Jeremiah M. Gelles MD
Cardiologist | Interventional Cardiology8714 5th Avenue Brooklyn New York, 11209
Dr. Jeremiah Gelles is a cardiologist practicing in Brooklyn, New York. Dr. Gelles 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. Gelles also practices preventative medicine, helping patients maintain a heart-healthy life.
Education and Training
New York University School of Medicine
New York University School of Medicine 1966
Internal MedicineAmerican Board of Internal MedicineABIM
Jeremiah M. Gelles MD's Expert Contributions
Hard to imagine that a fish bone you swallowed just started causing symptoms after 48 hours. However, to be sure you would have to see a gastroenterologist. READ MORE
Depends mainly on if you are in heart failure and how bad that is. You would have to ask your cardiologist. READ MORE
This is a neurological issue not a cardiac issue. You should see a neurologist. READ MORE
If this is different from what you have experienced in the past you need to see a physician. There are a lot of possibilities of what might be causing this and it could be normal. But get it checked out. READ MORE
It’s a different medication. READ MORE
You should see your pediatrician. READ MORE
See a neurologist. READ MORE
It should not be painful. You should be sedated. You may feel a small needle prick for the IV line and for the insertion of the catheter. READ MORE
Very very unlikely that it is a heart attack. Almost certainly a gas bubble from the carbonated beverage. READ MORE
Absolutely there is treatment for heart attacks! The most important part of the treatment is prevention, but that is not an answer to your question. You should be sure to go to your doctor and make sure you are doing everything possible to avoid a heart attack. Textbooks have been written about treating heart attacks, and I can hardly write a textbook in answer to your question. Let's talk about what CAN and should do if you think you might be having a heart attack. The doctors should know what to do once you get to see them. 1. Let someone know and they should call 911. 2. Chew and swallow an aspirin. Lie down and try to relax. Don't eat or drink. If you are experiencing a cardiac arrest, hopefully someone will be around who knows what to do and, if you are lucky, you are near a defibrillator. Once you get to an appropriate medical facility, they will take care of the rest. There is a great deal they can do. The death rate from heart attack patients who reach a facility is quite low. It is the out-of-hospital cardiac arrests that stubbornly resist an improvement in the outcomes, to some extent because our streets are so congested that ambulances can't reach a victim and cannot get a victim to an emergency room quickly enough. READ MORE
They are genetic to some extent. After all, everything is but they are mainly a result of lifestyle and medical issues such as smoking, cholesterol, hypertension, diabetes, exercise, diet, stress, and so on. Family history plays a role but since you can't pick your parents you better concentrate on optimizing these other risk factors. READ MORE
Yes. Open heart surgery can cause/precipitate depressive symptoms. If that has happened to you or someone you know, seeking help from a mental health professional is an excellent idea. READ MORE
The first thing you have to do is see a cardiologist and get a monitor so you and your doctor will know what is the nature of the palpitations that occur after you eat. READ MORE
If the blockage in the artery is significant and your heart is not getting enough oxygen when the demand for oxygen increases, you should not feel the symptoms you are feeling now if they are due to the blockage which is to be stented. In fact, for the vast majority of blockages, that is the main reason for stenting them. Presumably your cardiologist has recommended coronary intervention because he/she believes that whatever your complaints are they will be relieved by opening an obstructed coronary artery with a stent. If you have any doubts regarding this you should seek another opinion. There is a lot of data that shows that stenting a coronary artery in the absence of an acute event does not save lives. It relieves symptoms. So unless you are having an acute or subacute coronary syndrome (severe symptoms related to a blocked artery), you should only have a stent if the blockage or coronary artery stenosis is affecting your quality of life. READ MORE
Garlic does not remove plaque from arteries. READ MORE
Get 8 hours a night. READ MORE
It all depends what is the cause of your irregular heartbeat. Generally, if you go to a cardiologist and the doctor is able to determine what is the cause of your irregular heart beat and is able to correct the problem (if it needs correcting), then your lifespan should be normal. READ MORE
1) Find your optimal weight and stick to it. 2) Exercise regularly. 3) Get enough sleep. 4) Reduce the stress in your life. 5) Eat a heart-healthy diet, e.g., the DASH diet. 6) Don't smoke. 7) Check your lipid profile. If you need to take medications after doing as well as possible with the quality of life recommendations, take them. If you have no evidence of cardiovascular disease, make sure your LDL is under 100. If you have evidence of vascular disease, it should be under 70. 8) If you have diabetes, get it treated with diet, exercise, and medication, if needed. 9) If your blood pressure is above 130/80 even after all the lifestyle changes, take medications for it. In order to do all of the above, you will need to see a physician regularly and maybe a cardiologist and other specialists occasionally. READ MORE
The symptoms of heart muscle damage depends on the severity of the damage. Severity is based on the amount of muscle that is damaged, how badly damaged, and where in the heart the damaged muscle is. How badly damaged is based on the kind of damage. The damage can be due to lack of oxygen, due either to blockage of the arteries supplying blood to the heart muscle or a demand for oxygen that is so excessive that the arteries cannot supply it. (Don't forget, the heart is the only organ whose energy supply is dependent on its own activity.) The damage may also be due to tumors in the heart, inflammation in the heart due to infections or noninfectious inflammatory disease. The damage may be due to damage to the nerves supplying the heart. Almost any disease that occurs in the human body can affect the heart and may damage heart muscle. Various nutritional/vitamin deficiencies can affect the heart. Emotional and psychological issues can have a very damaging effect on heart muscle mediated through the nervous system. Hormonal diseases such as hyperthyroidism can affect the heart. The list is endless and embodies that entire field of medicine and cardiology. You can see that you have asked a very complicated question for which there is no simple answer. I will assume the most general interpretation of your question: when you say "damaged" you mean weakened. Then the symptom would be shortness of breath on exertion. That is the most straightforward answer to your question. Other symptoms that could occur depending on all the factors I mentioned above are palpitations, lightheadedness, chest pain, sudden blacking out. I hope this is at least a start to the answer of your question. READ MORE
The blue means the blood is going away from the probe. The red means the blood is coming towards the probe. The colors are imposed on the blood flow by the computer program. What the probe is actually recording are doppler signals, ultrasound pulses bouncing off the cells that are in the blood. You really need to sit down with a cardiologist reading echo's and see the actual pictures to understand this fully. You are probably looking at still images from the echo video. READ MORE
No. Percutaneous coronary intervention (PCI. I am assuming you mean an arterial stent in the artery or arteries supplying the heart with blood.) should not cause chest pain. However, if a person still had blockages in other heart arteries or if the stent had clotted (thombosed) right after the stent implant or some time after the implant, chest pain (angina) might occur. READ MORE
Chest pain after stent placement may be due to acute or subacute thrombosis of the stent. It is also possible for stents to thrombose anywhere from six months to over a year after placement. These events have become relatively rare with the newer stents and the increasing expertise of the interventionalists implanting the stents. Another reason and probably a more likely reason for chest pain after a stent implant is that there are one or more blockages in the arteries supplying the heart with blood that have become critically blocked since the stent placement or maybe were blocked at the time of the stent placement and should have been stented as well. If thr chest pain is unrelated to coronary artery disease then there are many possible causes. READ MORE
There are probably psychological ways to manage such as meditation which it wouldn't hurt to try. Some of my patients take a valium/diazepam tablet 5mg when they fly. That seems to help. If this problem is really disabling, I would suggest you see a psychologist or psychiatrist. READ MORE
Stents do not show up on x-rays. They may sometimes be seen during fluoroscopy when you are getting a stent and stents can reliably be seen on computed tomographic imaging of the heart, CTA. READ MORE
There is no particular way your pulse feels during a heart attack. Depending on the nature of the attack it could be slow, fast, regular, irregular, weak or normal. I am assuming you mean by a heart attack a coronary artery thrombosis and/or occlusion. READ MORE
This is a very interesting question. First and foremost the best way to prevent heart attacks is to lead a healthy lifestyle. That means do not smoke! There are drugs to help stop smoking. That means eat properly, a Mediterranean or DASH diet and not adding salt to your food and avoiding food that you know has a lot of sodium. No junk food. Avoid altogether or at least limit food that is high in saturated fat and refined carbohydrates. That means exercise regularly, at least 3-4 times per week. That means minimize stress in your life. Understandably very difficult during these times. At least try to have relationships with family and friends that are constructive, helpful, and relatively conflict-free. That requires work but hopefully not stressful work if everyone is on board. That means getting enough sleep, also not always possible. At least 7 hours a night. That means avoid excessive screen time. It frequently is not relaxing. Find books to read and shows to watch that do not add more stress to your life, that serve to some extent as an escape from the stresses of everyday that we all inevitably face. That means get enough vacation time. Get away from it all! That means finding activities that relax you whether it is a sport with friends or fishing or gardening or stamp collecting, dancing, star-gazing, bird watching, whatever. I am well aware that for too many of us these recommendations are not possible, now more than ever. The goal of drug therapy is to minimize the risk factors that remain even after the life-style changes (I hate that expression!) I have recommended. One risk is your weight. We have no drug that will safely and over the long run help with that but you should attempt by following the life-style recommendations above to optimize your weight. Another risk is your lipid profile. That is something you will have to go to a doctor to check. If, after doing the best you can with achieving a healthy life-style, your lipids are still not optimal, there are drugs that help optimize lipids like the statins, ezetimibe, PCSK9 inhibitors, bempedoic acid, and icosapent ethyl, a fish oil derivative. Some of these are not generic and very expensive. There are others but they are not as well tolerated as these. They would have to be prescribed by a doctor. I believe that, in general, a cardiologist should manage the more complicated lipid problems. Blood pressure must be kept under control. There are many drugs that are used to accomplish that, too many to list them all. Your doctor would have to prescribe them. A good internist should be able to manage all but the most complicated hypertension problems. If you have diabetes, it must be well-controlled. That is done by the life-style recommendations and drugs. Once again, a doctor would have to prescribe. There are many drugs. If you have a bad family history of vascular disease, you cannot change your parents so all other modifiable risk factors must be aggressively addressed. You cannot change your sex and men have more risk of coronary disease than premenopausal women. Your risk profile should be assessed by your doctor and if after everything is done you still have a significant risk of a coronary event, I would recommend a low dose aspirin every day but that would be most unusual in someone 37yo. READ MORE
There are a number of blood tests which can indicate heart problems or increased risk of heart problems. A lipid profile at your age should be done. Make sure you don't have diabetes. There are other tests, but they would only be indicated if there was already a strong suspicion that you have a heart problem. A troponin might suggest damage to your heart. NT Pro-BNP would be indicated if it was thought you might have heart failure. Abnormal kidney function would suggest further investigation including cardiac issues. However, what is most important is getting a thorough annual exam from a competent physician who will know what tests to order. Dr. Gelles READ MORE
Hopefully you have a competent family doctor/general internist who can evaluate you and decide whether you need to see a cardiologist. If you do not have a primary care practitioner, then you need to find one. Ask a friend who has good judgement for a recommendation. Ask one or both of your parents if they are available or a reliable family member if you trust their judgement. Absent those alternatives, call the department of medicine at your local hospital and ask them for a recommendation. If there is a local university or teaching hospital, even better. READ MORE
I don't know. There are many reports from many people who have survived cardiac arrests and they have had different experiences. Sudden death due to cardiac arrest is not a "one shoe fits all" event. The first thing that happens is people become unconscious. They only report what they experienced after they regain consciousness. Whether those reports are accurate or just something they imagined after waking up is impossible to say. I would advise against questioning this "experience." It will not endear you to someone who is a survivor of cardiac arrest. Becoming unconscious from cardiac arrest is much different from becoming unconscious from anesthesia or trauma. Cardiac arrest causes oxygen deprivation to the brain. It may affect different parts of the brain at different times, what is called spatial and temporal distribution of oxygen deprivation. That is probably what causes people to have different experiences along with the fact that no one's life experiences and memories are exactly the same as another person's. READ MORE
Depending on what you do for a living, you can work with ischemic heart disease. If you are doing physical labor or you are in a psychologically stressful occupation then you have to be careful. There are also factors such as how you get to and from work and what the hours are. It also depends on whether your IHD is stable. If you have unstable IHD, that must be taken care of before you can have any discussion about returning to work. The best judge of whether it is safe for you to return to work is your cardiologist. You have to discuss the issue and all its ramifications with him/her. READ MORE
You can't know without seeing a doctor if you have heart-related chest pain and I would be concerned about giving you what might be definite signs of a heart condition because if you did not have the classic signs it might give you a false sense of security (like a negative Covid-19 test, for example, gives people a false sense of security). There are many types of atypical chest pain that reflect a heart condition. You must see a doctor if you have chest pain. There are a couple of points I will make for you. At your age if you are not a smoker and don't have a hereditary lipid/cholesterol abnormality and don't take contraceptive medication, it would be highly unlikely that you have a heart condition involving blockage of the arteries to your heart. But notice I said "very unlikely." I did not say impossible. I would have to qualify almost everything I say like that. That's why you should go to a doctor and have your chest pain evaluated. READ MORE
Yes, if it occurs in a venue where you can be promptly resuscitated. The key issue is the time it takes between the onset of the arrest and the initiation of CPR (cardiopulmonary resuscitation). That's why AED's (automatic external defibrillators) need to be strategically placed. That's why the more people who are able to do bystander-initiated cardiac arrest and know what to do the more likely it is that someone will survive with minimal brain damage. Calling 911 as quickly as possible is crucial. There are many courses one can take online that teach bystander CPR. You should review them. READ MORE
Try to stay calm if at all possible. Try to work out a plan to address your situation. If you have lost your insurance, check with the local public health authorities regarding other options for obtaining coverage. These are very difficult times for many working people who cannot just pick up and work from home and who have fixed expenses that must be paid. Make sure you are taking advantage of whatever help the government is offering. You have been contributing to society and society has a debt to you. See if you can find groups that are working to address in a constructive way the problems in this society that this pandemic has revealed. This will help with whatever anger you are feeling about this. Try to restrict the salt in your diet. That is the least expensive way to control your blood pressure from a strictly medical point of view. If you can combine that with a generally healthy plant based diet that will help you lose weight if you need to, that too will help keep your pressure down. Exercise every day even if it is just going out for a walk and don't forget to wear your mask and maintain social distance. If your state has prescription help, make sure you take advantage of it and make sure your doctor is treating your hypertension with generic medications. Good luck and stay safe. READ MORE
Profuse perspiration, hyperhidrosis, in the absence of an obvious cause may be one of the signs of a heart attack but rarely alone. When associated with a heart attack, or myocardial infarction, it is usually accompanied by other vagal symptoms such as pallor, a sense of coldness, a sense of weakness, impending doom, and nausea. Of course, tightness and a constricting feeling in the chest is the classic symptom of a heart attack but one have all of the symptoms or just a few or even none, a silent heart attack. READ MORE
You should ask the interventionist who puts the stent in. I am quite certain he/she will tell you very specifically. Furthermore, strictly speaking, unless you are in atrial fibrillation, you will not be on "blood thinners," an expression that is generally applied to anticoagulation with warfarin or one of the newer anticoagulants that do not work through a vitamin K dependent mechanism. You will be on anti-platelet drugs such as low dose aspirin plus clopidogrel, prasugrel, or ticagrelor. Generally you will be on two of these, aspirin and one other, for at least 6 months if you get a drug-eluting, medicated, stent. If you get a bare metal stent, the time of dual anti-platelet therapy will be less. I cannot be more specific than this since it entirely depends on the factors I mentioned above. However, one thing is for sure. Once you stop the two anti-platelet drugs, you will have to be on one, usually aspirin, for as long as possible. The risk of bleeding with anti-platelet drug(s) is less than that with "blood thinners." Jeremiah M. Gelles MD FACP FACC READ MORE
An ECG can certainly detect an abnormality of the electrical activity of the heart which may reflect an enlarged heart or a heart not getting enough oxygen or a heart with an abnormal rhythm and many other pathologies. It is the first diagnostic test in assessing a person's heart. The limitation of the ECG is that it is not specific enough in general to make an accurate diagnosis and it is not sensitive enough to pick up many cardiac conditions. Based on your symptoms and physical findings and the ECG, your doctor may advise additional tests that are more likely to indicate what the problem, if any, is. READ MORE
Fish oil doesn't hurt but it's not the best way to go about taking care of your heart. First you should get a thorough check-up by your physician and see if you have any risk factors for heart disease. This includes a thorough physical exam with any additional tests as indicated. The major risk factors for coronary heart disease, that is hardening of the arteries or atherosclerosis, are diabetes, smoking, family history of coronary artery disease at a young age (less than 60 or so), hypertension, and cholesterol level. The first steps to take better care of your heart are eating properly and exercising regularly. Rest and adequate sleep and avoiding unnecessary stress are important ways to improve your heart's well-being. A good internist should be able to address all these issues with you. READ MORE
Are you a woman or a man? That makes a difference in terms of your risk at age 30. Premenopausal women are protected to some degree against angina. Angina means that some part of your heart muscle is not receiving enough blood. When your level of activity or anything that increases the oxygen needs of your heart exceeds the supply of oxygen-carrying blood, angina occurs. The lack of blood could be from a blockage in an artery or even diseased smaller blood vessels supplying blood to your heart. There are a number of risk factors for these blockages including cholesterol, diabetes, smoking, hypertension, and family history. Having coronary artery disease significant enough to cause angina at the age of 30 is unusual. Your doctor should have done a stress test. If the stress test was positive, he/she should have referred you for computed tomographic angiography with a coronary calcium score. If your symptoms truly represent angina, then an angiogram should be performed. A specific diagnosis must be made. You are too young to rely on probabilities. A diagnosis of angina at your age affects your life expectancy and your ability to get insurance. Intensive therapy is mandatory. READ MORE
Depending on what the nature of the irregular rhythm (arrhythmia; dysrhytjmia) is it can be quite serious. It might cause a stroke if it is atrial fibrillation or worse. If it reflects some more serious underlying heart disease it might result in death. You need to see a cardiologist and get evaluated. Hopefully it is benign but we don’t know that yet. 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. 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. READ MORE
Probably not. Most likely high blood pressure and heart rate are caused by the same thing. See your doctor. 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! READ MORE
Yes. 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. 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. READ MORE
There must be something to bleed in order for the antiplatelet drug to precipitate bleeding. He needs to be seen by a urologist. 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. 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. 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. 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. 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. 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. 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! 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. 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. 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. 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. 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. READ MORE
Exercise regularly. Eat a heart healthy diet. Try to achieve optimal weight. Get enough sleep. Avoid stress. ( Not easy these days!) Check your risk factors: Don’t smoke!! If you are diabetic, adhere to your medications and diet and get your A1c as low as possible at least under 7 preferably under 6. Keep your systolic blood pressure under 120-130 if possible with a low salt heart healthy diet (DASH) and with meds if necessary. (Most of the time 2-4 meds are needed to achieve optimal BP.) Hopefully you won’t experience side effects. These often subside with time. Keep bad cholesterol LDL-C under 100, under 70 even. The lower the better! If you need a statin, be thankful we have them! The closer you get to these goals without meds the better but don’t be afraid of pills. Be thankful we have medications that can help us achieve our goals without becoming a hunter-gatherer in some remote paradise! Depending on your overall risk and other factors you might want to take low dose aspirin daily. Ask your doctor about this. You obviously can’t change your sex, your age, or your parents! Good luck! READ MORE
Age is one of many risk factors. Grandparents dying of a heart attack over the age of 80 would not be considered a risk factor for you. Unless you have diabetes, are a smoker, have high blood pressure, a very bad lipid profile, or a first degree relative who had premature (under 60 yo) coronary disease, at 34 you are very low risk for a heart attack. READ MORE
Did the doctor do an ECG? You need to get a recording of your heart when you are having these symptoms. This can be done with any one of a number of monitoring techniques. Sounds like you should see a cardiologist. READ MORE
I am experiencing tachycardia after having heavy bleeding during my menstrual cycle. What should I do?
Sinus tachycardia would be a normal response to the stress you describe. However, if it is an abnormal tachycardia, that still might be caused by your stress but would not be a normal response. I assume that your ekg just showed tachycardia and not an ectopic tachycardia. READ MORE
You need to check the accuracy of your fitness tracker. You can do this by counting your own pulse by putting your fingers on your wrist where you can feel your pulse and counting for one minute. If the tracker is correct, you need to see a cardiologist to assess why you have a fast resting heart rate. Your resting heart rate should be around 50-60 at your age. READ MORE
Speak to the neurologist who cared for her and have him/her refer your mom to a rehabilitation facility. READ MORE
- Effect of transmembrane potential on the manifestations of ouabain toxicity in sheep cardiac Purkinje fibres.
- Use of calcium ionophores to determine the effects of intracellular calcium on the action potential of canine cardiac Purkinje fibers.
- Use of calcium ionophores to determine the effects of intracellular calcium on the action potential of canine cardiac Purkinje fibers.
- Electrophysiologic effects of dopamine on sheep cardiac Purkinje fibers.
- Effect of ouabain on the current underlying spontaneous diastolic depolarization in cardiac Purkinje fibers.
- A new method for producing short cardiac Purkinje fibers suitable for voltage clamp.
- Electrogenic hyperpolarization in canine cardiac Purkinje fibres exposed to calcium ionophores.
- Electrogenic hyperpolarization in canine cardiac Purkinje fibres exposed to calcium ionophores.
- Medicine and the Holocaust.
- The effect of ouabain, dinitrophenol, and lithium on the pacemaker current in sheep cardiac Purkinje fibers.
- Voltage clamp analysis of the effects of dopamine on the transmembrane ionic currents underlying the action potential of sheep cardiac Purkinje fibers.
- The electrophysiological effects of ionophore X-537A on cardiac purkinje fibres.
Areas of expertise and specialization
- High Cholesterol
- Heart Disease
- High Blood Pressure (hypertension)
- Coronary Artery Disease (cad)
- Vascular Disease
- CEME/Mount Sinai Medical Center Program
- Mount Sinai Hospital, New York
- Mount Sinai Hospital, New York
- Mount Sinai Hospital, New York
Professional Society Memberships
- American Heart Association, Kings County Medical Society
Articles and Publications
- Dr. Gelles has contributed to several articles on cardiac electrophysiology.
Jeremiah M. Gelles MD's Practice location
Brooklyn, New York 11209Get Direction
BROOKLYN, NY 11215Get Direction
Jeremiah M. Gelles MD's reviewsWrite Review
Patient Experience with Dr. Gelles
- The Diabetic's Connection to Heart Disease
Many already know that diabetes has a deep connection with heart disease, but a lot aren't sure about why or how. However, according to several studies, high blood glucose levels are a key contributor to this connection. High levels of blood glucose, or sugar, will often result in damage to the...
- Different Types of Heart Doctors Explained
IntroductionDoctors who specialize in the diagnosis and treatment of conditions or diseases of the cardiovascular system (the heart and blood vessels) are called heart doctors or cardiologists. These specialists are trained to identify, treat, and help prevent heart issues. There are also different...
- Medical Conditions That Are Associated with Lethargy
What are The Symptoms of Lethargy?Lethargy symptoms include:• Sluggishness• Being moody• Decreased level of alertness• Low energy levels• Fatigue and lack of motivation• Depression• Weight loss• Sweating and diarrheaMedical conditions such as premenstrual syndrome and medicinal side...
- Causes and Treatment of a Persistent Cough
What is a persistent cough?It can be annoying to have a cough that lasts for more than a couple of weeks. A cough is considered chronic or persistent if it does not go away after four weeks in children and eight weeks in adults. However, most persistent coughs are due to colds, flu, infection, or...
- Are Statins Safe?
Statins are a class of drugs that help to reduce the levels of cholesterol in blood by inhibiting the enzyme involved in the production of cholesterol in liver. It is one of the most commonly prescribed drug to lower cholesterol levels and to avoid complications like stroke and heart attacks....
- The Signs of Stroke in Women
Stroke is found to be the third leading cause of death in women around the world. As women generally live longer than men, the effects of a stroke affect women more than men. Women also live longer in a healthcare facility after having a stroke than men do. Women are more prone to a stroke...
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