EXPERT
Dr. Juan P. Montoya
Cardiothoracic Surgeon
Dr. Juan Montoya is a cardiothoracic surgeon practicing in Boynton Beach, Florida. Dr. Montoya specializes in surgical procedues of vital organs in the chest such as the heart, lungs, esophagus and more. As a cardiothoracic surgeon, Dr. Montoya typically treats conditions like heart disease and lung disease. This class of surgeon can also include cardiac surgeons, cardiovascular surgeons, congenital heart surgeons and general thoracic surgeons.
Dr. Juan P. Montoya
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I have been detected with a growth in my esophagus. Should I consult a cardiothoracic surgeon?
You need to have an esophagoscopy (scope) to evaluate and biopsy the growth. A Cardiothoracic surgeon can do the scope but so can a gastroenterologist. Either way, the surgeon READ MORE
You need to have an esophagoscopy (scope) to evaluate and biopsy the growth. A Cardiothoracic surgeon can do the scope but so can a gastroenterologist. Either way, the surgeon will eventually need to be seen.
Why do I feel palpitations and increased heart rate?
This most likely is atrial fibrillation (an irregular heart beat) and needs to be investigated to find out the reason behind it.
I have chest soreness and radiating pain. Is this due to pleurisy or costochondritis?
Pleurisy or costochondritis usually hurts when you take a deep breath. That is the main difference from a cardiac cause of chest pain.
How long does it take for someone to recover from a cardiac surgery?
Everyone is different. I tell my patients that no 2 people are alike. Some will recover within a few weeks, others may take longer. Usually, the more active patients (and older READ MORE
Everyone is different. I tell my patients that no 2 people are alike. Some will recover within a few weeks, others may take longer. Usually, the more active patients (and older ones) recover more quickly. I usually give a ballpark of 4-8 weeks of full recovery.
What causes increased heart rate in a pregnant woman?
It is normal for a woman's heart rate to go up during pregnancy (she is feeding blood to 2 people now instead of just one). There are many changes that women go through during READ MORE
It is normal for a woman's heart rate to go up during pregnancy (she is feeding blood to 2 people now instead of just one). There are many changes that women go through during pregnancy and it should not alarm you. I would recommend seeking the OB-GYN that sees her and having them explain it to you in detail.
My son has a hole in the heart. What is the treatment procedure?
Typically, heart defects such as this need to be corrected with surgery.
Even though all my tests seem normal, I am having chest pain. What could be the reason?
There are many causes of chest pain, these include cardiac related, digestive cause such as reflux (heartburn), stomach or esophageal ulcers, esophageal motility problems, muscular READ MORE
There are many causes of chest pain, these include cardiac related, digestive cause such as reflux (heartburn), stomach or esophageal ulcers, esophageal motility problems, muscular or chest wall pain, lung problems, etc. It seems like cardiac-related issues have been ruled out. Other causes need to be explored.
Will diastolic dysfunction lead to heart failure?
Diastolic dysfunction means the relaxation of the heart is not functioning properly. The filling of the heart is inadequate. This can eventually lead to heart failure if the underlying READ MORE
Diastolic dysfunction means the relaxation of the heart is not functioning properly. The filling of the heart is inadequate. This can eventually lead to heart failure if the underlying problem is not corrected.
I have symptomatic PVCs. When do they become dangerous?
This is question better answered by a cardiologist (I am a cardiac surgeon), but I will try to answer as best as I can. PVCs can potentially convert into ventricular tachycardias, READ MORE
This is question better answered by a cardiologist (I am a cardiac surgeon), but I will try to answer as best as I can. PVCs can potentially convert into ventricular tachycardias, which can be very dangerous. If these PVCs are symptomatic, having an ablation is the best possible solution to control this. You should also have a cardiac catheterization and echocardiogram to see if there are other causes.
Would LAD lesion cause tachycardia?
65% lesion is a significant lesion. Other causes of tachycardia include atrial fibrillation (an irregular heart beat) that can be caused by other structural heart conditions such READ MORE
65% lesion is a significant lesion. Other causes of tachycardia include atrial fibrillation (an irregular heart beat) that can be caused by other structural heart conditions such as leaky valves. When patients have tight lesions (70% or greater), sometimes they can have tachycardias caused by the lack of blood flow to a large area of the heart muscle.
My grandfather is 87 years old and has suffered a heart attack. What should we do?
At 87 years old, there are several options, usually 3 of them. He can be managed with medications (medical management), the cardiologist can put stents in his heart to open up READ MORE
At 87 years old, there are several options, usually 3 of them. He can be managed with medications (medical management), the cardiologist can put stents in his heart to open up the blockages, or he can have open heart surgery. It is hard to put an 87-year-old patient through surgery as the recovery is harder on the older population. Having said that, if he is an active 87-year-old that is a good candidate, surgery would be the best option.
How can I tell if it's a heart attack or just a chest pain?
There are many causes of chest pain, these include cardiac related, digestive cause such as reflux (heartburn), stomach or esophageal ulcers, esophageal motility problems, muscular READ MORE
There are many causes of chest pain, these include cardiac related, digestive cause such as reflux (heartburn), stomach or esophageal ulcers, esophageal motility problems, muscular or chest wall pain, lung problems, etc. Cardiac causes such as heart attack present as a heaviness or tightness that goes to your neck or arms and does not go away with anything, as we say in medicine, it is a pain that feels like "impending doom."
After my bypass surgery, I am having heavy bleeding during my periods. Could there be a connection?
The only reason you might be bleeding more after surgery is if you have been put on blood thinners (coumadin) or an anti-platelet medication (aspirin, plavix).
My son is 8 years old and has been detected with a hole in the heart. Is surgery the only option?
For children, usually surgery is the only option. I am not a pediatric cardiac surgeon, so there may be other options that I don't know of. In adults, there are options such as READ MORE
For children, usually surgery is the only option. I am not a pediatric cardiac surgeon, so there may be other options that I don't know of. In adults, there are options such as plugs for those holes, but children are a bit more complicated. Hope this helps.
What is the difference between a cardiologist and cardiothoracic surgeon?
A cardiologist has done a residency in internal medicine and sub specialized in diseases of the heart. They can do certain procedures such as stents, but cannot operate (i.e., READ MORE
A cardiologist has done a residency in internal medicine and sub specialized in diseases of the heart. They can do certain procedures such as stents, but cannot operate (i.e., cannot do open heart surgery). A cardiothoracic surgeon trains first in general surgery then sub specializes in heart, lung and esophageal surgery. We as surgeons do open heart surgery. Hope this helps.
Caffeine and heart surgery?
30-50 % of all cardiac surgery patients go into atrial fibrillation (which is an irregular heart rhythm) after surgery due to the swelling of the heart. Caffeine can predispose READ MORE
30-50 % of all cardiac surgery patients go into atrial fibrillation (which is an irregular heart rhythm) after surgery due to the swelling of the heart. Caffeine can predispose to this as well especially when the heart is very sensitive after surgery. You can continue to drink the coffee but I would recommend stopping it a couple of days before surgery. Hope this helps!
Heart transplant question
Transplant rejection is very variable amongst different patients. The most serious is called hyper acute rejection which is antibodies already formed against the new heart. This READ MORE
Transplant rejection is very variable amongst different patients. The most serious is called hyper acute rejection which is antibodies already formed against the new heart. This is seen in the immediate surgical period once the heart is in. Typically if the patient is noncompliant with their immunosuppressive medications, the heart can be rejected quite quickly.
Routine biopsies will tell you if the heart is doing well or rejecting in some way. The patient would be having symptoms such as shortness of breath and congestive heart failure if the heart started being rejected. All of a sudden can happen if the patient has a heart attack. Hope this helps!
Routine biopsies will tell you if the heart is doing well or rejecting in some way. The patient would be having symptoms such as shortness of breath and congestive heart failure if the heart started being rejected. All of a sudden can happen if the patient has a heart attack. Hope this helps!
Don't want to have surgery for enlarged heart--any other options?
Thanks for your question. It depends on the cause of your enlarged heart. If your doctor saw your CXR and said you have an enlarged heart and based his opinion of needing surgery READ MORE
Thanks for your question. It depends on the cause of your enlarged heart. If your doctor saw your CXR and said you have an enlarged heart and based his opinion of needing surgery on that, that is not correct. Further testing such as an echocardiogram needs to be done to actually see what going on, the cause of the enlarged heart. Many different causes exist including leaky valves, tight valves and disease of the heart muscle itself.
Depending on the cause and the symptoms, then the decision to manage medically or surgically can be made. Until all of the diagnostic testing is done to rule out certain things and actually find the cause of this enlarged heart, no assumptions should be made. Hope this helps!
Depending on the cause and the symptoms, then the decision to manage medically or surgically can be made. Until all of the diagnostic testing is done to rule out certain things and actually find the cause of this enlarged heart, no assumptions should be made. Hope this helps!
I have symptomatic PVCs. When do they become dangerous?
PVC are extra beats that your ventricle takes. When they become symptomatic (which is usually when they are more frequent or have a bunch in a row) is when one should worry because READ MORE
PVC are extra beats that your ventricle takes. When they become symptomatic (which is usually when they are more frequent or have a bunch in a row) is when one should worry because you can go into whats called ventricular tachycardia which is dangerous. Having said that, if you are managed medically by an electrophysiologist (a cardiologist specialized in heart rhythm) then he certainly would know better than me how to manage as I am not a cardiologist and I don't treat these types of conditions. I am a cardiac surgeon. I am happy to help though in any way.
Maybe a second ablation will be necessary based on symptoms. I would ask your cardiologist. Hope this helps!
Maybe a second ablation will be necessary based on symptoms. I would ask your cardiologist. Hope this helps!
Gum disease and heart disease
Gum disease is caused by bacterial plaque buildup. Heart disease is caused by cholesterol and calcium deposits in the arteries. They are 2 different processes. Having said this, READ MORE
Gum disease is caused by bacterial plaque buildup. Heart disease is caused by cholesterol and calcium deposits in the arteries. They are 2 different processes. Having said this, gum disease can predispose to heart disease by causing a blood infection (the bacteria that form the plaque buildup in the gums) that infects the valves of the heart and making the valves leaky. This is a very serious condition and can cause the heart to go into failure, as well as other organs such as the lungs, kidneys, brain and spleen. Hope this helps!
