expert type icon EXPERT

Tim Alexander Fischell, MD

Cardiologist

Dr. Tim Fischell is a cardiologist practicing in Kalamazoo, MI. Dr. Fischell specializes in diagnosing, monitoring, and treating diseases or conditions of the heart and blood vessels and the cardiovascular system. These conditions include heart attacks, heart murmurs, coronary heart disease, and hypertension. Dr. Fischell also practices preventative medicine, helping patients maintain a heart-healthy life.
Tim A. Fischell, MD
  • Kalamazoo, MI
  • Accepting new patients

Do stents prolong life?

This is a question that has been controversial. There is now essentially no argument that in patients with “acute coronary syndromes” such as heart attack, small heart attack, READ MORE
This is a question that has been controversial. There is now essentially no argument that in patients with “acute coronary syndromes” such as heart attack, small heart attack, or unstable angina that stents have a positive impact on mortality. In patients who do not have an acute coronary syndrome, and have stable anginal symptoms and ischemia you have it and suggest that stents do not prolong, life but may have a substantial effect in improving the quality of life.

Can you die from angina?

It is definitely unusual to die from angina. Angina is a symptom of chest discomfort or shortness of breath related to lack of blood flow to the heart muscle when the heart rate READ MORE
It is definitely unusual to die from angina. Angina is a symptom of chest discomfort or shortness of breath related to lack of blood flow to the heart muscle when the heart rate goes up, typically during physical activities. If one were to push yourself extremely hard through this and keep exercising, the heart muscle could become more ischemic and this could trigger an arrhythmia that could even be fatal. That is extremely rare. When the symptoms get worse in a syndrome called “unstable angina” it suggests that there could be rupture of one of the plaques and this could predispose one to a real heart attack which does have a mortality risk.

Is a pacemaker implant safe?

Pacemaker implants are generally very safe. There is typically a less than 1% risk of a serious complication with could include bleeding at the site of insertion or infection typically READ MORE
Pacemaker implants are generally very safe. There is typically a less than 1% risk of a serious complication with could include bleeding at the site of insertion or infection typically around pocket created to insert a pacemaker generator. Overall, a very safe procedure .

Can my body reject a pacemaker?

No. The pacemaker is a mechanical device that in general does not elicit any immune response of the type you’re thinking about when you use the term “rejection.“ But can occasionally/rarely READ MORE
No. The pacemaker is a mechanical device that in general does not elicit any immune response of the type you’re thinking about when you use the term “rejection.“ But can occasionally/rarely have an infection, but this is not your body rejecting the pacemaker. That does not happen.

What can cause an irregular heartbeat?

Most of the time and irregular heartbeat is caused by premature beat coming from either the top (atrium or APC) or less frequently the bottom chambers parentheses ventricles (vPC) READ MORE
Most of the time and irregular heartbeat is caused by premature beat coming from either the top (atrium or APC) or less frequently the bottom chambers parentheses ventricles (vPC) of the heart. When you have a premature beat there is typically a slight pause before your normal pacemaker picks over and beat again. This may cause a palpitation with the beat that is felt being not the premature beat but the beat after the premature beat. Occasionally and irregular heartbeat could be caused by a more sustained heart rhythm problem. At age 32 that is much less likely. In general, these premature beats are very benign. Sometimes they can be made worse if you are not getting enough sleep or are consuming too much caffeine. I would recommend, getting plenty of sleep and using caffeine in moderation.

Are cardiac catheterization and cardiac angiography the same?

Those two terms are not exactly the same. Cardiac catheterization basically means putting catheters into the body typically perform a diagnostic procedure but occasionally associated READ MORE
Those two terms are not exactly the same. Cardiac catheterization basically means putting catheters into the body typically perform a diagnostic procedure but occasionally associated with doing a therapeutic intervention as well. Cardiac or coronary angiography is a term that relates to the process of injecting contrast into or the heart arteries or other arteries in order to do imaging using x-ray digital acquisition to look at heart anatomy.

Is tachycardia the same thing as irregular heartbeat?

Tachycardia means fast heart rhythm. What you have is an irregular heart rhythm. The most common cause of this or premature beats coming from the top chambers or the atrium and READ MORE
Tachycardia means fast heart rhythm. What you have is an irregular heart rhythm. The most common cause of this or premature beats coming from the top chambers or the atrium and occasionally from the lower chambers or the ventricle. These are called atrial premature beats and ventricular premature beats. Sometimes it is due to a more serious rhythm called atrial Ferb relation. If this persists, you should probably see your doctor and get a rhythm monitoring device and an EKG.

Tim A. Fischell, M.D., FACC

My heart beats harder when I lay down. What can be the cause?

Sounds like you probably are having some premature beats when you change position and lie down. After a premature be the next bit it’s felt very forcefully. Most likely this is READ MORE
Sounds like you probably are having some premature beats when you change position and lie down. After a premature be the next bit it’s felt very forcefully. Most likely this is a form of palpitations caused by some premature heartbeats. This would be especially true if it were a regular. If it’s regular it just made me and that you’re feeling your heart beat more when you lie down. In either event, it is likely to be benign. Of course you should always have your blood pressure check and make sure that you were happy current guideline of systolic blood pressure at or below 130 mmHg.

Tim A. Fischell, M.D., FACC

I am experiencing a shortness of breath while walking. Should I get my ECG done?

This is definitely a potentially significant symptom. You should immediately see your physician or a cardiologist. They would likely perform an EKG and possibly a stress test. READ MORE
This is definitely a potentially significant symptom. You should immediately see your physician or a cardiologist. They would likely perform an EKG and possibly a stress test. This can be a sign of coronary artery blockage that can preceed a heart attack. In other cases this could be related to heart valve problems or a silent heart attack that was not recognized. This is a symptom that should not be ignored.

Why is my mom's blood pressure on the higher side after bypass?

There is no obvious reason why someone’s blood pressure would increase after bypass surgery. However, in some cases after bypass surgery the heart muscle is getting more blood READ MORE
There is no obvious reason why someone’s blood pressure would increase after bypass surgery. However, in some cases after bypass surgery the heart muscle is getting more blood flow and is contracting more vigorously. This can create a higher pressure. In this case blood pressure medication should be considered to get down to target blood pressure which is a systolic blood pressure of 130 or lower.

What are the various causes of high blood pressure?

High blood pressure is very common. Under the current guidelines hypertension is defined as a systolic blood pressure above 130 mmHg, 46% of American adults have hypertension. READ MORE
High blood pressure is very common. Under the current guidelines hypertension is defined as a systolic blood pressure above 130 mmHg, 46% of American adults have hypertension. More than 90% of hypertension is labeled as “essential hypertension.” This basically means that there is no apparent cause of hypertension. However, the most common causes in these types of patients are obesity as well as diabetes and mild kidney dysfunction. In other cases, there is a definable “secondary“ because of the high blood pressure these would include conditions were the aldosterone levels secreted by the adrenal glands are increased, or hyperthyroidism, and occasionally other more rare conditions including tumors that secrete epinephrine, etc.

What is the treatment for marfan syndrome?

Marfan syndrome is a rare condition that affects the connective tissue. Over a lifetime this Santa Claus cardiovascular complications such as aortic enlargement and aneurysm. READ MORE
Marfan syndrome is a rare condition that affects the connective tissue. Over a lifetime this Santa Claus cardiovascular complications such as aortic enlargement and aneurysm. It is also associated occasionally with ophthalmologic problems such as lens displacement. There is no total treatment to reverse the genetic problem but in many patients beta blockers are recommended to decrease the force of heart contraction to reduce the stress on the aorta. You should definitely see a specialist or one of the special clinics such as the ones at Johns Hopkins or Stanford University.