Pascal J. Goldschmidt, MD

Most likely, you do not need a heart transplant. Most arrhythmia (irregular heart beat) at your age are benign and result from non-cardiac factors (excess coffee, stress, thyroid problem, etc.). You should consult with your primary care provider for more consideration of the cause for the irregularity of your heart.


Pascal J. Goldschmidt, M.D., Fellow A.C.C., Fellow A.H.A.

Normal heart rate is between 60 and 100 beats per minute. A rate of 50 is called bradycardia. However, if you are an athlete, your stroke volume increases (the amount of blood displaced by each heart beat) by about 20%-25%. As a result, your heart does not need to pump as often to provide needed oxygen and other nutrients to brain and body. Hence, 50 could be the proper heart rate for you at rest. If you are not an athlete, you should consult your doctor or nurse to find out why you have bradycardia, conditions like hypothyroidism and sick sinus syndrome could be the cause...

Pascal J. Goldschmidt, M.D., Fellow A.C.C., Fellow A.H.A.

Atherosclerosis is the pathological process that causes arteries (the vessels of the body that distribute oxygen and nutrients to the heart, brain, guts, kidneys, limbs, etc.) to get clogged.
It is a unique inflammatory process that can be accelerated by inherited factors, diabetes, high cholesterol, high blood pressure, smoking, obesity and else. It usually contributes to the build-up of atheroma (obstructive lesions in the arteries) which, one they reach a threshold volume, can limit the amount of blood flow that can reach these organs, leading to symptoms (chest pain, fatigue, shortness of breath, weakness, etc.) and health crises like stroke, heart attack or sudden cardiac death may ensue. Sometimes these atheroma (also called atherosclerosis plaques) can rupture, thus creating a condition prone to clot formation within the culprit artery, which can destabilize the victim by causing sudden death, acute myocardial infarction (heart attack), stroke, ischemic bowel (acute guts crisis), limb ischemia (loss of blood flow to the extremities). Atherosclerosis is the underlying condition that kills more fellow humans than any other known condition. It is the right thing to do to see your doctor about it, and to make sure the condition is stabilized with the life style changes (like diet, exercise, sleep hygiene, etc.) and medications.

The greatest risk factor for stroke is lack of regular physical exercise, it was recently identified as a greater risk than even hypertension, which is the next strongest risk (a risk that can also be substantially improved with regular exercise). Atrial fibrillation (A-Fib), an irregular heart rhythm that develops relatively often with age, is also a serious risk for stroke, because the small chamber (called atrium) of the heart does not contract efficiently as a result of atrial fibrillation, and therefore blood stagnation ensues in the left atrium, upstream from the brain arteries. Indeed, a blood clot can form in the atrium due to A-Fib, and small fragments of the clot can be dislodged and migrate to the brain arteries where they can cause a blockage in a small brain artery, such as the Middle Cerebral Artery, leading to stroke symptoms. Elevated cholesterol is not a risk factor for stroke, although a family of cholesterol lowering medications, called statins, have been shown to reduce the risk of stroke for your father. The other risk factors for stroke include smoking, diabetes, and others. So, if your father, or you, smoke, stop! Initiate a carefully crafted daily exercise routine, your father should seek advice from a care provider to initiate an incremental physical exercise routine, while minimizing risk. Your father must be tested to rule out A-Fib (he probably was already), and so do you if you have an irregular heart beat at times. Your father should be on a medication regimen, which may include a statin, anti-hypertensive, anti-clotting medications, etc.

I will assume that your Father never had a problem with his kidneys or urinary tract, including the bladder. Most likely the bleed is a result of the placement of a foley catheter to collect urines during surgery. You Father probably was also taking anti-platelet agent(s) before surgery, because of his coronary artery disease problem, which increases the chance of bleeding. However, he should have a urine test a couple of weeks after surgery, to make sure that the "blood in urine" problem is resolved, otherwise he should discuss the problem with his internist, or see a urologist.