Breathing difficulties
• Rapid heartbeat
• Weak pulse
• Bluish skin color (cyanosis)
• Poor feeding
• Extreme sleepiness

If truncus arteriosus is suspected, healthcare providers may use the following diagnostic tools:

1. Echocardiogram: This ultrasound of the heart can confirm the diagnosis by showing the single large vessel coming from the heart, the misshapen truncal valve, and any associated defects like a ventricular septal defect.
2. Pulse oximetry screening: This simple bedside test measures the oxygen levels in a baby’s blood. Low oxygen levels can indicate a critical congenital heart defect like truncus arteriosus.

What Are the Treatment Options for Truncus Arteriosus?

Truncus arteriosus is a critical congenital heart defect that requires prompt medical intervention. The primary goal of treatment is to separate the mixed blood flow and ensure proper circulation to the lungs and body.

Surgical Repair

The standard treatment for truncus arteriosus is surgical repair, typically performed within the first few weeks of life. The surgery involves:

• Separating the pulmonary arteries from the truncus
• Creating a new connection between the right ventricle and the pulmonary arteries using a tissue or artificial conduit
• Closing the ventricular septal defect
• Repairing or replacing the truncal valve if necessary

While this surgery is complex, it has significantly improved outcomes for babies born with truncus arteriosus. However, follow-up surgeries may be needed as the child grows, particularly to replace the conduit connecting the right ventricle to the pulmonary arteries.

Medications

Before and after surgery, various medications may be used to manage symptoms and support heart function:

• Diuretics to reduce fluid buildup
• Medications to strengthen heart contractions
• Drugs to lower blood pressure in the lungs

Long-term Care

Children with truncus arteriosus require lifelong cardiac care and monitoring. Regular check-ups, echocardiograms, and other tests are essential to track heart function and address any complications that may arise.

What Is the Prognosis for Individuals with Truncus Arteriosus?

The prognosis for individuals with truncus arteriosus has improved significantly over the past few decades, thanks to advancements in surgical techniques and medical management. However, it’s important to understand the long-term outlook and potential challenges.

Survival Rates

With early diagnosis and appropriate surgical intervention, the majority of infants with truncus arteriosus survive to adulthood. Studies have shown that:

• The 30-day survival rate following surgical repair is approximately 90%
• Long-term survival rates (20 years post-surgery) range from 70% to 80%

These figures underscore the importance of early detection and timely treatment in improving outcomes for affected individuals.

Quality of Life

Many individuals who have undergone surgical repair for truncus arteriosus can lead relatively normal lives. However, they may face certain challenges:

• Need for multiple surgeries throughout life, particularly to replace conduits as they grow
• Potential for arrhythmias or other cardiac complications
• Possible exercise limitations
• Ongoing need for cardiac monitoring and medications

Despite these challenges, many patients achieve good functional status and report a satisfactory quality of life.

Reproductive Considerations

Women with repaired truncus arteriosus who wish to become pregnant should consult with a cardiologist specializing in adult congenital heart disease. While pregnancy is possible for many, it carries increased risks and requires careful monitoring.

How Can Truncus Arteriosus Be Prevented?

As with many congenital heart defects, there is no guaranteed way to prevent truncus arteriosus. However, certain measures may help reduce the risk of congenital heart defects in general:

• Prenatal care: Regular check-ups during pregnancy can help identify potential issues early.
• Folic acid supplementation: Taking folic acid before and during pregnancy may reduce the risk of certain birth defects, including some heart defects.
• Avoiding harmful substances: Pregnant women should avoid alcohol, tobacco, and illicit drugs.
• Managing chronic conditions: Women with conditions like diabetes should work closely with their healthcare providers to manage their health during pregnancy.
• Genetic counseling: For families with a history of congenital heart defects, genetic counseling may provide valuable insights and guidance.

While these measures may not specifically prevent truncus arteriosus, they contribute to overall fetal health and development.

What Research Is Being Conducted on Truncus Arteriosus?

Ongoing research into truncus arteriosus aims to improve understanding, diagnosis, and treatment of this rare congenital heart defect. Some key areas of investigation include:

Genetic Studies

Researchers are working to identify specific genetic mutations associated with truncus arteriosus. This could lead to improved genetic testing and counseling for at-risk families.

Fetal Intervention

While not yet a reality for truncus arteriosus, researchers are exploring the possibility of fetal cardiac interventions for various congenital heart defects. This could potentially allow for treatment before birth, improving outcomes.

Tissue Engineering

Scientists are developing new materials and techniques for creating artificial blood vessels and heart valves. This could lead to improved conduits for surgical repair, potentially reducing the need for repeat surgeries as patients grow.

Long-term Outcomes

Ongoing studies are tracking individuals with repaired truncus arteriosus into adulthood. This research provides valuable insights into long-term prognosis, quality of life, and potential late complications.

Novel Surgical Techniques

Surgeons continue to refine and improve surgical techniques for repairing truncus arteriosus, aiming to enhance outcomes and reduce complications.

These research efforts offer hope for improved management and outcomes for individuals affected by truncus arteriosus. As our understanding of this complex condition grows, so too does our ability to provide effective care and support to patients and their families.

Congenital Heart Defects – Facts about Truncus Arteriosus

Truncus arteriosus pronounced TRUNG-kus ahr-teer-e-O-sus), also known as common truncus, is a rare defect of the heart in which a single common blood vessel comes out of the heart, instead of the usual two vessels (the main pulmonary artery and aorta).

What is Truncus Arteriosus

Truncus arteriosus is a birth defect of the heart. It occurs when the blood vessel coming out of the heart in the developing baby fails to separate completely during development, leaving a connection between the aorta and pulmonary artery. There are several different types of truncus, depending on how the arteries remain connected. There is also usually a hole between the bottom two chambers of the heart (ventricles) called a ventricular septal defect. Because a baby with this defect may need surgery or other procedures soon after birth, truncus arteriosus is considered a critical congenital heart defect (CCHD). Congenital means present at birth.

In a baby without a congenital heart defect, the right side of the heart pumps oxygen-poor blood through the pulmonary artery to the lungs. The left side of the heart pumps oxygen-rich blood through the aorta to the rest of the body.

In babies with a truncus arteriosus, oxygen-poor blood and oxygen-rich blood are mixed together as blood flows to the lungs and the rest of the body. As a result, too much blood goes to the lungs and the heart works harder to pump blood to the rest of the body. Also, instead of having both an aortic valve and a pulmonary valve, babies with truncus arteriosus have a single common valve (truncal valve) controlling blood flow out of the heart. The truncal valve is often abnormal. The valve can be thickened and narrowed, which can block the blood as it leaves the heart. It can also leak, causing blood that leaves the heart to leak back into the heart across the valve.

Learn more about how the heart works »

Occurrence

Truncus arteriosus occurs in less than one out of every 10,000 live births. It can occur by itself or as part of certain genetic disorders. There are about 250 cases of truncus arteriosus per year in the United States.¹

Causes and Risk Factors

The causes of heart defects, such as truncus arteriosus, among most babies are unknown. Some babies have congenital heart defects because of changes in their genes or chromosomes. Congenital heart defects are also thought to be caused by the combination of genes and other risk factors such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses.

Read more about CDC’s work on causes and risk factors »

Diagnosis

Truncus arteriosus may be diagnosed during pregnancy or soon after the baby is born.

During Pregnancy

During pregnancy, there are screening tests (also called prenatal tests) to check for birth defects and other conditions. Some heart defects might be seen during an ultrasound (which creates pictures of the body). If a health care provider suspect a baby might have truncus arteriosus, the health care provider can request a fetal echocardiogram to confirm the diagnosis. A fetal echocardiogram is a more detailed ultrasound of the baby’s heart. This test can show problems with the structure of the heart, like a single large vessel coming from the heart, and how the heart is working with this defect.

After a Baby is Born

Infants with truncus arteriosus usually are in distress in the first few days of life because of the high amount of blood going to the lungs which makes the heart work harder. Infants with truncus arteriosus can have a bluish looking skin color, called cyanosis, because their blood doesn’t carry enough oxygen. Infants with truncus arteriosus or other conditions causing cyanosis can have symptoms such as:

• Problems breathing
• Pounding heart
• Weak pulse
• Ashen or bluish skin color
• Poor feeding
• Extreme sleepiness

If a health care provider suspects a baby might have truncus arteriosus, the health care provider can request an echocardiogram to confirm the diagnosis. An echocardiogram is an ultrasound of the heart that can show problems with the structure of the heart, like the single large vessel coming from the heart or misshapen truncal valve. It can also show how the heart is working (or not) with this defect, like if the blood is leaking back into the heart or if it is moving through a hole between the ventricles. Echocardiograms are also useful for helping the doctor follow the child’s health over time.

Truncus arteriosus is a critical congenital heart defect (CCHD) that may be detected with newborn pulse oximetry screening (also known as pulse ox). Pulse oximetry is a simple bedside test to determine the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a CCHD. Newborn screening using pulse oximetry can identify some infants with a CCHD, like truncus arteriosus, before they show any symptoms.

Treatment

Medications

Some babies with truncus arteriosus also will need medicines to help strengthen the heart muscle, lower their blood pressure, and help their body get rid of extra fluid.

Nutrition

Some babies with truncus arteriosus might become tired while feeding and might not eat enough to gain weight. To make sure babies have a healthy weight gain, a special high-calorie formula might be prescribed. Some babies become extremely tired while feeding and might need to be fed through a feeding tube.

Surgery

Surgery is needed to repair the heart and blood vessels. This is usually done in the first few months of life. Options for repair depend on how sick the child is and the specific structure of the defect. The goal of the surgery to repair truncus arteriosus is to create a separate flow of oxygen-poor blood to the lungs and oxygen-rich blood to the body. Usually, surgery to repair this defect involves the following steps:

• Close the hole between the bottom chambers of the heart (ventricular septal defect) usually with a patch.
• Use the original single blood vessel to create a new aorta to carry oxygen-rich blood from the left ventricle out to the body.
• Use an artificial tube (conduit) with an artificial valve to connect the right ventricle to the arteries going to the lungs in order to carry oxygen-poor blood to the lungs.

Most babies with truncus arteriosus survive the surgical repair, but may need more surgery or other procedures as they get older. For example, the artificial tube doesn’t grow, so it will need to be replaced as the child grows. There also may be blockages to blood flow which may need to be relieved, or problems with the truncal valve. Thus, a person born with truncus arteriosus will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems.

Reference

1. Cara T. Mai, Jennifer L. Isenburg, Mark A. Canfield, Robert E. Meyer, Adolfo Correa, Clinton J. Alverson, Philip J. Lupo, Tiffany Riehle‐Colarusso, Sook Ja Cho, Deepa Aggarwal, Russell S. Kirby.  National population‐based estimates for major birth defects, 2010–2014. BDR Oct 2019.

The images are in the public domain and thus free of any copyright restrictions. As a matter of courtesy we request that the content provider (Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities) be credited and notified in any public or private usage of this image.

The images are in the public domain and thus free of any copyright restrictions. As a matter of courtesy we request that the content provider (Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities) be credited and notified in any public or private usage of this image.

Google Slides: Adding Pictures and Shapes

Lesson 11: Adding Pictures and Shapes

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Adding pictures and shapes

Adding pictures and shapes can make your presentations more interesting and engaging. The picture and shape tools in Google Slides also let you customize your images by cropping, reordering, changing colors, and adding other formatting.

Inserting pictures

You can insert a picture from a file on your computer onto any slide. Google Slides even includes tools for finding online pictures and adding screenshots to your presentation.

To insert a picture:

1. Open the Insert menu, then select Image.
2. You can choose an image from a number of sources. In our example, we’ll Search the web.
3. The Google images search pane will appear on the right. Enter your search terms to find an image you’re interested in.
4. Click the desired image, then click Insert.
5. The image will appear on the selected slide.

Formatting pictures

There are a variety of ways to format the pictures in your slide show. Google Slides has tools to resize and rotate the picture, crop the picture, adjust the image, and more.

To crop an image:

1. Select the image you’d like to crop, then click the Crop command.
2. Cropping handles will appear around the image. Click and drag one of the handles to crop the image. Make sure the mouse is right over the black cropping handle so you don’t accidentally select a resizing handle.
3. Click the Crop command again. The image will be cropped.

To crop an image to a shape:

1. Select the image you want to crop, then click the Mask Image drop-down arrow next to the Crop command. From the drop-down menu, hover over a category; then, choose the desired shape that you want to insert.
2. The image will appear formatted as the shape.

After cropping the image to a shape, you can click the crop button again to use the cropping handles and adjust the size and proportions of the shape.

Image options

You can adjust an image’s transparency, brightness, contrast, and more. To do this, select the image, then click Format options on the toolbar or in the Format menu. The Format options pane will open.

Moving and resizing pictures

• To move an image: Select the image, then drag it to the desired location.
• To resize an image: Select the image you want to resize. Sizing handles will appear. Click and drag the sizing handles until the image is the desired size. You can use the corner sizing handles to change the image’s height and width at the same time.
• To rotate an image: When the image is selected, click and drag the rotation handle above the image.

Inserting shapes

Shapes are a great way to make your presentation more interesting. Google Slides gives you a lot of different shapes to choose from, and they can be customized to suit your needs, allowing you to use your own color palette, preferences, and more.

To insert a shape:

1. Click the Shape command on the toolbar to open the drop-down menu. Hover over one of the categories, then choose a shape.
2. Click and drag in the desired location to add the shape to the slide. In our example, we’ll draw the shape on top of the robot image for now.
3. The shape will appear on the slide.

Formatting shapes

In Google Slides, you can modify shapes in a variety of ways to suit your needs. Shapes can be moved and resized just like images, and they have a few other options for adjustment.

Some shapes have the option to change their dimensions and proportions. To adjust the proportion of a shape, select it, then click and drag the diamond handle.

You can further customize shapes by changing their fill color, line color, line weight, and line dash. Select a shape, then click one of the four shape format commands to see the menu for that option.

Reordering objects

In Google Slides, each slide may have multiple items, such as pictures, shapes, and text boxes. When objects are inserted into a slide, they are placed on levels according to the order in which they were inserted into the slide.

In our example, we drew a teardrop shape on the top level, obscuring the robot picture behind it. We can reorder it to put it behind the other objects.

To reorder an object:

1. Select the object you want to reorder.
2. Open the Arrange menu, select Order, then choose how you’d like to reorder the object. In our example, we’ll select Send to back.
3. The object will reorder. In our example, the shape is a nice background for the robot image.

You can arrange multiple overlapping objects using the Order commands. In our example, we selected the robot image and used the Send backward command. The robot image is behind the cloud, but in front of the teardrop shape.

Challenge!

1. Open our example file. Make sure you’re signed in to Google, then click File > Make a copy.
2. Select slide 15 and resize the picture of the robot so it’s as tall as the slide.
3. Crop the robot so the robot’s hands and everything below them are no longer showing.
4. Move the robot to the lower-right part of the slide.
5. To the left of the robot picture, insert a speech bubble shape.
   Hint: Speech bubbles can be found in the callout category.
6. With the shape still selected, drag the yellow diamond handle toward the robot’s mouth, then type the words Go forth and be safe!
7. Change the font size of the text to 30 pt and the alignment of the text to center align.
8. Change the fill color of the shape.
9. When you’re finished, your slide should look something like this:

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Cardiac Cycle – an overview

12.2 Echocardiographic approach to the LV contractility

During a cardiac cycle, the LV wall shortens, thickens, and twists along the long axis. Shortening and thickening can be quantified by measuring regional strains. Strain or myocardial deformation from developing forces is expressed as either the fractional or the percent change from the original dimension [17,18]. Positive radial strains represent wall thickening (radial deformation), whereas negative strains represent segment shortening (e.g., circumferential shortening, longitudinal shortening, and fiber shortening) [14].

Three perpendicular axes orienting the global geometry of the LV define the local cardiac coordinate system: radial, circumferential, and longitudinal.

Echocardiographic techniques like tissue Doppler imaging have excellent temporal resolution (± 4 ms) and could be used for the assessment of myocardial deformations [14] (see Chapter 2).

The base and apex of the LV rotate in opposite directions. Twist defines the base to apex gradient in the rotation angle along the longitudinal axis of the LV and is expressed in degrees per centimeter [9,23]. Torsion and twist are equivalent terms. Torsion can also be expressed as the axial gradient in the rotation angle multiplied by the average of the outer radii in apical and basal cross-sectional planes, thereby representing the shear deformation angle on the epicardial surface (unit degrees or radians) [23]. This normalization can be used as a method for comparing torsion for different sizes of LV. When the apex-to-base difference in LV rotation is not normalized, the absolute difference (also in degrees or radians) is stated as the net LV twist angle [24].

Speckle-tracking echocardiography (STE) has emerged as an alternative technique [25] (see Chapter 2). The robustness and the clinical applicability of that technique are nowadays only validated for the assessment of global longitudinal strain [26,27]. When considering regional longitudinal strains, there are inaccuracies according to the software used. Longitudinal LV mechanics, which are predominantly governed by the subendocardial region, are the most vulnerable component of LV mechanics and therefore most sensitive to the presence of myocardial disease. The first of them is the ischemic etiology that will affect first the subendocardium. The mid-myocardial and epicardial function may remain relatively unaffected or weakly affect in patients with HF and preserved LV EF. Circumferential strain and twist may remain normal or show exaggerated compensation for preserving LV systolic performance. Increase in cardiac muscle stiffness, however, may cause progressive delay in LV untwisting. Loss of early diastolic longitudinal relaxation and delayed untwisting attenuate LV diastolic performance, producing elevation in LV filling pressures and a phase of predominant diastolic dysfunction, although the LV EF may remain normal. The diagnostic of these HF with preserved ejection that most affect the subendocardium could be very difficult and might require submaximal exercise stress echocardiographies [28]. It has not been proposed in past recommendation, but that could change [29].

On the other hand, an acute transmural insult (like a myocardial infarction) or progression of disease results in concomitant mid-myocardial and subepicardial dysfunction, leading to a reduction in LV circumferential and twist mechanics and a reduction in LV EF. Assessment of myocardial function, therefore, can be tailored per the clinical goals. The detection of altered longitudinal function alone may suffice if the overall goal of analysis is to detect the presence of early myocardial disease. Further characterization of radial strains, circumferential strains, and torsional function provides assessment of the transmural disease burden and provides pathophysiologic insight into the mechanism of LV dysfunction [30]. For instance, the pathophysiologic process such as radiation that affects both the pericardium and the subendocardial region may produce attenuation of both longitudinal (first) and circumferential (afterwards) LV function [31]. Several studies have reported the strain values in patients with systolic HF (Table 12.1), HF with preserved LV EF, and hypertrophied cardiomyopathies. The data proposed in Table 12.1 are rather convergent; however, these measurements of LV systolic longitudinal strains are not used or proposed in guidelines such as in those for HF with preserved LV EF.

Table 12.1. Principal studies published in the field of heart failure with depressed LV ejection fraction

GLS, global longitudinal strain.

As a rule of thumb, a global longitudinal strain less than − 17% is an independent parameter of severity of the cardiomyopathy [33]. In HF with preserved LV EF, the prognostic cut-off that is most frequently reported is − 16% [38].

In more complex cardiomyopathies like those induced by anthracyclins, it seems that as soon as the global longitudinal strain is less than − 19%, physicians have to carefully monitor the patients. Studies are ongoing to know whether dedicated treatments like ACE-inhibitor and B-blockers should be introduced [26].

Although strain data are valuable in patients with systolic HF, the indication for an ICD or a biventricular pace maker remains dependent upon the degree of LV dysfunction as determined by the LV EF (Figures 12.1 and 12.2). The LV EF should be measured, according to recommendations using the apical four- and two-chamber views using the Simpson method. The M mode should not be used especially in hearts having a spherical remodeling.

Figure 12.1. Automatic measurement of left ventricular volumes in systole and diastole for an automatic calculation of the ejection fraction (Simpson method).

Figure 12.2. Use of an ultrasonic contrast agent to improve the echocardiographic detection of left ventricular endocardial borders. It will help to best quantify the left ventricular geometry and systolic function.

In the present and even more in the very near future, real-time 3D echocardiography (RT3DE) should improve the robustness and reproducibility of the echo data [39–41]. It is not yet available everywhere (see Chapter 2). Still, improvements in transducer are required for the actual transfer of the 3D approach in clinical practice. Feasibility remains lower than for the 2D approach [42,43]. It has been demonstrated that in patients in whom serial examinations are obtained, the 3D echocardiographic approach is the most reliable [39,44].

Other approaches are available (Figures 12.1–12.4) [25,45]. Pulse tissue Doppler is the most relevant and is a way for assessing LV longitudinal systolic function as well as MAPSE.

Figure 12.3. Assessment of regional and global left ventricular longitudinal strain.

Figure 12.4. Assessment of the longitudinal component of the left ventricular systolic function. MAPSE: mitral annular plan systolic excursion measured by M-mode; S’: pulse tissue Doppler recording systolic and diastolic velocities and s’ is corresponding to the systolic peak velocity of the displacement of the mitral annulus; longitudinal global strain: assessment of the longitudinal deformation of the whole left ventricle using the speckle tracking technique.

In addition to these measurements (LV EF required, global longitudinal strain, or pulse tissue Doppler), one must measure the LV stroke volume (Doppler and volumetric approaches) for estimating the cardiac output and finally the efficacy of this LV contractility to eject enough blood in the arterial tree (Figure 12.5).

Figure 12.5. Right ventricular shape in normal and pathological condition. Under normal loading conditions, the right ventricle (RV) appears crescent-shaped in cross section (a) and triangular-shaped in the sagittal plane (c), and the interventricular septum is concave toward the LV in both systole and diastole. In condition of RV pressure and volume overload, left deviation of the interventricular septum may occur, which causes a reduction of the LV cavity and LV function impairment (b and d). In this patient, an end-dyastolic LV sphericity index (LV major axis/LV minor axis) = 2 (b), identifies a severe alteration of LV morphology due to severe pulmonary hypertension.

Also, as already mentioned, stress tests might be required to look for contractile reserve, in particular. Without going into much detail in regard to the technique, dobutamine could be used, but submaximal exercise stress echocardiography is probably the ideal approach to test the systolic response and the diastolic response of the failing heart. In HF with preserved ejection, the absence of systolic and diastolic reserve has already been mentioned. In ischemic heart disease, it has to be tested; sometimes, one is “surprised” to observe that without any acute ischemia, the exercise unmasks a dynamic functional mitral regurgitation that might be very useful for understanding the symptoms and is perhaps the best treatment of a patient with systolic HF [46].

In addition to the assessment of viability or contractile reserve, it might be necessary to look for myocardial ischemia. The techniques are the same as in a non-failing heart, being nevertheless aware of the risk of maximal dobutamine stress test in patients with a failing heart (risk of ventricular arrhythmia, in particular).

See Priyanka Chopra as a Kid in Cute Pic Shared by Nick Jonas

Nick Jonas celebrated his wife’s birthday by looking back. Way back—as in long before he even knew her. For her 39th birthday on July 18, Jonas posted a throwback photo of Priyanka Chopra as a kid, along with a more recent photo of her in a similar outfit. Chopra has shared many old pictures of herself on Instagram that show everything from her childhood to her late ’90s style, and it’s sweet to see Jonas get in on the action in honor of her special day. Read on to see what Jonas posted and more of how Chopra celebrated her birthday.

RELATED: Priyanka Chopra Just Shared an Adorable Throwback of Herself at 17.

In his Instagram post, Jonas shared two photos: one of Chopra recently, and another when she was a little girl, wearing a sari in the same light pink shade as she is in the first. “Happy birthday my love,” he wrote. “You deserve all the happiness in the world. Today and every day. I love you.” The photo of adult Chopra was taken at the wedding of Jonas’ brother, Joe Jonas, and his wife, Game of Thrones star Sophie Turner. 

© Priyanka Chopra / Instagram

Chopra didn’t post much about her birthday celebration, but she did share a photo on her Instagram Story of a very fancy bottle of wine on a table covered with party poppers and confetti. She wrote on the post, “[heart] you @nickjonas.” According to the Hindustan Times, Jonas is in the U.S. currently while Chopra is in London, so it appears he had the wine sent to her. The bottle she photographed goes for an average of about $1,700.

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Jonas always makes a point to post about Chopra’s birthday. Last year, he shared a photo of them sitting together on a balcony and wrote, “I could stare into your eyes forever. I love you baby. You are the most thoughtful, caring and wonderful person I have ever met. I am so grateful we found one another. Happy birthday beautiful.”

In 2019, he shared photos of Chopra, again taken at Joe and Turner’s wedding. “Light of my world. My whole heart. I love you baby. Happy birthday,” he captioned the post.

Denis Makarenko / Shutterstock.com

For Jonas’ 28th birthday on Sept. 16, 2020, Chopra posted a video full of various clips of Jonas, including him working on The Voice and them dancing together. “So grateful you were born. Happy birthday my love,” she wrote.

The previous year, she posted a similar video that also include pictures from their December 2018 wedding. “The light of my life,” Chopra wrote. “Everyday with you is better than the last. You deserve all the happiness in the world. Thank you for being the most generous loving man I have ever met. Thank you for being mine. Happy birthday Jaan. I love you.”

RELATED: 17 Celebrity Women Who Have Much Younger Partners.

Parts of the Heart | Norton Children’s Louisville, Ky.

The heart is a muscle about the size of your fist. The parts of the heart work together as two pumps in one. The right side of the heart receives blood from the body and sends it to the lungs. The left side of the heart receives blood from the lungs and sends it out to the body. The blood gives the body oxygen and nutrients, as well as carries waste away.

The parts of the heart fall into three broad categories:

• Chambers
• Valves
• Heart wall

Heart Chambers

The heart has four chambers. The chambers are blood-filled areas attached to major veins or arteries that bring blood to or carry blood away from the heart.

• The left and right atria are the upper two chambers that receive blood. The right atrium receives oxygen-poor blood from the two largest veins, the superior vena cava and inferior vena cava. The left atrium receives oxygen-rich blood from the pulmonary veins. Both atria then pump this blood supply into the ventricles.
• The left and right ventricles are the lower two chambers that send blood out of the heart. The right ventricle pumps oxygen-poor blood into the lungs through the pulmonary artery. The left ventricle pumps oxygen-rich blood into the body through the largest artery in the body, called the aorta.

The atria and ventricles work together. The atria fill with blood, then move blood into the ventricles. The ventricles squeeze, pumping blood out of the heart. While the ventricles squeeze, the atria then fill up with blood to ready for the next pump.

Heart Valves

The heart has four one-way valves that connect the chambers. These parts of the heart all work together, acting like doors opening and closing to keep blood flowing in the right direction. They close to keep blood from flowing backward in the wrong direction.

• These valves let blood flow from the atria to the ventricles:
  • Mitral valve: Located between the left atrium and left ventricle
  • Tricuspid valve: Located between the right atrium and right ventricle
• These valves control blood flow from the heart to the body:
  • Aortic valve: Located between the left ventricle and the aorta
  • Pulmonary valve: Located between the right ventricle and the pulmonary artery

Heart Wall

The heart wall has three layers:

• Endocardium: The thin membrane that lines the inside of the heart
• Myocardium: The middle and thickest layer of the heart
• Epicardium: The thin layer on the surface of the heart where the coronary arteries lay

The septa, or septum, are muscular walls that divide the heart into two sides.

The pericardium is a thin sac that contains the heart. It often is filled with fluid that helps separate the heart from other organs, including the lungs.

How the Heart Beats

Learn how the heart beats from Christopher L. Johnsrude, M.D., pediatric cardiologist and associate professor in the University of Louisville School of Medicine Department of Pediatrics. Dr. Johnsrude serves as director of the pediatric arrhythmia service at Norton Children’s Hospital.

How The Heart Beats

Heart Care at Norton Children’s Heart Institute

At the Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, you will find a comprehensive array of advanced pediatric heart services and compassionate care for children of all ages, from before birth to newborns, kids and teens.

Our multidisciplinary team practices medicine with great skill. We use advanced diagnostic and surgical procedures to treat congenital heart defects and acquired heart conditions in children. We also provide lifelong follow-up care for adults with congenital heart disease. Our heart center truly provides care for a lifetime. From diagnosing a congenital heart defect before birth to caring for the adult needing follow-up later in life, we are your heart care partner for a lifetime.

Cards and pictures Hearts Cards

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Postcards and pictures Hearts

In this category you will find postcards, pictures, which depict hearts, hearts. Send your loved ones thousands of hearts! Let your love overcome any distance with the help of love cards! Just send a postcard from the Hearts section and make your soul mate happy.Here are collected beautiful and funny cards with hearts.

Even if you are now not close, but far from each other, or just work, and you have a desire to tell your loved one about love, then this section is for you. Here you will find many delicate virtual postcards.

Download for free and send these postcards to your beloved girlfriend, boyfriend, beloved, beloved, husband, wife! Now you can share these cards via social networks.

Free Postcards Postcards and Pictures Hearts Postcards.

You are in the “Postcards” gallery. This category is described by our visitors as follows “Cards and Pictures Hearts Cards”
Here you will find a lot of pictures on the theme “Cards and pictures Hearts Cards” online. You can download any postcards, pictures, animations to your phone, tablet, computer, laptop for free and send them to your friends, relatives, relatives and share them for free via social networks or WhatsApp (whatsapp).

Heart: pictures and drawings

In ingenious simplicity, the drawing of the heart gives the most sincere and strong emotions.It is a romantic gift, a symbol of love and passion. And if you make the image yourself, then the pictures will easily win the heart of the person to whom they are intended. All that remains is to choose the right one so that the girl or boyfriend, child or parents feel your love.

And there is plenty to look for! On our site there is a huge selection of photos with hearts, for every taste. But to make it easy to navigate in our one of the best collections, where various heart pictures are collected, we divided them into 3 categories:

1. Common templates, where you can find different shapes and types;
2. Wallpaper and background, funny and funny, gentle and cute ideas are waiting for you here;
3. Drawing for sketching.Any template on this page can be downloaded to complete the love surprise yourself.

Now let’s pay more attention to each section.

Stylish pictures with imagination

Here you will find only a picture with hearts! Many, many and completely different. You can’t even imagine what kind they might look like:

• Small and large;
• Cool and touching;
• Convex and plump.

Whatever it is, these images always have a cool look with different shapes, surfaces, and textures.

It is a pleasure to enter this beautiful section together with a dear person. Or download images to make a gift, or, most likely, a transparent loving hint of your feelings. Such a photo will be highly appreciated.

Cute drawings of hearts:

Heart emoticons:

Various wallpapers

Everyone who got into this section will have a real love story. What will not be discussed here! And in whatever form a heart capable of love will not appear before us: here is an angel with him, and a valentine, and a Teddy bear, and a bunny, and even a teddy bear, whose hand holds a red heart.There is a kiss. And how do you like it caught with a clothespin, or a collage where the palm opens this symbol of a wonderful feeling?

This and much, much more.A whole poem that your loved one will appreciate. Perhaps he will especially like your idea of ​​giving two hearts at once, as if hinting that you are a couple whose feelings have united forever.

Or, variations where a wing or palm decorate the picture. A fluttering heart can be presented to a dear person. This naive, almost childish gesture simply and intelligibly says a lot. As if you are fluttering from surging feelings and are ready to tell the whole world about it.

These pictures are perfect for the background on the desktop.They will give a positive mood, and their inherent romantic side will give a little brightness to any day.

We draw using templates

But in this section we are waiting for all creative people! Take a pencil in hand and start creating your best masterpieces. Dedicate them to your loved ones, it will be especially pleasant for them to receive the picture you created.

In this category, you will find blanks for the manifestation of your talent. Download the outline of the image you like in black and white, and think about how you want the picture to turn out.You are free to choose even the style of sketching and design. Do you want you to get a work in the avant-garde style or surrealism will add color to the picture. Everything! Anything you want! And we will help you create this masterpiece.

In our collection, this theme has different facets, and takes into account the taste of all our visitors. We propose to explore each section in order to be able to take advantage of the offer – download a picture.

Give a heart image, set it as wallpaper and develop creatively! 90,000 What can be done to keep the heart healthy – Rossiyskaya Gazeta

What can be done to keep it healthy

Despite the fact that mortality from heart attacks and strokes in Russia has declined, the absolute figures remain very high.Every year in our country 1.2 million people die from heart and vascular diseases.

Galina Baryshnikova, Professor of the Department of Family Medicine of the Central State Medical Academy of the Administrative Department of the President of the Russian Federation, spoke about what a person can do to reduce the risk, and at any age.

What makes the heart hard

The risk of developing heart and vascular diseases depends on many factors. Gender and age are so-called uncontrollable factors that we cannot change.But there are also many that we can influence ourselves or with the help of doctors. These are arterial hypertension, high cholesterol, smoking, obesity, unbalanced diet, excess alcohol, physical inactivity.

Men 45-50 years old are already at risk. Even if they feel quite “eagles”, it is still necessary to be examined at this age. The fact is that a person may not feel high blood pressure at all, consider himself healthy. And then suddenly fall off with a seizure.It is high blood pressure that most often provokes a stroke.

Hypercholesterolemia is also not felt and does not affect the state of health, and it is possible to identify trouble only by making a blood test. Therefore, control is needed.

All this fully applies to women. Moreover, after 50 years, women quickly catch up with men in terms of the frequency of heart disease.

“The good news is that most of the risk factors for cardiovascular diseases are controlled – they can be dealt with,” explains Galina Baryshnikova.- It’s another matter whether we really want this, whether we are concerned with our health. Thus, 44 percent suffer from hypertension. adult Russians, among men – 47 percent, and many do not treat her. The acceleration of the rhythm of life, numerous stresses lead to the fact that hypertension is getting younger. “

1. Where to start

Of course, with finding out the state of your body. To do this, you need to regularly measure blood pressure and cholesterol levels.

What indicators to focus on “Not so long ago, American and European cardiologists revised the normal blood pressure figures.Previously, the upper limit of the norm was considered a pressure of 140/90, now 130/80 is already hypertension. And the norm is 120/80. If you “catch” hypertension at the beginning, while the indicators are borderline, you can try to cope with it without pills, only by changing the daily routine. But at a certain stage, Professor Baryshnikova emphasizes, drug therapy is required. Moreover, this is not a one-time intake of drugs that “bring down” blood pressure (by the way, this is very risky). The medications prescribed by the doctor must be drunk constantly.

A loose waist warns: there is a high risk that the heart will ache to normalize blood pressure. Recently, drugs have appeared in which both anti-pressure components and cholesterol-lowering components are combined in one tablet, which, by the way, according to the latest recommendations, should also be kept as low as possible. “

2. Helpers for the heart

In addition, potassium and magnesium help support the health of the heart and blood vessels. “The lack of these trace elements is caused by stress, taking certain medications, their lack is observed in patients with diabetes mellitus. And even absolutely healthy people who regularly visit the gym and baths are at risk, since trace elements are lost along with sweat,” Baryshnikova explained. their deficiency disrupts the heart rhythm, pressure fluctuations occur, muscle weakness, headaches, sleep disturbances and much more may appear.Low potassium levels lead to the development of arrhythmias, heart failure. In regions where water is depleted of these substances, mortality from cardiovascular diseases is higher. You can compensate for the deficiency if you take medications containing potassium and magnesium. It is not necessary to drink them all the time, but it would be useful to take a monthly course, say, in spring and autumn. “

Photo: Alexander Korolkov.

3. What’s on the plate

There are no” special “products for the heart …”Ate, and order” – that will not work. But on the other hand, proper nutrition is the same for the prevention of all diseases. Nutritionists’ advice is simple: the basis is vegetables, herbs, fruits, whole grains (not “quick-boiled”, but those that have to be cooked a little longer), legumes. Lean meat (pork to a minimum, but turkey, rabbit, chicken, veal – good). As well as fish, especially sea fish. All of this, including low-fat dairy products and eggs, is a source of protein. And “fast” carbohydrates – sweets, breads and white flour baked goods – should be kept to a minimum.Like salt, this alone will help lower blood pressure by a few units. Well, do not forget about foods with a high content of potassium and magnesium: greens, orange and red vegetables and fruits, oatmeal, buckwheat.

The method of preparation is also important. Baked potatoes are not forbidden (there is a lot of potassium), but it is better to stop loving fries. It’s better to cook yourself – it’s easier to make food healthy. In fast food, as in canned food and processed meats (sausage, etc.), there is too much salt and sugar.

Photo: depositphotos.com

4. Ski poles instead of weights

Cardiologists do not recommend intensive strength training – to pull weights and a barbell. This is for the young and healthy. Moderate but regular activity is needed to maintain vascular health. Enough 30 minutes of brisk walking a day, plus skiing, biking, swimming on weekends. With aerobic exercise, breathing is activated and the pulse rises, the metabolism is accelerated – this is the most effective way to get rid of extra pounds.

Photo: depositphotos.com

5. What to strive for

Doctors use two benchmarks for normal physique: BMI (body mass index, which is obtained by dividing weight in kilograms by the square of height in meters). The upper limit of the norm is 25 (for example, a person has such a BMI with a height of 1.72 m and a weight of 73-74 kilograms).

The second indicator: waist circumference, by which doctors judge about “internal” (abdominal) obesity, which affects the blood vessels in the most deplorable way. OT for a woman should not exceed 80 cm, and for a man – 94 cm.If OT is higher than 88 and 104 cm, respectively, doctors warn of a high risk of heart and vascular diseases.

Photo: depositphotos.com

6. Habits under control

As for bad habits, doctors definitely have a negative attitude towards smoking. “Every smoked cigarette is a nail in the heart,” said Dr. Baryshnikova. But cardiologists are more loyal to wine. “In the Mediterranean countries – France, Italy, Spain, where they eat not only fish and seafood, but also a lot of meat – there is a low mortality rate from heart disease,” says Baryshnikova.“Largely because they drink red dry wine there.”

Red wine contains substances useful for blood vessels: flavonoids, the antioxidant resveratrol. The main thing is not to be greedy, to drink in moderation, which, unfortunately, is not typical for our culture.

WHO established a safe daily dose of alcohol: no more than 30 ml in terms of alcohol for men and no more than 20 ml for women. The norm is modest – a glass or two of dry wine or a glass of strong alcohol at a time. But we want to stay healthy.

“Studies in large cohorts have shown that the risk of death from cardiovascular disease is higher in those who do not drink at all or abuse alcohol. But those who do not give up alcohol, but drink in moderation, get sick less often”, – explained the professor. True, some experts had doubts about an absolutely sober lifestyle: it is quite possible that not completely healthy people got into the group of non-drinkers, hence the higher mortality rate.

Heart for a wedding – 59 photos of examples of using the attribute of lovers

In a wedding ceremony, the whole atmosphere is filled with particles of love.And of course, no wedding is complete without heart-shaped decorations, because this is a symbol of love and fidelity.

They can be different: large, small, colorful, paper, money and even balls.

And if you are a master of fantasy, then you can come up with something more original. For example, create a volumetric composition of two connected hearts or one large red heart, as in a wedding photo.

Article content:

Applications for Heart Jewelry

You can make a wedding composition from hearts yourself, or you can attract professionals.

As a rule, heart-shaped ornaments are used to decorate:

Cars for newlyweds and guests. Stickers with hearts are glued in front, and a volumetric structure in the form of a heart or two connected together is attached on top.

If you have the time and skillful hands, you can safely reproduce such a masterpiece yourself, using the Internet tips, otherwise professional salons are at your service.

Celebration room.Almost no wedding is complete without a heart made of balloons.

But only without using helium! Even if the heart is fixed very firmly, it is not worth the risk that at one, completely inappropriate moment, this splendor does not fly up to the ceiling.

Premises for the first wedding night. For this, you can also use various compositions of hearts: from balls, from flowers, from paper, cardboard, etc.

Collage of photographs of the bride and groom, which are usually presented as a gift by close friends of the newlyweds.For example, on one side there are photos of the groom, and on the other – the bride.

And so, the photos placed in a chaotic manner gradually approach the center of the collage, which is decorated with hearts of different shapes and colors.

And completing the idea of ​​a collage photo in the center – newlyweds in each other’s arms.

Gifts. A heart-shaped gift made of money will be unusual. But for this, you should prepare in advance, attend either a master class, or use design ideas and step-by-step instructions from the Internet.

So, you can make a heart for a wedding with your own hands from cardboard paper and wrap it in paper bills, fixing it on small strips of stationery tape.

Or, alternatively, make origami figures in the shape of hearts out of money and present them on a beautiful stand.

A wedding cake that can be not only decorated with hearts, but also made in the shape of a heart.

Today it is not difficult at all.It is enough to entrust this matter to professionals.

But if there is a skilled and experienced cook in your environment, then it will not be difficult for him to bake a heart-cake on his own. To do this, you need to bake two biscuit cakes, one in the shape of a square, the other round, so that the diameter of the circle is equal to the length of the square.

Divide the circle in half and apply it to the near edges of the square. A cream is applied on top and covered with glaze or mastic.

Fire show compositions.At the end of the wedding celebration, fireworks and fireworks in the form of hearts can flare up.

Or young ones at nightfall can light prepared hearts with special impregnation located on the street with torches. This will leave a lasting impression on those present.

You can launch Chinese lanterns in the shape of a heart into the sky.

Quilling paper heart

Quilling is a newfangled phenomenon in the production of volumetric or flat compositions from paper, performed using the paper-rolling technique.

To make a heart in this way you will need: red paper, thin sticks for twisting paper or toothpicks, PVA glue.

First cut the red paper into strips. Then these strips are wound on thin sticks in the form of a spiral. The necessary details are made from the spirals. Glue them together from the center to the edges, forming a heart. You can decorate the entire wall with such hearts, which will really surprise your guests.

Paper bulk heart

This process can involve all not indifferent and creative relatives or resort to professional craftsmen.

For independent creativity you will need: cardboard, red paper, graphite pencil, PVA glue, double-sided tape and scissors.

Cut out patterns of several hearts of different sizes from cardboard. Use them to make copies on red paper in pencil. Use scissors to cut them out, making a small notch in the center.

Bend the cut edges slightly and form a voluminous heart by gluing the edges. Glue the tape on the other side of the heart.Now decorate the walls with them to your liking.

What will be your wedding to choose for you, but it will definitely not do without hearts! But the main thing is that your two hearts are already beating in unison and advice and love to you!

Photo of a heart for a wedding

90,000 Why does the ♥ symbol look like this?

The heart is a rather unsightly-looking organ.A lump of intertwined ventricles, veins and muscles, you see, does not cause absolutely any romantic associations. However, in its crudely simplified form, the heart has become the main metaphor for love.

This refers, of course, to the well-known symbol of the heart (♥), which is especially popular among the younger generation. In the modern world, it is found everywhere: in jewelry, Valentine’s Day cards, on T-shirts, in the form of graffiti on the walls, etc.

How did it happen that this symbol, strange from a medical point of view, became a familiar image of the human heart and, moreover, an expression of our love and desires?

Or, more precisely, like this:

… became this?

The origins of the heart shape

Historians have discovered relics whose shape strongly resembles the modern symbol of the heart.But these early specimens (3000 BC), engraved on Greek, Minoan, Cretan, Mycenaean and Roman pottery, were only images of ivy leaves or fig trees and had absolutely nothing to do with the human heart or the idea of ​​love. …

In Ancient Greece, for example, this symbol was often used to depict a vine, personifying the god of winemaking Dionysus. During festivities in his honor, priests used to decorate their heads with a wreath of ivy leaves, reminiscent of the modern heart symbol:

Gold ivy wreath found in Halkidiki, Greece (c.350 BC)

In Etruscan art (4th century BC, Italy) ivy leaves symbolized procreation, fidelity, rebirth and were often presented during wedding ceremonies to the bride and groom. In the 2nd century BC. Buddhists began to use this symbol to depict the leaves of a fig tree, symbolizing enlightenment.

Heart-like symbols were originally images of ivy leaves and had nothing to do with the idea of ​​love

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In the city of Kyrenia in the 2nd century, this symbol was used to denote sylphium, a plant used as a contraceptive.The trade in this plant was so profitable that even coins with the image of sylphium seeds were issued:

Cyrene coins with the image of sylphium seeds

Despite the obvious external similarity with the modern symbol of the heart, these images had nothing to do with human anatomy … Historians are not entirely sure when exactly these images began to be associated with the heart, but the answer, obviously, lies in the lack of serious anatomical knowledge in ancient times.

Some of the earliest studies in the field of anatomy were carried out by Galen of Pergamum, a Greek physician who treated serious gladiatorial injuries and was able to examine human organs without performing an autopsy. He presented the results of his research in 22 volumes of medical text, including a description of the heart, the shape of which was compared to a pine cone or an inverted leaf.

Between antiquity and the Middle Ages, much of the medical knowledge was lost in part due to the obstacles of the Roman Catholic Church.As a result, scientists, artists and doctors were forced to rely on ancient anatomical descriptions. Galen’s writings have been the primary source of authority for all writers and physicians for nearly 1,300 years.

The appearance of the heart symbol

Starting from the middle of the 13th century, the ♥ symbol began to appear in works of art, depicting no longer ivy leaves, but a human heart and, moreover, love.

The first known instance of this use was found in the French manuscript Le roman de la poire (1250 BC).). As was then customary, the first letter of each chapter was often decorated with ornaments and miniatures. One of these letters, “S”, depicted a man offering his heart (a symbol of love) to his beloved:

French manuscript “Le roman de la poire” (1250), depicting a kneeling man who Offers his heart to his beloved

Despite significant advances in anatomy in the 16th and 17th centuries (including Leonardo Da Vinci’s anatomically accurate sketches of the heart), the ♥ symbol gained immense popularity.

Anatomically accurate sketches of the human heart by Leonardo Da Vinci (1507)

While all previous depictions of the heart symbol were usually inverted, starting in the 1500s. they have acquired their present direct position. Here are some examples we found:

An image from the French manuscript “Petit Livre d’Amour” (c. 1500) illustrates a man who places his heart in a flower representing his beloved

Shield depicting the five wounds of Jesus during his crucifixion (c.1530)

Saint Augustine holding a burning heart (Philippe de Champagne, circa 1650)

Another reason for the appearance of this symbol is associated with playing cards. The first deck of cards was developed by the Egyptian Mamluks in 1370 and consisted of 4 suits: bowls, coins, swords and polo clubs. By 1450, the Swiss had changed them to shields, roses, acorns, and bells. Only at the beginning of the 1500s. the French invented the suits that are known to us to this day: trèfles (clubs ♣), carreaux (tambourines ♦), piques (spades ♠), and cœurs (hearts ♥ (translated from French.cœurs – hearts)).

Playing cards gained immense popularity, and the ♥ symbol, in turn, finally took on the meaning of the heart.

French deck of cards (circa 1550)

On December 27, 1673, Margaret Maria Alakok, nun of the Order of the Visitation of the Blessed Virgin Mary, announced that she had a vision of Jesus Christ calling her to rest her head against his heart and tell the world about his eternal love for him. Since then, there has been a belief that the physical heart of Jesus Christ is the embodiment of divine love for humanity.

We ♥ Symbols

In 1977, the I ♥ NY logo was developed during an advertising campaign in New York, which was the first use of the symbol as a substitute for the verb to love “.

Interestingly, after the symbol was used in the video game The Legend of Zelda (1986) to represent “lives left,” health food companies and even the American Heart Association began to use the symbol as ideograms of health.

Today this symbol is found absolutely everywhere: schoolchildren draw it on the margins of their notebooks, secretly sighing for their beloved; someone wears a T-shirt with a heart, and someone decorates the bumper of their car with a heart.

This is how the once unsuccessful attempt to depict the human heart turned into such a popular and cute symbol “♥”, personifying love and our preferences in general.

High conversions for you!

Based on materials from: priceonomics.