Cardiac Risks

Poor R wave progression on my EKG

Question: 

Dear Sirs my EKG says poor R wave progression borderline I was rushed to and echocardiogram which came out totally normal.  my dr says its age related  changes im 61 never had a problem what can I believe 146 rate 76 qt 372 qtch 400 qrsd 86 pqrst 56/69/58 degree  no one answers me they say don't worry I am very nervous the tech ewas doing it wrong he made her do it again he says it came out the same twice.

Hi Michelle,
Poor R wave progression on your EKG could have meant you have had a heart attack in the past or long standing hypertension, none of which were proven when the echocardiogram was done. EKG Lead misplacement (frequently in obese women) is another cause. 
If you have a normal heart function and no cardiac risks, you have nothing to worry about.

PVCs during stress tests

Question: 

is it normal for pvc's to show on 2 stress test..and does everyone throw some pvc's  exercise?

Hi Sarah,
PVCs  happen! If you have a normal heart function and no cardiac risks, you have nothing to worry about. If these PVCs are a new finding, you need to be checked for coronary artery disease
Hope this helps, 
Dr T

Could this be angina?

Question: 

hello, i am 37fem with 3 kids. lately i have been experiencing odd pains in my chest/back(occasionally and scared it's angina.

specifically, started few weeks ago, i went for my pap test and got nervous when waiting i started feeling like "water" running in my chest and i believe i had acid reflux. then on friday, i was on the bus with my kids and i started having pains like bruising up in my chest , got scared but tried to brush it off. yesterday i was washing my terrace when i had pains again in my chest, then all day my chest (esophagus) and neck area hurt but not at the same pain level. got to sleep with a terrible migraine woke up ok i decided to exercise in my treadmill, was feeling fine fine fine but after i finished and got off i had pain in my upper back no other feeling whatsoever. i did some jumping jacks etcc. and felt a bit of pain again when i sit down it went away. i know this is the description of angina but could it be my esophagitis? i neglected my meds and diet all winter and have been taking my meds again for about a month now. could it be angina with normal to low cholesterol/high hdl very low triglykerides , negative heart disease in family etc...?

i had no other symptoms except in the morning when i woke up i had a burning tongue. i am of normal weight don't smoke or drink, stay away of sugar and fatty foods and exercise as much as i can with 3 kids. no edema anywhere. as i am writing this i am very very scared !!!

i have hashimots thyroiditis, gastritis and esophagitis , mild mitral prolapse, had a heart check up last year, was given the all clear.

would be grateful for any info.

Hi Tonia,
It is unlikely to be your heart or angina, but with your history of GI problems, I suspect another problem such as esophageal spasm may be an issue. This can only be resolved with an examination and appropriate testing.
Hope this helps,
Dr T

Antibiotics after heart surgery

Question: 

Hi. In July of '11, I had cardiac arrest and emergency quad bypass. All went well, and after discharge was NEVER set up any followup in the two years following. My primary care Dr. seems to think I'm doing well too. Now I have some teeth that need to be pulled so I can get a bottom denture, but my dentist says I have to get approval from my cardiologist first and be cleared for what they said was "pre meds"...antibiotics IN CASE I developed an infection. I've been on a few antibiotics in the last two years, one I know was while still in the hospital for the bypass, and one just a couple months ago when I was diagnosed with COPD. Could you please explain to me why the dentist says I need approval for an antibiotic because I simply don't understand at all. Your explanation will be greatly appreciated as soon as you can get it to me. Things are all in an uproar between the two Dr's and me in the middle not understanding why, and what steps I could do to speed things up. Thank you!

Hi Chuck,
As you can read in this list, there is no need for prophylactic antibiotic therapy after coronary artery bypass surgery, thus your dentist is incorrect. This is only necessary in case of a problem or procedure inside your heart such as a heart valve operation. 

Antibiotic prophylaxis is used to prevent an infection inside the heart (called Infective endocarditis) of susceptible patients. As an example, even a minor infection, such as a tooth abscess can cause severe bacterial endocarditis.

How the End of World War II Made Us Fat

 

The American economy took off following the end of World War II, fattening both our wallets and our waistlines. In this video, Academic Earth examines the post-war boom that busted our seams. Take a look at this article and video, submitted by Lisa Miller, a contributor to Academic Earth:

Will a Heart Healthy Lifestyle Cure Heart Disease?

Question: 

I have heart disease. I take statins, exercise every day, and now eat the Dean Ornish diet. My LDL has ranged from 109 to 65 in the last six months on this diet. Yet I have had no improvement in my angina. How long can it take for heart disease reversal to begin working? 

No present treatment can cure Coronary Artery Disease (CAD)! If you have heart disease your present heart-healthy lifestyle will slow down the progression of disease or even control your symptoms but will not reverse the process of atherosclerosis that caused your heart disease. However, you can live a long and symptom free life if you continue like this.

High triglyceride levels

Question: 

I am healthy male of 35 years, but I have a question - and I am clueless about the reason for it. 2 months back, my lipid profile was:
TC-156; HDL-29; LDL-82; VLDL-45; Triglycerides-220. 
With low HDL and high Triglycerides - I started a lifestyle changes. In diet I included: Flaxseed powder, walnut, almond, omega3 capsules. Also, extensive workouts - 1.5 hours on average per day, including running, abdominal exercises. No smoking, very less alcohol. 
This week I did lipid profile again, the results are:
TC-173; HDL-31; LDL-66; VLDL-75; Triglycerides-370
Though good signs for HDL and LDL, but I am quite clueless for Triglycerides. Can you help me why this has happened?
Thanks in advance
regards
Aritra

Hi Aritra,

Triglycerides are a form of fat found in the body, blood and in food. Our bodies use them for energy, so they are necessary for good health, but when triglycerides are high it increases the risk for Cardiovascular disease and may indicate that you suffer from metabolic syndrome which raises the risk of heart disease, stroke and diabetes.

Bradycardia in children

Question: 

My son is 3 years old and has airway problems. He had a Type 3 Laryngeal cleft repair in 2012. Otherwise, he seems to be fine. A few months ago we noticed that his heart rate started dropping into the 60's and 50's during the night and staying there. EKG was done and was normal. His oxygen stays in the 96-100 range, no issue there. While in the hospital, I noticed on the heart monitor it kept saying "Sinus rhythm", "SV Rhythm", and SV Brady. His heart rate did not drop down though like it does at home & I think it's due to his albuterol and recemic epi breathing treatments there as well as steroids. He is on Amoxicillin and Prednisolone currently. The dr's do not take me serious when I ask them about this issue. Any advice?

The monitor read-outs reflect a variation in your son's heart rate, not an interpretation of what it means. A normal heart rhythm in children varies quite a bit based on age as well as activity level. A resting heart rate is typically between 60 - 100 bpm. With activity, the heart rate may get as high as 200 bpm. During sleep, the heart rate can occasionally drop as low as 30-40 bpm. An EKG will show whether this a normal variaition or the result of abnormal electrical conduction within his heart.

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