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Dr. Jeremiah M. Gelles

Cardiologist

Dr. Jeremiah M. Gelles is a top Cardiologist in Brooklyn, . With a passion for the field and an unwavering commitment to their specialty, Dr. Jeremiah M. Gelles is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr. Jeremiah M. Gelles is a prime example of a true leader in healthcare. As a leader and expert in their field, Dr. Jeremiah M. Gelles is passionate about enhancing patient quality of life. They embody the values of communication, safety, and trust when dealing directly with patients. In Brooklyn, New York, Dr. Jeremiah M. Gelles is a true asset to their field and dedicated to the profession of medicine.
Dr. Jeremiah M. Gelles
  • Brooklyn, New York
  • New York University School of Medicine
  • Accepting new patients

How does high blood pressure cause a stroke?

There are two main types of stroke. One is an ischemic due to a blood clot either forming in a vessel supplying the brain with oxygen or a blood clot that travels to the vessel READ MORE
There are two main types of stroke. One is an ischemic due to a blood clot either forming in a vessel supplying the brain with oxygen or a blood clot that travels to the vessel and blocks it depriving the part of the brain supplied by the vessel of oxygen.
Less commonly a piece of cholesterol may break off and travel to the brain. These strokes are called thrombotic or embolic respectively. Thrombotic strokes are almost always due to partial blockages in the artery that are caused by cholesterol build up and hypertension. The arterial wall is damaged and a blood clot forms.

The other main type of stroke is hemorrhagic. The arterial wall is damaged by longstanding hypertension and finally bursts. Bleeding in the brain is a serious problem because the brain is in an enclosed space, the skull, and pressure builds up rapidly causing even more damage. Occasionally there may be a small aneurysm in the brain that ruptures due to high pressure.

Chronic Chest Pain

Hi 40yo male (man, I assume), Several things strike me about your story: -Firstly, you seem to date the onset of pain to when you started the bp meds. Have you tried stopping READ MORE
Hi 40yo male (man, I assume),

Several things strike me about your story:

-Firstly, you seem to date the onset of pain to when you started the bp meds. Have you tried stopping the meds to see what happens to the pain?

-Secondly, you do not characterize the pain either as to quality, severity, inciting factors, relieving factors, exact location, or radiation. This is obviously important in trying to figure out the cause.

-Thirdly, although coronary artery disease has been thoroughly ruled out as well as microvascular disease, you suggest a possible connection with SVT. Have you had a Holter monitor or longer term monitoring to see if there is an association between the pain and the arrhythmia?

-Fourthly, have you had a GI work up? Since the most common cause of non-musculoskeletal chest pain is gastro-esophageal reflux. (I assume musculoskeletal issues have been excluded.)

Another cause of pain anywhere could be neurological. Is there anything that suggests a neurological cause of this pain? Of course, any pain is complicated by emotional factors. Are there any issues in your emotional life that might exacerbate pain? Finally, I do not think that you have anything to worry about as far as basketball is concerned. Based on the almost complete work-up you have had, the likelihood of your having a heart attack or damaging your heart during physical activity is remote.

Good luck.

Is my high blood pressure the reason behind my increased heart rate?

Probably not. Most likely high blood pressure and heart rate are caused by the same thing. See your doctor.

Is it safe to go to the gym 6 months after coronary artery bypass surgery?

The absolute most important thing for you to do is to make sure your lipid profile is optimal. Your LDL must be well under 70! Second your blood pressure must be aggressively READ MORE
The absolute most important thing for you to do is to make sure your lipid profile is optimal. Your LDL must be well under 70! Second your blood pressure must be aggressively controlled. Systolic under 130 preferably 110-120. You may not smoke. If you have diabetes it must be tightly controlled: A1c under 6. Then you should get into a supervised cardiac rehab program. Optimize your weight and keep BMI under 25. Once all this is done and you are on a heart healthy diet you may return to the gym. No “bulking.” Your goal is strengthening, core control, and aerobic conditioning. A well-trained certified personal trainer is the way to start. See your cardiologist regularly. Coronary artery disease is chronic and when it occurs in someone your age it must be treated aggressively. Good luck!

Is excessive sweating a sign of heart problem?

Excessive sweating is not likely to indicate a heart attack. Sweating, or diaphoresis, is associated at times with heart attacks but there are a lot of more prominent symptoms. READ MORE
Excessive sweating is not likely to indicate a heart attack. Sweating, or diaphoresis, is associated at times with heart attacks but there are a lot of more prominent symptoms. Excessive perspiration would not be one of the major symptoms. Chest pressure associated with stress, exercise, or any increased demand on the heart is the main symptom of a heart attack, especially in men.

Can a blood transfusion cause disruption in my heart rate?

I doubt that the transfusion would increase your heart rate in the long run. It might increase the rate transiently during and for a while afterward as the transfused blood would READ MORE
I doubt that the transfusion would increase your heart rate in the long run. It might increase the rate transiently during and for a while afterward as the transfused blood would increase the volume of blood in your body and that would cause your heart rate to increase. But that transient tachycardia should subside. I think other factors related to your accident are causing your resting heart rate to increase. Have your doctors check it out.

Can blood thinners cause excessive bleeding?

There must be something to bleed in order for the antiplatelet drug to precipitate bleeding. He needs to be seen by a urologist.

Are there any supplements recommended after bypass surgery?

No particular supplements are recommended. The Mediterranean diet is a good choice. She needs plenty of protein fruits and vegetables and high quality carbohydrates. Get her out READ MORE
No particular supplements are recommended. The Mediterranean diet is a good choice. She needs plenty of protein fruits and vegetables and high quality carbohydrates. Get her out and keep her active.

What could be the side effects of a pacemaker?

1. Anxiety related to knowing you have a pacemaker and knowing your life may depend on it and that it is an electrical device with a battery and lead(s) that go into your heart. 2. READ MORE
1. Anxiety related to knowing you have a pacemaker and knowing your life may depend on it and that it is an electrical device with a battery and lead(s) that go into your heart.

2. A sense of security that now you have a safe reliable life-saving device implanted that will also improve your quality of life.

3. Infection risks, mainly at implant.

4. Rarely, removal of the device and leads if they become infected. This may require difficult lead extraction procedures.

4. Discomfort at implant site.

5. Necessity to monitor regularly.

6. Availability of remote monitoring so that your doctor will know in real time if anything is wrong.

6A. Confusion about remote monitoring in elderly patients.

7. Possibility of device malfunction or lead problems that may require revision of the implant.

8. Necessity to reprogram the device periodically to enable more effective control of the arrhythmia and heart function.

9. Necessity to replace the battery periodically, usually after at least 5 years, often much longer.

10. Necessity to upgrade the device as your father's condition changes.



There are other side effects but I would like to emphasize that, whatever the problems and they are not common, pacemakers are miraculous devices that save lives and enable improved quality of life. Just make sure that the doctor implanting the pacemaker is experienced and has a good track record and that the doctor following your father's device is experienced, responsible, honest, conscientious, and caring. These two doctors may be the same or different people.

What are the signs of identifying a problem with the heart?

Hearing a murmur on auscultation of the heart would be the most likely way of discovering a congenital heart condition. Obviously, a heart condition that causes cyanosis or “blue READ MORE
Hearing a murmur on auscultation of the heart would be the most likely way of discovering a congenital heart condition. Obviously, a heart condition that causes cyanosis or “blue baby” is obvious as are symptoms such as shortness of breath, manifested in infancy as difficulty feeding.

Is it true that a glass of wine everyday can prevent heart problems?

A glass a day of red wine may be helpful but nothing like 70%! In any case, I would not rely on red wine to prevent heart attacks. Controlling cholesterol, blood pressure, diabetes, READ MORE
A glass a day of red wine may be helpful but nothing like 70%! In any case, I would not rely on red wine to prevent heart attacks. Controlling cholesterol, blood pressure, diabetes, weight are more important and exercising regularly and eating a heart-healthy diet and allowing time for relaxation and stress reduction are crucial lifestyle modifications that can help prevent the progression of atherosclerosis. It is hard to understand the “French paradox” related to red wine. My guess is that it is not related to the wine but to the very different and less stressful lives that French people live as compared to US inhabitants. Some people think it is related to the resveratrol in the wine and there are a lot of people making a lot of money off this illusion, which is not to say that resveratrol is bad but only to say what I have noted above, it is not the main course to follow to prevent heart attacks.

I experience a rapid heartbeat during my periods. What could be wrong?

Menstruation is associated with a lot of hormonal changes and these certainly have an effect on the heart. There are also emotional changes during your period that can effect your READ MORE
Menstruation is associated with a lot of hormonal changes and these certainly have an effect on the heart. There are also emotional changes during your period that can effect your heart beat. So long as it isn’t excessive, say over 150 beats per minute, you should not worry. However, if you find the palpitations very annoying, see your doctor. You might be able to take a short acting beta blocker like propranolol when you are very symptomatic; but I hope that my reassurance will be sufficient so that you will not need to be medicated for what is a benign condition posing no threat to your health.

Can anesthesia cause breathlessness?

I assume your cardiac status was ok when you had the section. Presumably you have a doctor who follows you for general medical issues. First you should see the surgeon who did READ MORE
I assume your cardiac status was ok when you had the section. Presumably you have a doctor who follows you for general medical issues. First you should see the surgeon who did the section. If the surgeon feels that this is something more than the after-effects of the section and having a new baby, etc. then he/she should refer you to the appropriate specialist. This might be a pulmonary specialist, a general internist, or a cardiologist.

After a bypass, how long will I have to follow diet restrictions?

Not knowing exactly what your doctor prescribed, it is difficult for me to answer that question. In general, you should eat a healthy, Mediterranean style diet that is low in carbs, READ MORE
Not knowing exactly what your doctor prescribed, it is difficult for me to answer that question. In general, you should eat a healthy, Mediterranean style diet that is low in carbs, especially refined carbs, and saturated fats, for the rest of your life. Atherosclerosis for which you had the bypass is a chronic disease and will come back if you do not adhere to a healthy lifestyle which I would assume is what your doctor recommended along with no smoking, blood pressure control, tight control of diabetes, if you have that, and aggressive lipid lowering. It is probably too late to change your parents!

My heart is beating fast even when resting. Is it due to some underlying problem?

The answer depends on what you mean by “fast.” A normal resting heart rate is about 50-80 beats per minute. If yours is over 100, that would not be normal. The answer also depends READ MORE
The answer depends on what you mean by “fast.” A normal resting heart rate is about 50-80 beats per minute. If yours is over 100, that would not be normal. The answer also depends on whether the abnormally rapid resting heart rate is regular or irregular and whether it occurs while you are standing or lying down and whether it is related to anxiety. There are a number of medical conditions that can cause an abnormally fast resting heart rate including, for example, a low blood count and thyroid disorders. Sometimes it is a stand-alone problem known as idiopathic tachycardia syndrome. You should definitely see a doctor about this.

Could a big belly indicate a heart problem?

Abdominal obesity is associated with the metabolic syndrome of diabetes or insulin resistance, cholesterol abnormalities such as high triglycerides, and hypertension. It is of READ MORE
Abdominal obesity is associated with the metabolic syndrome of diabetes or insulin resistance, cholesterol abnormalities such as high triglycerides, and hypertension. It is of concern and is associated with cardiovascular problems. Your husband should be on a weight loss diet and should exercise regularly. He should see a doctor and have his blood pressure and cholesterol checked and get nutritional advice and whatever other work-up the doctor deems necessary. He should be checked for diabetes.

Can heart blockages be cleared with medicine?

Is your brother symptomatic on optimal guideline-directed Medical therapy? Where are the blockages, i.e. in what arteries? Did your brother have some sort of objective ischemic READ MORE
Is your brother symptomatic on optimal guideline-directed Medical therapy?
Where are the blockages, i.e. in what arteries?
Did your brother have some sort of objective ischemic evaluation with a stress test done with an imaging modality?
Heart blockages cannot be cleared with medicine and lifestyle alterations alone. However, that does not mean they need to be treated with angioplasty. Is your brother being treated by a board-certified cardiologist who is up to date on the literature regarding this issue. See especially the ORBITA study and the COURAGE study.

I am a 37 year old man. How often should I do a treadmill test to know my fitness levels?

If you are feeling ok and have a normal exercise tolerance and have no major risk factors that would merit more intense monitoring, then you don’t need to do stress tests at all. READ MORE
If you are feeling ok and have a normal exercise tolerance and have no major risk factors that would merit more intense monitoring, then you don’t need to do stress tests at all. Just listen to your body and make sure you eat properly, don’t smoke, get a good night’s sleep, and exercise regularly.

Can ayurveda help in clearing heart blockages?

There is no evidence that would pass scientific scrutiny that indicates that Ayurveda would open up blocked arteries. That said, anything that diminishes stress and tension and READ MORE
There is no evidence that would pass scientific scrutiny that indicates that Ayurveda would open up blocked arteries.
That said, anything that diminishes stress and tension and anxiety is beneficial for the atherosclerotic process.