Solving the Mysteries of Heart Disease
Page 46
Importantly, humans have leaned upon these natural governing patterns as they design their own constructions. Da Vinci observed the aortic whorls of blood flow in the heart — spirals that are linked mathematically to patterns created on architectural pillars adorning Greek temples, as well as to mazes atop Neolithic tombs in Ireland in 3000 BC — whose designs ultimately match the gigantic spiral galaxies.
Figure 7: The harmony of natural spirals. The aorta by da Vinci, prehistoric Greek columns, spiral mazes in Ireland, and the cosmos.
But broadening my view toward Stonehenge and the heart required that I move beyond spirals. I had already explored Pythagoras’ introducing the golden section to describe another mathematical principle that is a unifying feature recurring throughout nature’s forms. Figure 8 repeats a previous diagram because I believe this fundamental concept underlies the central focus of my search for uncovering similarities within nature’s grand design.
Figure 8: Upper is the golden section by Pythagoras in 600 BC, where small is to large, as large is to whole. Lower is interface of golden section to create logarithmic spiral by Fibonacci in AD 1250.
Finding Analogies
The emergence of this novel broader view enabled me to search for other mathematical similarities within Stonehenge’s basic construction, some of which might parallel the heart’s geometric form. To my delight, clear, straightforward, and sensational findings emerged.
To begin, the outer Sarsen Circle of Stonehenge (Figures 5 and 9) is a circle that contains within it:
a square in the center, whose width and length are defined by the arms of the inner Bluestone Trilithon Horseshoe
matching rectangles whose outer corner edges touch the outer walls of the Sarsen Circle. A startling harmonic relationship is revealed: if the square size is given a 1.0 value, these two components that touch the Sarsen Circle will each have a 0.618 proportion as they form rectangles. This is the golden section mathematical relationship. (Figures 5, 8, and 9)
3 Pythagorean triangles appear within the 4 Sarsen outer wall pillars. (Figure 6) The summer solstice sunrise is seen as you look through them.
How wondrous that Stonehenge’s creators integrated the core mathematical elements of circle, square, rectangle, Pythagorean triangles, and the golden section ratios before these forms were even known! They dramatically preceded Pythagoras (570–495 BC), who formulated his theorems a thousand years later!
The composite of these structural shapes is simply incredible. Was it happenstance that these prime mathematical relationships are an integral part of Stonehenge? This seems unlikely, as these elements are repeated in nature, and through their presence in Stonehenge, certify they instinctively exist within the mind of the human.
And finally, in the midst of recognizing all of these forms… I found the cardiac analogy.
Uncovering the Answer
My guideline of “elegance is simplicity and confusion is complexity” pointed me toward concentrating upon three specific endpoints: an apex, a conical shape, and a surrounding wrap.
I began with Stonehenge’s view from the circle’s centerpiece (Altar Stone) toward the perpetual summer solstice sunrise. The sun becomes an “apical tip” beyond the megalithic structure — one that is equivalent to the heart’s apex, so vital to its function. (Figure 9)
Figure 9: Relationship between Stonehenge and heart. Each has a conical tip: Stonehenge has the Midsummer sunset and the heart has its vortex. Stonehenge’s “conical body” is surrounded by “a circular wrap,” whose shaded sections mirror the golden section. Likewise, the heart’s apical loop is circumferentially wrapped by the basal loop.
Stonehenge’s conical shape then becomes apparent by creating a simple line drawing extending from each of the U-shaped arms of the Bluestone Trilithon Horseshoe toward this tip (Figure 9) — mimicking the conical shape of the normal heart’s construction.
I was enthralled to discover that the side distances between the horseshoe arms and their surrounding Sarsen circle create an “external buttress” as seen in Figure 9 (I clarified this concept by shading the two outer rectangle boundaries), which mirrors the heart’s buttress-like wrap muscle. Remarkably, these “supporting structures” become the small (area within the shaded rectangles) that relate to the large (area in the larger rectangle that includes the central unshaded square) — within Stonehenge construction.
The Heart’s Golden Proportion
I found it extraordinary that the heart’s architecture parallels the construction of Stonehenge. How astounding that the proportionality between the arms of the Trilithon Horseshoe and Sarsen Circle has the same harmonic relationship that exists within the heart’s inner and outer helical arms… a cardiac parallelism that Figure 10 re-emphasizes.
This dramatic and matching construction between the megaliths and the heart leads to one conclusion: unity wins.
Figure 10: Relationship of helical heart to mathematics. Above, the helical heart, whose spiral is partially unfolded…adjacent to the spiral of mathematics formed by golden proportion. Below, the helix is unwrapped, and the proportional size of the descending (DS) and ascending (AS) segments is in complete harmony with the golden section.
Strength of Opposites
In The Power of Limits, Doczi introduces the term “dinergy” to describe opposite energies creating internal support through complementary actions. Doczi’s meaning is quite evident in the interactions of the helix and its surrounding wrap muscle in the heart. When the heart twists to pump, its stability is ensured because the circumferential wrap contains and prevents the twisting spiral helix from “exploding” as it develops powerful torsion to eject blood to the body. Similarly, the same wrap prevents the cardiac “implosion” that would occur as the helix uncoils to create an inward suctioning motion to rapidly fill the heart. In contrast, imagine the helical whorl of a hurricane where no wrap exists. The swirling expands over many miles to produce massive destruction since there is no complimentary force to contain it.
The equivalent to dinergy in Stonehenge’s geometry is more representational. (Figure 9) Its presence is evident in the two shaded reciprocal rectangles that surround the conical shape aimed toward the Heel Stone. Though the effect of this speculative counterforce upon function within Stonehenge is unclear, dismissing its existence as just a coincidental observation may reflect a shortsighted view, since the golden section’s reciprocal ratios conspicuously exist within this megalithic structure. We simply won’t understand the reason until others uncover the rest of Stonehenge’s mysterious history.
Relating to a Greater Whole
But Stonehenge and the heart are not isolated entities. Each connects to the world around them. Stonehenge is surrounded by the universe, and as far as we can tell, humans created this megalithic structure to allow them to focus upon the Earth’s place within the ever-moving galaxy that surrounds it. The heart possesses a similar pattern, with its location allowing it to constantly circulate nourishing blood to the surrounding body.
In the truest sense, the heart’s life-giving function has allowed humans to create Stonehenge’s spectacular architectural form. These massive stone markers, in turn, permit us to peer at the patterns generated by the grandeur of nature that encompasses us.
Greater Purpose?
The precise objectives of Stonehenge are unknown, though theories range from a “temple to the sun” to an astronomical calculator (that may predict eclipses as well).
But perhaps the perpetual wonder of Stonehenge is linked in part to the enticing simplicity of interdependence in construction that includes the basic mathematical elements: circle, square, rectangle, and triangle. Together, they perennially guide the light of the summer solstice sunrise to its apex, as well as other functions still to be understood. The same wonder applies to the heart, where its inter-functioning parts will efficiently beat together forever.
Everlasting Elegance
A more abstract similarity also exists between the heart and S
tonehenge. It relates to longevity. The configuration of our heart structure is eternal, persisting in generation after generation, and sustained the humans who constructed Stonehenge, which has its own longevity. Our pumping heart began beating over 400 million years ago in fish, and evolved about 100,000 years ago into the human form we have today. Stonehenge was constructed with a corresponding permanence, as those who built it created a megalith configuration that continued long past their own limited spans of time on Earth. The camaraderie between Stonehenge and the heart may further be that they share an enduring elegant simplicity.
What does seem absolutely clear to me is that nature provides us with guiding principles based on harmony and interrelatedness. We humans learn from nature and use this knowledge to introduce beauty and balance into our creations. Our intuitive recognition leads us to build structures with similar patterns and principles. Examples given earlier include the Gothic design of cathedrals (Figure 11) that express the same complementary support (dinergy) that nature employed in icebergs formed many millennia ago. Humans obviously did not participate in their formation, yet our heart’s shape and Stonehenge’s design have the same predictable architectural imprint. How fascinating.
Figure 11: Architectural commonality: On left, a gothic dome church with external buttress support and gothic contour of a church on right. Lower left shows iceberg, and lower right demonstrates how the heart’s apical loop is surrounded by circumferential wrap
Examining Stonehenge in this manner has been the most “out of the box” exploration I have ever pursed, and has resulted in my discovering some marvellous commonalities. The beauty of our interaction with nature is reflected in the parallels that exist between the design of this magnificent megalithic structure, and within the hearts of those who built this landmark over 1,800 years ago.
Intriguingly, the heart that has existed for eternity is only now beginning to be truly understood.
Perhaps Stonehenge will soon follow!
I summarized the structural and functional connections between Stonehenge and the heart in an editorial entitled, “Stonehenge and the Heart: Similar Construction,” in the European Journal of Cardio-Thoracic Surgery, and share this with the reader.
Link to Stonehenge and the Heart: Similar Construction:
https://academic.oup.com/ejcts/article/29/Supplement_1/S286/379460/Stonehenge-and-the-heart-similar-construction
CHAPTER 26
The Helix and Cardiac Disease: The Riddle of Pacemakers
Let’s revisit the current world of understanding heart function, reflected by how a high school science teacher, a medical school physiology professor, or a cardiologist might mimic cardiac action as “clenching a fist to squeeze” for ejection, and “opening all fingers together” for filling. The hand takes on the role of the heart, but this pantomime fails to mirror reality, because the heart primarily twists.
I have cited this discrepancy numerous times in this book because its persistence explains why many cardiac treatments are not more successful. Since disease reflects a departure from normal, the objective of a successful treatment should be to restore normality. But when conventional medicine has a misconception of what is normal — how can they treat a disease?
This is the reason I became so passionate about sharing Paco’s concept of the helical ventricular myocardial band with the medical world. Paco introduced an incredible discovery, but before I would write about and publish what he had uncovered, there were a number of primary questions I had to answer for myself (understanding the right ventricle, the septum, etc.). The last of these queries was how the electrical currents that stimulate the heart can cause the helical muscles to function as they do. (The events described in this chapter took place from 2002 to 2005, but are presented at this point to take advantage of your more complete understanding of the heart.)
I knew that the heart twisted and uncoiled. But why did this happen? I was a cardiac surgeon who possessed limited knowledge of the electrical system, a restriction that imposed a built-in obstacle to my quest. Yet as it would turn out, these absences in my understanding led me to uncover something that was entirely unexpected.
I would discover a vast gap in medical treatment — one that adversely affected millions of people worldwide.
Those who have pacemakers.
Measuring the Electricity
I began my exploration simply enough, by looking at the traditional starting place for calculating electrical impulses in the heart: the EKG.
In movies and in real life, in emergency and non-emergency situations, whenever there is a problem with someone’s heart, a physician will order an electrocardiogram (EKG or ECG). This is the classic approach, since it is electricity that stimulates a heart’s actions and the EKG measures those impulses. A patient lies down and electrodes are attached to the skin on their chest and each arm and leg. These are wired to a device that records the heart’s electrical signals.
An entire field of physicians, called electro-physiologists, focus on detecting and treating diseases from abnormal cardiac electrical impulses. Because of that, EKGs are not something a cardiac surgeon like myself becomes deeply involved with. I needed to start by acquiring a better understanding of this test.
What I knew was that the electrocardiogram records the flow of electrical current within the heart as it travels from one place to another, and this information is displayed as a “tracing” on a continuous grid. (Figure 1)
The tracing shows high and low points (spikes and dips) that are called waves. The terms P wave, QRS wave, and T wave indicate electrical signals that are associated with the heart’s different mechanical movements. The P wave has mild deviations and its impulses cause contraction of the atrium. In contrast, the QRS wave has very dramatic height changes. It appears to be where all the electrical action happens and I thought it represented the contractions of the ventricles. Finally, the medical texts I read indicated that the T wave reflects repolarization of ventricular muscle fibers… meaning they recover to resting levels.
Figure 1: Electrocardiogram, with typical tracing showing the P wave (when atrium contracts), QRS wave (initiation of electrical activity in ventricle), and T wave (recovery of ventricular muscle fibers).
When an EKG reveals a slow heart rate or other irregular rhythms, the most common and well-known solution is to implant a pacemaker to restore a normal heart rhythm and function.
Everyone, including me, believed all would be well after this remedy. But as I would uncover, this was not necessarily true.
Right Terms, Wrong Meanings
While grateful for the knowledge I gained through my novel understanding of the heart structure described by Paco Torrent-Guasp, his unique contribution did not help in my search for explaining how electrical impulses caused the helical heart to function.
Electro-physiologists refer to what they study as “excitation-contraction coupling” — a term that describes the relationship (coupling) between how the observed EKG impulses “excite” a muscle, and how that causes it to contract to produce the heart’s movements. But, as we have seen, the conventional description of the heart’s motion during contraction is wrong. So there was a challenge ahead to uncover how impulses actually stimulate the twisting heart.
More Answers Lead to More Questions
I realized I needed help. Fortunately, I knew just the person to provide it.
This is when I brought Paco with me to visit Jim Cox (the visit that was cited in Chapter 19 about creating my AATS lecture). Jim is the previously mentioned master surgeon and renowned electro-physiologist, who was Chairman of Cardiac Surgery at Georgetown University, and just elected to be the President of the American Association of Thoracic Surgery.
I began by having Paco explain his concept of how the heart functioned. This was Jim Cox’s first introduction to the helical heart and he thought it was nothing less than extraordinary.
The primary purpose of the visit was to discuss how the heart’s electrical sy
stem explained its function. Apparently, some of my conclusions were wrong. Jim explained that while it appears that most of the heart’s mechanical action takes place during the “explosion of electrical energy” displayed during the dramatic QRS wave — very little movement occurs then. Most of the muscular activity takes place during the much more modest-looking T wave interval, though no one entirely understands how.
In fact, while Jim Cox generously shared his knowledge about the interactive muscular relationships reflected by the QRS and T waves, he also highlighted his frustration at the scarcity of knowledge about what causes these heart motions.
I finally said, “Jim, I still don’t understand the relationship of the EKG to the helical heart that Paco just explained to you.”
Jim’s honest reply was, “I don’t either.”
So here I was in the office of one of the most esteemed individuals in the field of heart electro-physiology, and I left with more questions than answers. Of course, that’s not uncommon when interacting with people at the top of their field. The essence of research is that each new answer evokes a fresh question. That meeting was the catalyst for our undertaking the electrical impulse studies that this chapter will describe.
But all my enthusiasm hardly prepared me for the shocker I would encounter.
“All Together Now” (But Not Really)