expert type icon EXPERT

Dr. James A. Hearn

Cardiologist

Dr. James Hearn is a cardiologist practicing in Port Charlotte, Florida. Dr. Hearn 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. Hearn also practices preventative medicine, helping patients maintain a heart-healthy life.
45 years Experience
Dr. James A. Hearn
  • Port Charlotte, FL
  • Virginia Commonwealth University
  • Accepting new patients

Gum disease and heart disease

Yes, there has been a link between gingival disease and coronary disease, probably through a non-specific mechansim of increasing inflammation. It is a small link, but good dental READ MORE
Yes, there has been a link between gingival disease and coronary disease, probably through a non-specific mechansim of increasing inflammation. It is a small link, but good dental hygiene is always recommended. The plaques are totally different.

Is plavix( clopidogrel ) a blood thinner?

I cannot answer such specific questions about your situation, because I don't have your medical records. Yes, plavix is a blood thinner. I would advise you to ask your specific READ MORE
I cannot answer such specific questions about your situation, because I don't have your medical records. Yes, plavix is a blood thinner. I would advise you to ask your specific physician.

What are the possible triggers of left side chest pain?

You can have coronary artery disease without any risk factors. If you have chest pain, get evaluated with a stress test, hopefully with a cardiologist. Triggers of heart attack READ MORE
You can have coronary artery disease without any risk factors. If you have chest pain, get evaluated with a stress test, hopefully with a cardiologist.

Triggers of heart attack can be psychic stress from death of a loved one, or some other catastrophy, like a hurricane, earthquake, etc.

Get checked.

Can I have mitral valve prolapse when doctor can not hear heart murmur?

Not having it on either exam, physical and echo, would be very rare and the symptoms can be due to a lot of other things. Studies show that you either have the click/murmur, or READ MORE
Not having it on either exam, physical and echo, would be very rare and the symptoms can be due to a lot of other things. Studies show that you either have the click/murmur, or the echo findings to have MVP. Otherwise, it's essentially not there. Also, there are many causes of MVP and some of these may improve or go away.

Valve repair success

Valve repair of the mitral valve has much less complications that mitral valve replacement - if it's feasible. Repair is usually done when there is excess mitral valve leaflet. READ MORE
Valve repair of the mitral valve has much less complications that mitral valve replacement - if it's feasible. Repair is usually done when there is excess mitral valve leaflet. The surgeon cuts away the excess and then sews the remaining leaflets back together. It's very successful, when it can be done. However, most mitral valve operations are on very stiff, calcified, contracted valves that cannot be resected properly, so a replacement is necessary. We have found newer tissue valves are longer lasting than they used to be. So repair if you can, depending on the exact circumstances of your valve.

Vasovagal syncope getting worse

It probably is vasovagal, meaning an excess discharge of acetylcholine to the peripheral nerves, resulting in dilatation of the blood vessels, especially the veins, which hold READ MORE
It probably is vasovagal, meaning an excess discharge of acetylcholine to the peripheral nerves, resulting in dilatation of the blood vessels, especially the veins, which hold 80% of the blood volume. It can also cause slowing of the heart. So, it's a balance between the sympathetic nervous system (adrenaline) and the parasympathetic nervous system (acetylcholine). As one ages, the sympathetic nervous system may become less functional, leaving the dominance to the parasympathetic system. However, many different mediations may affect one or both systems. We usually do an echocardiogram, stress treadmill test, and cardiac monitor. If your rhythm is not the culprit, then you may be dropping your systolic blood pressure transiently, which may respond to proamatine. Get the evaluation first and see a cardiologist.

I have symptomatic PVCs. When do they become dangerous?

I know these can be bothersome. Single PVCs are rarely dangerous. They can sometimes be related to other things (e.g., low potassium or magnesium). Have you had an MRI of the right READ MORE
I know these can be bothersome. Single PVCs are rarely dangerous. They can sometimes be related to other things (e.g., low potassium or magnesium). Have you had an MRI of the right ventricle to check for RV dysplasia? That is fatty displacement of the right ventricle and may be dangerous, requiring an implantable defibrillator. Beta blockers and calcium channel blockers may be useful, but many times they fail to control the PVCs or their symptoms. Also, consider the EP physicians may vary on their skill at ablating the PVCs (second opinion, especially at a known center, e.g., Dr. Andrew Epstein or Dr. Neal Kay - UAB).

Abdominal aneurysm prevention

The no. 1 risk factor is cigarette smoking. My vascular surgeon colleague just gave us a lecture on this very thing. He said if you are male over 50 years old, and have smoked READ MORE
The no. 1 risk factor is cigarette smoking. My vascular surgeon colleague just gave us a lecture on this very thing. He said if you are male over 50 years old, and have smoked 100 cigarettes or more in your life, then you need a screening abdominal aortic ultrasound. A warning sign can be abdominal pain, but there are so many causes of abdominal that most are not due to AAA. These are undetectable in a large minority of patients by physical exam, so either an ultrasound or CT scan are recommended. Unfortunately the first warning sign may be rupture with severe abdominal pain and shock, with mortality rate reaching nearly 90%. This is one screening test (ultrasound) that is worth it. I would quit smoking immediately and control blood pressure well. If the size gets "big", consult a vascular surgeon. A stent graft or open surgery may be needed.

Are there alternatives to a catheter ablation for atrioventricular reciprocating tachycardia

This disorder refers to a physical bypass tract that bridges the atria to the ventricle. The electrical circuit is usually well defined and permanently responsive to catheter ablation READ MORE
This disorder refers to a physical bypass tract that bridges the atria to the ventricle. The electrical circuit is usually well defined and permanently responsive to catheter ablation by an EP doctor. Some medications slow the current in the AV node and actually encourage conduction over the bypass tract, resulting in tachycardia. The ablation has a high success rate, so I would strongly consider the procedure. This is general advice and may not apply to all cases.

Will my hip replacement put me at risk for heart disease?

Hidden heart disease is fairly prevalent. Dr. Gruentzig used to say the first symptom of heart disease is sudden death in about 30% of patients. For that reason, when I clear somebody READ MORE
Hidden heart disease is fairly prevalent. Dr. Gruentzig used to say the first symptom of heart disease is sudden death in about 30% of patients. For that reason, when I clear somebody for major surgery or general anesthesia, I recommend an exercise, or chemical, stress test is indicated. Patients rarely die from heart reasons, if they pass this test.

Don't want to have surgery for enlarged heart--any other options?

With that level of information, it's impossible to give an accurate answer. I can only give my general opinion. I would see a cardiologist immediately and make sure to get an READ MORE
With that level of information, it's impossible to give an accurate answer. I can only give my general opinion. I would see a cardiologist immediately and make sure to get an echocardiogram. Usually, chest x-rays are notoriously inaccurate when "enlarged heart" is diagnosed. Even when everything has been ruled out, weak heart can recover to full strength in many patients. Get evaluated.

Increasing resting heart rate, what is it?

This is one area where the actual numbers are important. Also, many things may contribute to elevation in heart rate, like thyroid elevations, anemia, anxiety, undiagnosed heart READ MORE
This is one area where the actual numbers are important. Also, many things may contribute to elevation in heart rate, like thyroid elevations, anemia, anxiety, undiagnosed heart weakness (needs echo). The heart responds to other things and it's not usually intrinsic to the heart. A heart monitor which records the actual heart rates is important in this regard.

Regaining strength after a stroke

That's impossible to know exactly, not knowing your mom. But usually stroke patients get involved with a physical therapist. There are so many reasons for generalized weakness, READ MORE
That's impossible to know exactly, not knowing your mom. But usually stroke patients get involved with a physical therapist. There are so many reasons for generalized weakness, that I am not sure exercise is right for all situations (e.g. low potassium). A full evaluation would be advisable.

Weak from a stroke

I would recommend asking your neurologist this question as it is based on many very specific aspects of your stroke. It is not possible for me to say. It also depends on the "plasticity" READ MORE
I would recommend asking your neurologist this question as it is based on many very specific aspects of your stroke. It is not possible for me to say. It also depends on the "plasticity" of your brain, something very idiosyncratic and difficult to determine.

Is running ever bad for your heart?

Running is a great exercise, but like anything else should be done in moderation. I think 3-4 miles a day is fine. Jim Fixx wrote a whole book on Running. Remember to keep hydrated READ MORE
Running is a great exercise, but like anything else should be done in moderation. I think 3-4 miles a day is fine. Jim Fixx wrote a whole book on Running. Remember to keep hydrated with water and I think this shouldn't be a problem. If you are over 50 years old, I would consider a treadmill stress test because coronary artery disease is so prevalent.

Is chest heaviness related to my past heart issues?

Heavy feeling in the chest, especially during physical activity could be a sign of coronary artery disease (blockages in heart arteries). Having a second heart attack may be more READ MORE
Heavy feeling in the chest, especially during physical activity could be a sign of coronary artery disease (blockages in heart arteries). Having a second heart attack may be more dangerous, because the damage may accumulate and lead to heart failure or "sudden death". This is something that requires cardiology evaluation, probably with a nuclear stress test or heart cath even. Don't delay.