Overview and Anatomy & Physiology | Endocrine System (Part 1)

Summary

This educational video series introduces the endocrine system, focusing on its role in regulating the body's internal environment through various glands and hormones. It differentiates between endocrine and exocrine glands, explains the types of hormones, and their mechanisms of action. The series will cover endocrine disorders, such as Addison's vs. Cushing's and diabetes, providing foundational knowledge for understanding these conditions. The host, Eddie Watson, encourages viewers to subscribe for more critical care educational content.

Takeaways

• 📚 The video introduces a new series focused on the endocrine system, aiming to provide a solid foundation for understanding various endocrine-related disorders.
• 🔬 The endocrine system is responsible for regulating the body's internal environment through the secretion of hormones by endocrine glands into the bloodstream, as opposed to exocrine glands which secrete substances into ducts.
• 🧠 The nervous and endocrine systems work closely together to regulate growth, reproduction, metabolism, and homeostasis, with the nervous system reacting quickly and the endocrine system having a slower, widespread effect.
• 💉 Hormones are chemical messengers that affect distant target cells and can be categorized into endocrine, paracrine, and autocrine hormones, each with different mechanisms of action.
• 🔑 Hormones bind to specific receptor sites on target cells, acting like a lock-and-key mechanism to initiate a response, with some cells having multiple receptor sites for different hormones.
• 🌟 Hormones can be classified into peptides (water-soluble), steroids (lipid-soluble), and amines (amino acid derivatives with variable behavior), each interacting with receptors in different ways.
• 🔄 Feedback mechanisms, primarily negative feedback, regulate hormone release, maintaining balance by reducing stimulation for hormone production once a certain effect is achieved.
• 🧠 The hypothalamus acts as the control center of the endocrine system, linking the central nervous system with the pituitary gland, which in turn controls other endocrine glands.
• 🌐 The pituitary gland, often referred to as the 'master gland,' releases hormones that stimulate or inhibit the function of other endocrine glands, with distinct hormones from its anterior and posterior parts.
• 🚀 The endocrine system includes various glands such as the thyroid, parathyroid, adrenal glands, and gonads, each with specific roles in metabolism, calcium regulation, stress response, and sex hormone production.
• 🌱 Other organs like the heart, kidneys, stomach, and intestines also release hormones, but their primary function is not endocrine, and they contribute to broader physiological processes.

Q & A

What is the main function of the endocrine system?

The main function of the endocrine system is to regulate the body's internal environment through the secretion of hormones by endocrine glands.

How does the endocrine system differ from the exocrine system?

The endocrine system secretes hormones directly into the bloodstream, while the exocrine system secretes substances into ducts that lead to external places.

What is the role of the hypothalamus in the endocrine system?

The hypothalamus acts as the control center and the link between the central nervous system and the endocrine system, regulating hormone release through signals to the pituitary gland.

Why is the pituitary gland referred to as the 'master gland'?

The pituitary gland is called the 'master gland' because it controls the release of hormones from almost all other endocrine glands in the body.

What are the three subcategories of hormones?

The three subcategories of hormones are endocrine, paracrine, and autocrine hormones, each with different mechanisms of action and target cells.

How do hormones interact with target cells?

Hormones interact with target cells by binding to specific receptor sites on the cell surface or inside the cell, leading to a specific response.

What are the three main categories of hormones based on their chemical nature?

The three main categories of hormones are peptides (protein hormones), steroids, and amines (amino acid derivatives).

How do feedback mechanisms regulate hormone release in the endocrine system?

Feedback mechanisms, primarily negative feedback, regulate hormone release by adjusting the secretion of hormones based on the effects they have on target cells.

What is the primary function of the thyroid gland?

The primary function of the thyroid gland is to release hormones T3 and T4, which regulate metabolism, tissue growth, and help maintain blood pressure.

What are the roles of the adrenal glands?

The adrenal glands have two parts: the cortex, which produces steroid hormones like cortisol and aldosterone, and the medulla, which produces catecholamines like adrenaline and norepinephrine.

What is the significance of the gonads in the endocrine system?

The gonads (ovaries in females and testes in males) are responsible for releasing sex hormones, which are crucial for secondary sexual characteristics, puberty, and menopause.

Outlines

00:00

😀 Introduction to the Endocrine System Series

This paragraph introduces a new educational series focusing on the endocrine system. The host, Eddie Watson, outlines the series' goals, which include providing an overview of the endocrine system and discussing various related disorders such as Addison's and Cushing's diseases, hypoglycemia, diabetes, DKA, HHS, DI, and SIADH. The endocrine system's role in regulating the body's internal environment through endocrine glands is highlighted, differentiating them from exocrine glands. The system's interaction with the nervous system in maintaining homeostasis is also emphasized. The host invites viewers to subscribe for more critical care educational content and thanks them for their support.

05:00

🔬 Understanding Hormones and Their Mechanisms

This section delves into the nature of hormones as chemical messengers and their three subcategories: endocrine, paracrine, and autocrine hormones. The paragraph explains how hormones bind to specific receptor sites on target cells, using the analogy of a lock-and-key mechanism. It also describes the two ways hormones can interact with cells: through surface receptors or by entering the cell to bind with internal receptors. The distinction between water-soluble and lipid-soluble hormones is made, with examples provided for each category, including peptides, steroids, and amines. The paragraph concludes with an introduction to feedback mechanisms, crucial for hormone regulation, with a focus on negative feedback loops as the primary method of control.

10:01

🧠 Anatomy and Physiology of the Endocrine System

The third paragraph provides an in-depth look at the anatomy and physiology of the endocrine system, starting with the hypothalamus, which acts as the link between the nervous and endocrine systems. The pituitary gland is described as the 'master gland,' controlling other endocrine glands through the release of various hormones. The roles of the anterior and posterior pituitary are detailed, along with the functions of hormones like TSH, LH, FSH, prolactin, growth hormone, and ACTH. The paragraph also covers the pineal gland's role in sleep regulation through melatonin production and moves on to discuss the thyroid and parathyroid glands' roles in metabolism and calcium regulation, respectively.

15:06

🫁 Further Exploration of Endocrine Glands and Their Functions

Continuing the exploration of the endocrine system, this paragraph discusses the thymus's role in T-cell maturation, the pancreas's function in blood sugar regulation through insulin and glucagon, and the adrenal glands' complex structure and function. The adrenal cortex is responsible for steroid production, including cortisol and aldosterone, while the medulla produces catecholamines like adrenaline and norepinephrine, which are key to the fight-or-flight response. The paragraph also mentions the gonads, ovaries in females and testes in males, which produce sex hormones essential for secondary sexual characteristics and reproductive processes.

20:08

🌟 Conclusion and Preview of Upcoming Lessons

In the concluding paragraph, the host summarizes the endocrine system's overview, emphasizing the importance of understanding the system's anatomy and physiology for grasping upcoming lessons on endocrine-related disorders. The host thanks viewers for their engagement, encourages them to like and subscribe for more educational content, and teases the next lesson, which will focus on Addison's disease versus Cushing's disease. The host also invites viewers to explore previous series on heart failure, emphasizing the channel's commitment to providing in-depth and valuable educational material.

Keywords

💡Endocrine System

The endocrine system is a collection of glands that produce and secrete hormones directly into the bloodstream to regulate the body's internal environment. It is central to the video's theme as it is the main subject being discussed. The script provides an overview of the system, its components, and their functions.

💡Hormones

Hormones are chemical messengers that have an effect on target cells distant from the cells that secreted them. In the context of the video, hormones are the primary means by which the endocrine system communicates and regulates various bodily functions. Examples include insulin for blood sugar regulation and cortisol for stress response.

💡Endocrine Glands

Endocrine glands are ductless glands that release hormones into the bloodstream. The script differentiates endocrine glands from exocrine glands and explains their role in the endocrine system. Examples of endocrine glands mentioned in the script include the pituitary and thyroid glands.

💡Nervous System

The nervous system is the body's rapid response communication network, which works in conjunction with the endocrine system to maintain homeostasis. The video script explains how the nervous system uses neurotransmitters for fast, localized responses, contrasting with the slower, hormone-mediated responses of the endocrine system.

💡Homeostasis

Homeostasis refers to the body's ability to maintain a stable internal environment despite external changes. The endocrine system plays a crucial role in this process, as explained in the script, by regulating various physiological processes such as metabolism, growth, and fluid balance.

💡Feedback Mechanisms

Feedback mechanisms are processes that regulate the activity of a system by providing information about the system's output. In the context of the endocrine system, the script discusses how negative feedback loops control hormone release, using the example of thyroid-stimulating hormone (TSH) and its regulation by thyroid hormones.

💡Peptides

Peptides are a category of hormones that are protein-based and water-soluble. The script explains that peptide hormones, such as vasopressin and insulin, interact with receptor sites on the cell surface because they cannot penetrate the lipid bilayer of the cell membrane.

💡Steroids

Steroids are another category of hormones that are lipid-soluble, allowing them to pass through the cell membrane and interact with intracellular receptors. The script mentions examples like aldosterone, cortisol, progesterone, and testosterone, which are involved in various physiological processes.

💡Amine

Amines are hormone derivatives of amino acids that can act in different ways depending on their structure. The script explains that amines like epinephrine and norepinephrine act on the cell membrane, while others like T3 and T4 behave like steroids and act inside the cell.

💡Pituitary Gland

The pituitary gland, often referred to as the 'master gland' in the script, is a small gland that controls other endocrine glands by releasing hormones like TSH, LH, FSH, prolactin, growth hormone, and ACTH. It plays a central role in the endocrine system's regulation of body functions.

💡Thyroid Gland

The thyroid gland is an endocrine gland that wraps around the trachea and is responsible for producing hormones like T3 and T4, which regulate metabolism, tissue growth, and blood pressure. The script also mentions the parathyroid glands, which are closely associated with the thyroid and regulate calcium levels.

Highlights

Introduction of a new series focusing on the endocrine system.

Overview of the endocrine system and its components.

Explanation of the difference between endocrine and exocrine glands.

Role of the endocrine system in regulating body's internal environment.

Comparison between the nervous system and the endocrine system.

Definition and function of hormones as chemical messengers.

Subcategories of hormones: endocrine, paracrine, and autocrine.

Mechanism of hormones binding to specific receptor sites on target cells.

Types of hormones based on their solubility: peptides, steroids, and amines.

Importance of feedback mechanisms in hormone regulation.

Detailed anatomy and physiology of the hypothalamus and pituitary gland.

Function of the pineal gland in producing melatonin for sleep regulation.

Role of the thyroid and parathyroid glands in metabolism and calcium regulation.

Explanation of the thymus gland's role in T-cell development.

Function of the pancreas in blood sugar regulation through insulin and glucagon.

Description of the adrenal glands and their role in stress response and fluid regulation.

Overview of the gonads and their production of sex hormones.

Discussion on other organs with endocrine functions like the heart, kidneys, and intestines.

Conclusion summarizing the importance of understanding the endocrine system for future lessons on related disorders.

Transcripts

[Music]

all right welcome you guys this is gonna

be the start of a new series that we're

gonna be doing in which we are going to

be talking about the endocrine system in

this first lesson we're gonna give a

good overview of what the endocrine

system is and what it's composed of the

goal of this first lesson to give you a

good solid foundation when we start to

carry this conversation further about

different disorders that you're going to

encounter in relation to the endocrine

system because in future lessons we're

going to talk about things like the

difference between Addison's and

Cushing's we're also going to talk about

hypoglycemia as well as everybody's

favorite diabetes from there we're gonna

move on to talk about the differences

between DKA and HHS as well as talking

about the differences between di and

SIADH and then finally we'll wrap things

up with talking about the difference

between thyroid storm and Mike Sima coma

so stick with us through the series got

a lot of great lessons coming up for you

guys and so with that said if this is

your first time to our channel and

watching our videos I do want to invite

you guys to subscribe to our channel

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thank you guys all right and so with

that said let's go and start into our

first lesson here doing our overview of

the endocrine system my name is Eddie

Watson and this is ICU advantage so to

really start things off I really want to

begin and kind of talk about what

exactly the endocrine system is and to

really sum it up simply what it does is

it regulates the body's internal

environment and so our body does this

through the use of these glands which we

call endocrine glands but it's important

to differentiate between the endocrine

glands and these other glands that we

call the exocrine glands now each of

these glands are glands because they

produce hormone

which we'll talk about in just a minute

here but our endocrine glands will

secrete these hormones into the

bloodstream

while the exocrine glands are gonna

secrete these hormones into ducts and

those ducts are gonna carry those

hormones to some external place and so

with the endocrine system it's actually

going to be working very closely with

our nervous system and together these

two systems are going to be regulating

things like growth reproduction sex

differentiation metabolism fluid and

electrolyte balance and that internal

homeostasis but it's important to know

that the nervous system the endocrine

system are not duplicating each other

they're actually working in complement

with one another and so to review for

the nervous system basically this is

where it's releasing neurotransmitters

at synapsids at specific target cells

and this is causing some sort of effect

this is a local and specific effect

that's going to be being caused here and

the nervous system reacts very quickly

to stimuli in fact a matter of

milliseconds and then when it stops it

also stops very quickly whereas when we

look at the endocrine system is it's

releasing hormones into the blood that

are going to impact target cells and

cause and effect themselves so this has

a very widespread effect throughout the

body and because these hormones are

having to go into the blood this system

is going to react slowly so here we're

talking seconds to sometimes even days

and then once that stimuli is stopped

you may continue to have a response

after that stimulation is over and so

here we can see that really the big

differentiation between the endocrine

and the nervous system is the use of

these hormones but it helps if we have a

little bit more understanding of what

these are in order to have a good

foundation for understanding the

endocrine system

so essentially hormones are chemical

messengers that they have an effect on

target cells that are distant from the

cells that secreted them and there's

really three subcategories of hormones

that

we can talk about we have the endocrine

the Peregrine and the autocrine now what

we're gonna be talking about mostly is

what we refer to as the endocrine

hormones and these are the ones that are

in the bloodstream released into the

bloodstream but we also have these

paracrine hormones which are going to be

released and act on neighboring cells

and then finally we have the autocrine

hormones which are going to be released

and act on the self or the cell that has

secreted them and so when we talk about

hormones we can talk about these these

different chemical messages and these

hormones are going to act on specific

receptor sites on target cells so let's

imagine that we have a target cell

that's over here it's gonna have

specific receptor sites that will only

match up with specific hormones so in

this example here this hormone would fit

but if this other hormone came along it

would not bind with that receptor site

and would not cause any effect within

that cell and so really you can think of

this almost like a lock-and-key so it's

going to take a specific key for a

specific lock in order to activate that

response and then some cells can have

multiple receptor sites for different

hormones and some cells will have just

specific ones for a specific hormone but

in order to initiate that effect you're

gonna have to have the right hormone to

bind with that receptor site there's two

different ways in which these hormones

can bind with receptor sites on the cell

the first is like the example that I

drew here where these receptor sites are

on the surface of the cell and this

causes some secondary messenger to take

place with inside the cell ultimately

leading to whatever the effect is

supposed to be others are going to be

located within the cell and so here the

hormone must actually enter into the

cell in order to bind with that receptor

and this is usually going to directly

influence the synthesis of some sort of

protein that's going to give us the

effect that we're looking for and really

our differentiation for where these

hormones are going to interact

their receptor is based on whether

they're gonna be water soluble or lipid

soluble and we'll talk about that in

just a minute here and so let's look at

and talk about the different categories

and there's really three categories of

hormones that we're going to be looking

at the first of these is what we call

the peptides and essentially these are

our protein hormones and our peptide

hormones are going to be our water

soluble ones so this means that they're

going to interact with those receptor

sites on the cell surface because

they're not going to be able to

penetrate the lipid bilayer of the cell

surface an examples of these are like

vasopressin or the antidiuretic hormone

insulin growth hormone etc the next

category of hormones is what we call our

steroids and we can think of the

steroids as our lipid soluble hormones

so again these are the hormones that are

going to go inside the cell and interact

with those receptor sites inside of the

cell example of the steroids are things

like aldosterone cortisol progesterone

and testosterone and finally the last

category is something that we call the

amines and these are kind of like

peptide hormones because they're

actually amino acid derivatives and so

these are very interesting because

depending on their configuration they

actually can act different ways so

examples like epinephrine and

norepinephrine are actually going to act

on the membrane of the cell whereas t3

and t4 are going to behave like the

steroids and act inside the cell even

though both of them are made up of these

amino acid derivatives when it comes to

the type of hormone that they are

alright and so the next thing that we're

going to talk about now is the feedback

mechanisms that we deal with when we're

working with hoardin hormones

so some of these hormones are going to

act for a short period of time and with

a small amount of the hormone while

others are going to have a long period

of action and this can really be a very

complex and intricate set of controls

that are going on within this endocrine

system and the release of these hormones

is really going to be regulated by

either some sort of positive feedback

mechanism or some sort of negative

feedback mechanism although the vast

majority of them are going to be working

off this negative feedback and so in

order to really help give you an

understanding of this you have to think

about if we have some sort of stimuli

and that's going to trigger the

secretion of hormones which as we know

are gonna cause an effect on some target

cell now this effect that they have on

the target cell is actually going to go

back and cause a decrease in the

stimulation for the production of the

hormone and so this is that negative

feedback loop and so we're going to talk

about some of these glands here in a

minute but a really good example of this

is the pituitary gland releasing thyroid

stimulating hormone this goes to the

thyroid which causes it to release t3

and t4 and the t3 and t4 is going to go

out into the body and have its effects

on target cells but in addition to that

t3 t4 also inhibits the pituitary and

releasing the thyroid stimulating

hormone so now because we have enough of

this t3 t4 floating around the pituitary

is going to have less of an inclination

to ask the thyroid to release more t3

and t4 all right so that was a pretty

good overview now of the endocrine

system and some of the the differences

that we see within that system and so

the next thing that I want to move on

and talk about is some of the anatomy

and physiology related to the endocrine

system and what these different glands

are and what they're for and so as you

can see here we have a pretty

complicated set of several different

glands that oftentimes are going to be

working together to achieve the various

effects that we're looking to see and so

what we're going to do is we're going to

go through and talk about each of the

different glands

within this endocrine system as well as

talked a little bit about what those

glands are for and so to start off we're

actually going to take a look at our

brain and within our brain there's

actually three different areas that we

are going to talk about all right and

the first of these is actually located

right about here and this is something

that we call the hypothalamus and you

can really think of the hypothalamus as

our control center and the reason for

this is the hypothalamus is our link

between the central nervous system and

the endocrine system so it's going to

take stimuli that are coming in the form

of impulses from within the brain and

it's gonna pass those signals along to

the pituitary gland which is the next

gland that we're going to talk about and

you can find that right about here and

the pituitary is a little pea-sized

gland that's just hanging there

and we can really think about this as

our master gland because as we just

talked about it's gonna take signals

from the hypothalamus and it's going to

send out those signals to almost all the

other endocrine glands essentially

controlling them and telling them to

release their hormones and there's two

parts to the pituitary we have both the

anterior as well as the posterior and

the different parts of the pituitary

gland are going to release different

hormones the posterior is primarily

responsible for our antidiuretic hormone

or vasopressin as well as oxytocin while

the anterior is going to be responsible

for releasing TSH luteinizing hormone

and follicle stimulating hormone

prolactin growth hormone and ACTH and so

like I said these these hormones are

going to go out to many of the other

organs in the body and stimulate them to

do certain things

like for example TSH the thyroid

stimulating hormone is gonna go down and

have an effect on the thyroid

luteinizing hormone and follicle

stimulating hormone that those are gonna

go out to the gonads and have their

effects there but we do also have things

like growth hormone which is going to go

out and it's going to have an impact on

our muscles our skin our bones things

like that and so finally the last gland

that I want to talk about within the

brain is located right in here and this

is what we call the pineal gland and you

can really think of this one as our

sleep gland and the reason for that is

it's going to be producing melatonin to

help us sleep alright so that covers the

the three glands that we're going to

talk about within the brain and so next

we're gonna move on and talk about the

thyroid now we can't talk about the

thyroid though without actually talking

about the parathyroid glands and these

are typically found in four different

locations on the thyroid but these

glands have very different functions so

first let's go and talk about the

thyroid and so you can see the thyroid

and the parathyroid over here and it

actually wraps around the trachea and

the thyroid itself is responsible for

releasing t3 and t4 and t3 and t4 play a

lot of different roles but really you

can think of this as our metabolism

regulation our tissue growth and it also

helps to regulate our blood pressure now

next we'll talk about the parathyroid

glands and like I said you'll find those

actually located right here the green

dots that you see on the thyroid itself

and the parathyroid it actually releases

the parathyroid hormone and the main

goal of the parathyroid is to regulate

our calcium levels and we know that

calcium is important our body because it

plays a role both in muscle contraction

and bone growth now moving on down in

the body the next claim that I'm going

to talk about is this gland where

here and this is what we call the thymus

now I'm not going to cover much on this

because it really doesn't play into the

endocrine system as we really think

about it as a whole system but the

thymus plays a very important role in

the development and maturation of our

t-cells so immature t-cells will

actually go to the thymus in which it

will excrete its hormones to help to

develop those t-cells into mature

t-cells to be able to go out into the

body and to fight off disease so

definitely has an important role in our

body but when we're talking about this

endocrine system that we have here

that's really kind of working together

this one really kind of falls out of

that the line of that

now the next organ that we're going to

talk about is this one right here and

this is what we call the pancreas

now the pancreas is kind of similar to

the thymus and the fact that it doesn't

actually take signals from the pituitary

gland in order to function and do its

job and that's because the pancreas is

responsible for the secretion of insulin

and glucagon and insulin and glucagon

play a very important role in our blood

sugar regulation and so our insulin will

actually be secreted as a result of

eating while glucagon is going to be

secreted as a result of fasting and so

insulin after we eat is going to cause

that blood sugar to come down whereas

glucagon if we have an eight in a while

it's gonna stimulate the liver to

provide the body with the energy that we

need

alright so continuing our journey down

we're next going to talk about two

glands that function together and they

both are located right here on top of

the kidneys and these are what we call

the adrenal glands and the adrenal gland

is broken up into two parts

the first is what we call the cortex

which is the outer part and the other is

the medulla which is going to be the

inner part and

the cortex is going to be responsible

for our steroid production and so this

is going to be our cortisol and our

aldosterone the cortisol plays an

important role in our stress response

while the aldosterone plays an important

role in our fluid regulation now when we

take a look at the medulla this is going

to be responsible for our catecholamine

production so here think of our

adrenaline or epinephrine and our

norepinephrine and these two play a very

important role in our sympathetic

response and this is where you can think

about that fight or flight all right and

so finally moving down to the last two

organs that we have on our example here

which depending on if you are male or

female will determine which one of these

you have and these are gonna be our

gonads and so these obviously are going

to be either our ovaries if you're a

female or testes if you're a male now

the gonads are going to be responsible

for releasing our sex hormones and these

sex hormones are going to be responsible

for many different things including our

secondary sex hormone response as well

as puberty menopause things like that

and this is where you're gonna be

looking at if you're a female with the

ovaries you're gonna have estrogen and

progesterone whereas for the males with

the testes that those are gonna produce

testosterone all right so this pretty

much covers the overview of these glands

within our endocrine system although it

is important to know that there are

other organs within our body that do

have clusters of endocrine cells that

are releasing hormones but it's not

their primary purpose so some examples

of this are the heart which can release

both a n P and B and P which ANP

regulates our blood pressure and our

blood volume whereas B NP is released in

response to stretching within that heart

as well as the kidney itself is able to

produce a retro po eaten which promotes

the production of red blood cells as

well as it also produces renin which is

going to be associated with that release

of aldosterone the stomach and the

intestines they

so release hormones that control our

digestion and then even our bones skin

and our adipose tissue which releases

leptin to tell our body how much fat is

in there all of those also produce

hormones as well but the important thing

is with these organs while they do have

those endocrine cells that produce those

hormones that's not their primary

function they just happen to do that as

a byproduct of something else that they

need all right so that was a pretty

in-depth review both of the anatomy and

physiology as well as the basic

foundation of what the endocrine system

is hopefully you now have a better

understanding like I said a better

foundation to stand on with

understanding what actually the

endocrine system is because as we move

forward with the remaining lessons we're

going to talk about some of the

disorders that result from the lack of

production or overproduction of some of

these hormones within these glands so it

helps to have a good understanding of

what these glands are where they are

what they're doing and what sort of

hormones that they're responsible for

because when we start to talk about

these disorders it will make a little

bit more sense for you guys alright so

with that said I do want to thank you

guys for watching I really hope that you

guys found this lesson to be useful and

enjoyable if you did please hit the like

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long way to help support our channel as

well as if you haven't already make sure

and subscribe to our Channel in the next

lesson we're gonna start our dive into

some of these disorders that you're

gonna come across within the ICU related

to our endocrine system and for these

we're gonna be talking about our

Addison's vs. Cushing's in the meantime

feel free to check out the last series

of lessons we did in which we did an

in-depth coverage of heart failure as

always I want to thank you guys so much

for watching and you have a wonderful

day