Ask Dr T

Ask Doctor T. Blog

Posted by Dr T on January 27, 2013 - 7:30pm

Hi Rebecca,
Of course not; repeat stress tests depend on your symptoms, risks for heart disease and findings of heart disease if present If you are at high risk (calculate here), or have known heart disease, a repeat stress tests may be necessary for a limited period of time to judge whether your present therapy is adequate. Other than that, it...

Posted by Dr T on January 27, 2013 - 8:57am

Hi John,
If your symptoms are new since the pacemaker implant, it needs to be checked and I doubt the ER looked at all options. When the pacemaker leads were positioned inside your heart, one of them may have perforated your heart muscle and cause some blood to leak into your heart sack. If so, I am concerned you may have a pericardial effusion causing a condition called tamponade. You should see your doctor asap and ask for a cardiac echo to check this out.

I...

Posted by Dr T on January 26, 2013 - 12:31pm

Hi Sylvia,
While your thyroid disease may have contributed to your heart palpitations, it may not be the only reason. Sometimes one illness "uncovers" another one! In your case your slow heart rate on present therapy suggests your medications have been maximized and  have succeeded in slowing your heart rate down.

However, I am concerned you may have primary heart disease such as an arrhythmia and/or coronary artery disease that has not yet been investigated. My suggestion, have your heart checked for coronary artery disease including a cardiac...

Posted by Dr T on January 26, 2013 - 12:00pm

Answer:
Wolff-Parkinson-White (WPW) syndrome and Atrial Fibrillation (AF) are two different diseases. Both WPW and AF may require ablation. If the procedure was only partially successful, it may need to be repeated.

Being an Athlete doesn't protect your son from having a serious illness, but I agree with you to not accept a final verdict about the treatment of your son w/o consultation with another cardiologist (who is an EP specialist). The reason: Some patients with WPW are at high risk for...

Posted by Dr T on January 17, 2013 - 7:32pm

It means you may have had a previous heart attack that involved your septum. Don't worry too much, the reading may have been misinterpreted.

However, your anesthesiologist probably will ask for a cardiology consult, who may want look into your risks for heart disease:
Depending on what he finds, he probably would order some tests before clearing you for surgery and it might include a stress test:
Things to check:

  • ...
Posted by Dr T on January 16, 2013 - 5:05pm

Hi Charlotte,
The cardiologist only interpreted the cardiac echo (normal), he did not consult on your condition. That said, I don't see an indication to get a cardiologist involved with your care from what you have told me.
The "routine operation" must had something to do with your stomach - could it have been a bariatric operation for obesity? If so, the 'Heart size on the upper limits of normal' could be the result of early changes seen with hypertension, called hypertrophic cardiomyopathy.

Hope this helps,
Dr T

Posted by Dr T on January 15, 2013 - 9:22am

Hi Sam,
If you still get short of breath with minor exercise it means either you have not yet fully recovered or you are de-conditioned. In the first case you might have a residual pleural effusion and atelectasis preventing your lungs to ventilate properly, not uncommon after heart surgery. A chest X ray should do the trick to (dis)prove the its presence.

If your heart and lungs are now functioning normally as expected after a successful aortic valve replacement, gradually progressive exercising is indeed appropriate, but I would recommend aerobic exercise rather than weight lifting, which doesn't do much except create muscle mass and will not make you healthier cardaic-wise....

Posted by Dr T on January 14, 2013 - 1:57pm

Hi Tanya,

I am not convinced your cardiac evaluation is complete, because some of your symptoms are consistent with heart failure. There is a test that calculates your ejection fraction, but that test doesn't always all questions of cardiac function. I specifically think of some forms of cardiomyopathy, called restrictive cardiomyopathy, or another condition called pulmonary hypertension.

I also miss information about a...

Posted by Dr T on January 12, 2013 - 10:20am

Hi Meghann,
You are confusing two separate issues: the health effect of moderate red wine consumption (one glass for women, two for men/day, also shown to decrease the risk of diabetes) with your condition, which is called pre-hypertension. It means you should review your other risks for developing heart disease to see what you can change in your life style. You can also do a cardiac risk assessment to...