Ask Dr T

Ask Doctor T. Blog

Posted by Dr T on April 17, 2016 - 2:36am

The test proves you have insufficient blood supply to a small part of your heart, but that overall function is normal. Many patients can be treated with medications and a heart-healthy lifestyle, and a procedure such as a stent or bypass is only needed for them when there are disabling and/or progressive symptoms, or the blockage is in a dangerous location.

The blockage is likely in your right coronary artery and treatment should depend on  your symptoms and the heart muscle section at risk. You can...

Posted by Dr T on March 30, 2016 - 4:02pm

You are perfectly safe fro getting a shock yourself if an internal defibrillator fires during CPR. With an Automatic External Defibrillator stay clear when the device starts charging until after the shock has been delivered  and resume CPR afterwards until help arrives! Please read these links:

Hope this helps,

Dr T

Posted by Dr T on March 26, 2016 - 12:13pm

Any recurrent chest pain after stenting indicates a very real risk of stent failure and you need to see your doctors immediately to get checked. Your symptoms are consistent with angina. Ask for another stress test or a 2nd opinion if your cardiologist refuses. You now have a long-standing and recurrent problem (stents) that fail! You can calculate the optimal treatment in your case here.

When areyour doctors going to learn stents don’t work in your case? If you had been treated with a...

Posted by Dr T on March 18, 2016 - 8:51am

You certainly have every right to complain: no doctor should perform a procedure w/o a pt’s permission, and it is questionable whether you needed the stent. While you have proven coronary artery disease with hypertension and overweight as risk factors for future heart attacks and/or stroke, your weight loss and excellent cholesterol data would have been reasons for me to focus on getting your BP under better control, helped by continued diet and weight loss: so called "Optimal Medical Therapy" has proven to be just as effective (if not better)!

It is impossible to tell whether these new chest pains are a result of the stent procedure, but they do fail on occasion, so you may need to be re-evaluated to check whether this has happened if your...

Posted by Dr T on March 9, 2016 - 1:55pm
About Choosing a Doctor

You can do a number of things when deciding where to go. All physicians have a track record that includes:

  • Is rated to give quality care;
  • Has the training and background in Heart Disease that meet your needs;
  • Medical School education;
  • Years in practice;
  • Board certification;
  • Partnerships;
  • Has privileges at the hospital of your choice;
  • Is part of your health plan, unless you can you afford to pay extra;
  • Accessibility & coverage arrangements;
  • Encourages you to ask questions;
  • Listens to you;
  • Explains things clearly;
  • Treats you with respect;
  • Has your potential doctor ever been sued?

Of course this information neither guarantees expertise...

Posted by Dr T on March 6, 2016 - 11:29am

Broken Heart Syndrome is a condition caused by acute severe stress  and a sudden surge of stress hormones.. Some potential triggers of a broken heart syndrome include:

  • News of an unexpected death of a loved one
  • A frightening medical diagnosis
  • Domestic abuse
  • Natural disasters
  • Job loss
  • Divorce
  • Physical stressors, such as an asthma attack, a car accident, or major surgery

If it occurs in someone with an pre-existing heart condition such as coronary artery disease it may well cause a fatal acute heart attack


Posted by Dr T on February 18, 2016 - 9:41am

A choice of CABG vs. more stenting depends on many factors as I have explained not only in my video but many times:

When coronary artery bypass surgery is your best option

How long does a stent last? 

Thus, in your case, your choice depends on (recurrent) symptoms, whether your stent fails, or whether you have other blockages (and where), what your heart function is and your general health. I don't have enough information for a specific opinion.

Hope this helps.

Dr T

Posted by Dr T on February 13, 2016 - 10:27am
Hi Chris,
Improved heart function (as demonstrated with the Ejection Fraction) happens often if there was "viable but ischemic" heart muscle before the operation:
If the coronary artery bypass surgery (CABG) is proven  successful, not only for the grafts to work but in recruiting heart muscle that received insufficient blood supply before the operation (it is called "dormant"). It is one of the great benefits of bypass surgery, as opposed to stents. 
I have included some articles I wrote previously on the subject:
Posted by Dr T on January 23, 2016 - 10:33am
Acid reflux (GERD) often produces breathing problems because of chronic aspiration of stomach contents. Patients with CAD usually have cardiac risks (that or course might be also present in a pateint with GERD). However, usually a physician can figure out what is what. That said, I have performed a coronary bypass operation  on many a patient where GERD was diagnosed instead of...