Nachum M. Pfeffer, MD

This is a very general question, so the answer in general is yes. Not all heart attacks are the same, so different situations require different interventions either with procedures or medications. To be more specific, most heart attacks occur because of a sudden closure of a vessel that gives the heart its own blood supply (coronary arteries). If a person gets to an emergency room within a certain period of time from the moment the symptoms begin, we have the ability to reopen the related artery and usually deploy a Stent, that works like scaffolding to keep the artery open. There also are some specific medications that are required after this type of procedure.
Hope this was helpful.

Hi,

It is not “normal” to have palpitations. But having palpitations is not necessarily a significant problem or indication of disease. Palpitations is a general term for feeling the heart beating. Sometimes that is quite normal due to anxiety, tension, stress or having too much coffee, or taking certain OCT’s that have stimulants. There are situations that palpitations are due to an irregular heart beat, and there are many different types. So, the best thing to do, is have this evaluated by a cardiologist. It will be very easy to find out why you are having these symptoms and you may require additional testing such as wearing a portable monitor for 24hrs. Most of these situations can be resolved either by lifestyle changes or medications. Sometimes it may be more complex and require other types of evaluations. Best bet is to see a cardiologist.

Hi,

A catheterization is only a procedure. It is a way to assess the arteries that supply the heart. In experienced hands, it is very routine. It is INVASIVE, it requires going into an artery, usually in your right wrist. It is done with local anesthetic so it is not painful. During the procedure, a small tube “catheter” is advanced with assistance of X-ray camera, all the way to the arteries that are connected to your heart. There is no pain involved. There can be a very rare complication of Dissection, which is a small tear in the wall of an artery. This is very rare and uncommon. Some bleeding and bruising can occur at the site of entry in your wrist which can cause some mild discomfort for a day or two. You may have a dye reaction if you are allergic to IODINE, but this is usually mild, and if it is known in advance you are pre-treated. To sum up, this is the most diagnostic tool we have to evaluate the heart’s circulation. In well trained hands, the risk is minimal.

Blood transfusions treat only one thing, low red blood cell counts (anemia) and sometimes something called FFR - fresh frozen plasma or platelets. Neither of these treat vein disorders.

It depends. Generally, following exercise, at least moderate effort and duration, the blood vessels dilate/relax and the blood pressure will decline. However, if you have high blood pressure, exercise alone will not suffice long term, it needs to be coupled with weight loss via dietary changes like lowering carbohydrates, fast sugars from candy, pies, cookies, etc., and eating a Mediterranean diet rich in vegetables, olive oil and chickpeas (humus). It is a lifestyle change. Limiting alcohol is essential as well.

Hi,

Your baseline blood pressure is higher then it needs to be. The second blood pressure is actually excellent. Heart rate is very appropriate and not overly suppressed. I probably would have you stay on 50mg daily. But that is up to your physician to decide. Judging by the numbers you posted, there is no danger.

Lets first understand what got you to this point. You developed ATHEROSCLEROSIS in your arteries. There are reasons for that. We call then RISK FACTORS. Such as smoking, elevated cholesterol, high blood pressure, diabetes, obesity and sometimes a family history. So this "disease" has been present for a long time and will continue to be present UNLESS you make some significant changes in your life style, such as - a careful diet and a routine exercise - daily!
This is called risk modification. If you are very good at doing all of these things, including taking any prescribed medications, such as aspirin, you should do fine. We cannot say with 100% assurance that you will not have some disease recur, but if you do everything right, you will lower the risk the and limit the chances of recurrence.

In general, yes, it is safe. However, you should be aware that your sternum is not as perfect and strong as it was before surgery. You should limit the amount of weight you lift. A much better form of exercise for you would be a treadmill and stationary bike exercise at least for 45min/day. In addition, you could workout with resistive machines with limited loads.

There may be several reasons. The high blood pressure by itself is not causing a higher heart rate. You may be over weight, poorly conditioned or just have a high adrenergic drive (higher levels of adrenaline). Your thyroid may be slightly over active. This is a simple issue to determine by a careful medical history and exam.

An angiogram is a specific imaging of your CORONARY arteries, the arteries that sit on top of the heart and give it its blood supply. When this study is performed, a small tube is also inserted into the left heart chamber for measuring the internal pressures inside that chamber, and a small amount of dye is injected to see how the heart is contracting. The most important information will be the condition of the arteries.

Hi,
First, stop worrying. What you experienced is a very normal physiologic response. Since you lost more blood due to your heavy period, you became slightly anemic (loss of red blood cells). Since red blood cells carry oxygen, you body had to compensate to maintain blood supply to your tissues, so it increased you heart rate. You also may have been somewhat anxious during the EKG recording, and a heightened adrenaline level accelerated your heart rate. So, this anemia should correct itself slowly, and it would be helpful if you took IRON supplement for a short time. Of importance, is watch what happens to your next cycle, and if it is heavy again, then consult your GYN. Hope this was helpful.

Hi,
First, let me be clear, an xray is not a very reliable method for imaging the heart. It would require additional evaluation by ECHOCARDIOGRAPHY which is very easy to do and very diagnostic. If your heart is truly enlarged there may be other treatments required. But it must be established that your heart IS enlarged by a better modality.

Yes. It is important that you get evaluated by a cardiologist. Chest discomfort of meny types may be a warning sign of advancing coronary artery disease. On the bright side, it does not have to be eminating from your heart, it could be something else. Either way, get it checked out.

Nick Pfeffer M.D

The answer is yes. You may have MVP without an audible murmur, or that your Dr. cannot appreciate one. To begin with, you need to understand what a "murmur" is. In the case of MVP, it is a sound created by the mitral valve leaking. Not all MVP cases have a leaking valve. So it may be that you have a prolapsing valve without a leak, hence no murmur. The more important question is if when listening to your valve, can a "click" be heard. That is how MVP is diagnosed at the bed side. An echo cardiogram may be helpful, but only if it clearly shows prolapse. As to leaking valve, if present, it is easily demonstrated by echo/doppler.