Posted on January 31, 2014
How Will I Know If I Need Heart Surgery
Heart surgery is never an easy possibility to confront. It often involves both the question of if and when you need an invasive solution. There are a couple of indicators along the way that can help you both recognize and accept the decision that needs to be made. 
Treatment – it’s a Long and Winding Road
The first indicator that you might need heart surgery happens shortly after you’re definitively diagnosed with a form of heart disease.
Your general practitioner and cardiologist will go over the treatment options for your condition and the expected prognosis.
Pay attention to the prognosis. This portion of the conversation will let you know if surgery is a common approach or an expected eventuality for patients diagnosed with a heart condition like yours.
Even if the long-term prognosis points to heart surgery, unless this is an emergent cardiac situation or there are no other treatment options available, chances are it will be a while before you have to focus strictly on invasive measures.
In the meantime, focus on complying with the treatments that don’t involve an operating room:
- Adaptations
- Therapies
- Medications
- Assistive devices
By focusing on these kinds of treatments, you may be able to put off surgery or avoid it altogether.
When to put off Heart Surgery
Focusing on the space between your diagnosis and surgery may result in no longer needing an invasive procedure. It can also slow the progression of your heart condition and give you more time without the necessity of surgical intervention.
Certain forms of circulation therapy and minimally invasive procedures might be enough to restore function to your heart without undergoing bypass surgery. By the same token, in certain cases, it is best to avoid surgery for as long as possible. Assistive devices like L-VADs make it possible for patients to have a better quality of life while waiting for heart transplant.
If you’re wondering whether putting off surgery is a good idea or not, you need to speak to a heart surgeon as soon as possible. They can evaluate your case and tell you if immediate surgery is recommended. This is particularly important for patients who are outside of the normal age range for heart surgery and patients with aggressive forms of heart disease.
New advancements are being made in the field of cardiology every day. Some of these advancements will have an impact on your decision of whether or not to have heart surgery.
Get the latest advice from a specialist and a surgeon so you know whether surgery is in your best interest or not.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 30, 2014
How Do I Know If I Require Heart Surgery
Patients who need heart surgery are generally referred to an interventional cardiologist by their family doctor or clinical cardiologist. Based on an evaluation by a heart surgeon, you will be told whether an invasive procedure is necessary or not. 
This is definitely one way that you’ll know whether you need heart surgery or not, but it is generally the last step in the process rather than the first. To understand where the surgical process begins, you will need to back up by several months or even years, depending on your diagnosis.
Signs that may or may not point to Surgery
Patients with progressive conditions like coronary artery disease (CAD) or heart failure usually see heart surgery as an inevitability. This may be true, but that kind of intervention isn’t your only treatment option.
The road to surgery usually begins with trying other treatments first. No matter what your heart condition is, you are most likely looking at the same three treatments prior to surgery:
- Medication
- Therapeutic methods
- Dietary and lifestyle changes
Different combinations of these modalities are used to treat various heart conditions.
For example, CAD responds very well to dietary changes, while the progression of heart failure can be slowed using circulation therapy. Neither of these approaches are invasive, and some patients aren’t eligible for surgical options, so they need alternative treatments.
When surgery isn’t Immediate
The standard surgical treatment for CAD is coronary bypass. The standard treatment for advanced heart failure is a transplant. Neither of these eventualities are immediate and neither of them is guaranteed.
Some patients are too weak or too high risk for heart surgery. In cases like this, stents or EECP can be used to open up blocked arteries and improved the circulation capabilities of the heart. Assistive devices like the L-VAD make it possible for patients to wait longer for a transplant match.
All that said, there are a few indicators to consider that don’t necessarily relate to your symptoms. For instance, your quality of life is an excellent indicator for taking invasive measures.
Ask yourself whether or not it would improve with surgery. Are there things you’re not able to do now, that you could do after surgery? Would surgery relieve the stress and discomfort you go through on a daily basis? If your answers to questions like these is yes, it’s probably time to talk to a surgeon.
Following the recovery protocol from start to finish will give you the best chance at a new lease on life after heart surgery; especially following a sudden heart attack.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 29, 2014
What To Consider Before Deciding on The Heart Doctor Right For You
The road to your chosen heart doctor may start with a recommendation or referral from your general practitioner, but the journey doesn’t end there, unless you want it to. 
Patients are taking a larger and more active role in selecting their specialists. To make the right selection, you need to gather more information. The process starts by asking some specific questions.
Do I need a generalist or a specialist?
Patients with risk factors for heart disease and warning signs like minor hypertension can have their case managed by a general practitioner. However, there is another choice.
Assuming that selecting a heart doctor is your first exposure to specialty care, you can opt to make a specialist your primary care provider. A general practitioner may still be used to coordinate certain aspects of your care, but for patients with diagnoses like end-stage heart failure, it may make more logical sense for a specialist to oversee the majority of your medical care.
Many patients aren’t aware that this is an option. It does depend on each case, but cardiologists are trained in general medical practices, like internal medicine, as well as their specialty. The trade-off is that you have to make sure they are well-versed enough in both general and specialized care to adequately provide it. If not, it is better to retain the services of a family doctor.
How do I talk to a heart surgeon?
Whether you are looking at a non-invasive procedure or a life-altering surgery; the most important thing to pay attention to when discussing the procedure with the surgeon is their level of experience.
Ask them very direct questions, including how many of these surgeries have they performed? What is their complication rate? What does their current caseload look like?
These questions give you a window into their hospital privileges and how recently they’ve performed a particular surgery. A surgeon with a full caseload generally has more experience on a day-to-day basis than a surgeon with a lighter schedule.
What do I need to know about patient interactions?
The answer to this question will give you the most insight into your potential doctor-patient relationship. It is an influential factor in the heart doctor you ultimately select.
Pay particular attention to how the specialist manages patients. What is the average wait to see the cardiologist? When they are in the appointment how attentive and knowledgeable are they? Do they follow-up with patients after each appointment?
If you can answer these questions, it will tell you decide whether or not the cardiologist is right for you.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 28, 2014
Common Causes and Symptoms of Chest Pain
Chest pain is most commonly associated with the onset of a heart attack, but the medical definition of this symptom is a little broader. For one thing, it is not confined to the chest. 
The pain, pressure, tightness or discomfort that you feel is defined as chest pain if it occurs anywhere between your neck and your abdomen. This includes:
- Esophagus
- Heart
- Lungs
- Stomach
- Ribs
- Jaw
- Arms
- Head
There are a wide range of reasons you might experience chest pain. Some of them are cardiac-related, others are not. This article will look at some of the common health problems that can cause this pain.
One Symptom; Many Causes
Persistent pain in your chest should always be evaluated by a heart specialist. Here is a list of the usual suspects they tend to look for:
Angina-this can happen either with physical exertion (considered stable) or unexpectedly as a symptom of a more severe heart problem (considered unstable). It is an indication that there is a decrease in the blood flow and oxygen being supplied to the heart.
Heartburn-although this is generally a gastric problem between your stomach and your esophagus, it can cause pain in your sternum until the acid reflux is brought under control.
Heart attack-another way to think of this medical condition is severe, life-threatening angina. In this case, blood flow and oxygen are unexpectedly cut off by a restriction or blood clot. This causes severe chest pain and muscle death if the heart is not treated right away.
Aortic dissection-when the main artery of the heart separates from the muscle after prolonged hypertension or a sharp blow to the chest.
Esophageal spasm-a medical condition caused by uncoordinated muscle control between your throat and your stomach. In addition to chest pain, patients have difficulty swallowing.
Digestive problems-this could be something as simple as indigestion or something as complicated as ulcers and gallstones. Either way, these health problems have been known to cause chest pain.
This list ranges from the trivial to the life-threatening, which is the larger point of this article. Don
Posted on January 27, 2014
Chest Pain Left Side and Why You Need To See a Doctor
Whether by biological imperative or simply habit; the words “chest pain left side” automatically conjure up the possibility of a heart attack first and foremost. Given all of the information about heart disease and the emergency training; jumping to this conclusion is not surprising.
While seeking medical attention for chest pain is rarely a bad idea, you can also perform an in-home threat assessment, which can help you classify your chest pain left side a little easier. We will review how to evaluate your symptoms in this article.
Chest Pain Left Side with Heart Muscle Involvement
Pain in your chest cavity could very well mean you will soon experience a heart attack. That said, pay particular attention to how that pain is typically described and what side effects usually accompany it.
For instance, it is usually described as a feeling of pressure, squeezing, or fullness in the chest cavity. This sensation is accompanied by:
- Numbness, pain, prickling in the left arm
- Muscle weakness, pain, heaviness in the extremities
- Shortness of breath
- Fatigue which overtakes the body
- Lightheadedness or dizziness
- Sweating or flushing prior to the heart attack
- Back pain or gastric discomfort
These are common signs of heart attack, but every patient presents differently, so it is important to know what to look for, even if it doesn’t affect you in the same way as it would someone else. However, if you experience one or more of the symptoms, and the symptoms begin to worsen within a short span of time, seek medical attention immediately.
Chest Pain Left Side other Causes
Like we said in the introduction; it’s usually better not to assume the absolute worst scenario. Consider your activity level and how much stress you’re under before thinking heart attack and discounting all other possibilities.
If you are incredibly physically active or under a lot of stress, you may have left-sided chest pain as a direct result of your lifestyle choices. Talking to a specialist is the best way to make the long-term changes to your lifestyle and reduce secondary health conditions because of those changes.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 26, 2014
Common Causes of Chest Pain on the Right Side
Say the words “chest pain” and people automatically think: heart problem. The truth is there’s more to your chest then just what’s on the left side. Chest pain on the right side should not be ignored either. 
Your chest is home to several important organs and structures, including the:
- Heart
- Lungs
- Esophagus
- Ribs
- Muscles
When something goes wrong, it can be indicated by chest pain on the right side.
The other Side of Cause and Effect
We will list and describe several health problems that can originate or transfer to the right side of your chest.
Pleurisy – inflammation of the lining in your lungs and chest wall. It causes a sharp pain when you breathe, sneeze, or cough. Why does it happen? There can be a number of reasons. The root of the problem might be a common bacterial infection or a rare autoimmune disease like rheumatoid arthritis and lupus.
Viral infections – think of the common cold or flu. These illnesses can come with chest pain on the right side, due to chest congestion. It will feel like a deep and achy stabbing pain when you take a deep breath or cough. When the congestion subsides, so does the pain.
Pneumothorax – otherwise known as; a partially collapsed lung. This chest injury releases air into your abdomen each time you take a breath. For that reason, the pain is usually worse while breathing. This is a common injury in car accidents and high-impact falls.
Rib dislocation or fracture – you will feel this pain in your right upper chest area. It will worsen when you breathe, cough, or bend over. Other than pain management, there is very little that can be done for this injury. It will resolve on its own in a matter of days or weeks.
Problems with acid reflux – more commonly referred to as indigestion. This gastric upset can cause a burning sensation in your throat and chest. If it is bad enough, it can cause coughing fits as well. Avoid caffeine, alcohol, fatty foods, large meals, and smoking to maintain a healthy digestive tract.
There are several more diseases and organ malfunctions that can cause chest pain on the right side. These are just five examples. The best thing you can do is reduce and manage stress.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 25, 2014
Why You Are Experiencing Chest Pain While Breathing
Chest pain causes most people to think of the worst case scenario: a heart attack. While working backwards from the worst possibility to the best may be part of your process, pain in the chest doesn’t always translate to heart attack.
For one thing, cardiac chest pain has a sudden onset and feels very specific; more like your heart is in a vice grip or being compressed, not necessarily a sharp or stabbing sensation. These sharper sensations are actually associated more with the lungs and ribs than the heart.
Don’t Forget to Breathe
Chest pain has become rather heart-centric. It’s not uncommon for heart problems to come to mind before anything that might involve breathing or structural problems. The funny thing is most chest pain end up being from a secondary respiratory or inflammatory cause.
Pleurisy is one of the most common respiratory conditions that result in chest pain. Anything from infections to injury and disease can cause the lining of your lungs and rib cage to become inflamed and make it physically painful to breathe.
Whether the pain is dull and burning or acute and stabbing; it should be accompanied by several other symptoms including:
With this list of accompanying symptoms, you’re probably thinking of another possibility.
Pneumonia is an aggressive infection that occurs when bacterial pathogens enter the lungs and multiply. Your body sends in its own natural lines of defense, but these may not be strong enough to eradicate the infection without a medicinal boost.
Symptoms to watch for include:
- Difficulty breathing accompanied by sharp chest pain
- Fever
- Visible chills
- Productive cough
- Sweating and muscle pain
If you have an anxiety disorder, the treatment will consist of psychotherapy in combination with various antidepressant and anti-anxiety drugs.
A medical professional can help you find the source of your abdominal pain.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 24, 2014
There are over 26 known causes for sharp chest pain. The list includes:
- Stress
- Inflammation
- Angina
- Scleroderma
- Pregnancy
- Asthma
- Acid Reflux
- Herpes virus
For the sake of time and continuity, we will be reviewing two of the most common causes and the treatment protocol associated with them. The causes are angina and acid reflux.
First Aid and Emergency Treatment for Angina
The first thing to realize is that angina does not always mean a person is having a heart attack. However, the symptoms of angina, which include sharp chest pain, do raise the risk of heart attack.
It’s a good idea to know exactly what to do in an emergency situation where heart attack symptoms might be present.
The person complaining of sharp chest pain will likely know what kind of angina they’ve been diagnosed with. There are two types:
- Unstable angina
- Chronic stable angina
In either case, the symptoms associated with this condition mean that the heart muscle is not getting enough blood. If healthy blood flow is not restored to the muscle, it can cause a heart attack.
Treat angina using nitroglycerin tablets or nitroglycerin spray. Both of these delivery systems can be applied under the tongue. If the angina is unstable, wait five minutes to see if it subsides after the nitroglycerin dose. If it does not, call 911.
Patients with stable angina can be treated with up to three doses of nitroglycerin over a span of 15 minutes. Even if the episode subsides, the patient should follow-up with a cardiologist for further testing.
Acid Reflux or Heart Attack?
This may sound like a strange question to ask yourself, but believe it or not, a heart attack can be mistaken for a severe bout of acid reflux.
Don’t just look for sharp chest pain; pay attention to the other symptoms that accompany it, like:
- Shortness of breath
- Pain in the jaw, left arm, or back
If other symptoms are present seek emergency medical attention as soon as possible. Also, have the person chew an uncoated aspirin tablet to prevent clot formation within the heart.
An episode of acid reflux, on the other hand, can be treated with over-the-counter or prescription antacids. A prescription adjustment may be all that is immediately needed.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 23, 2014
Find a Doctor in NYC For Sharp Chest Pains
Sharp chest pains indicate one of over 26 different diagnoses. For the sake of clarity, the diagnostic possibilities are generally divided into two categories: 
- Cardiac chest pain
- Symptomatic chest pain
Obviously, not every twinge or discomfort in your chest or abdomen mean that you are having a heart attack. If heart involvement is suspected, you will likely be referred to one of two possible heart specialists:
- Interventional cardiologist
- Clinical cardiologist
Which type of doctor you see, will depend on what type of sharp chest pains you are having.
On Call in Cardiac Emergencies
Whatever the cause of your sharp chest pains; they should always be evaluated by a doctor. These pains can be a secondary symptom that help to get treatment for an underlying condition. When an underlying condition involves the heart, it’s best not to take any chances.
A sudden onset of sharp chest pains that does not subside in five minutes is considered an emergency situation. Call 911 and have the paramedics alert the hospital of a possible heart attack patient. This message will be sent to an interventional cardiologist on call in the emergency room.
By the time you arrive at the hospital, this specialist will be prepared to run a very quick and decisive battery of tests to figure out if you are suffering from a heart attack. Depending on the test results, you will either be treated and observed or sent directly into surgery.
Following your emergency treatment, you will be referred to a clinical cardiologist for rehab and condition management.
A Picture of Ongoing Care
Patients who have a definitive diagnosis of heart disease will be regularly seen by a clinical cardiologist.
This cardiologist can help diagnose and treat chronic sharp chest pains. Pain like this, especially when it happens after physical activity, is an indication of chronic stable angina. You will be put on a nitroglycerin regiment in order to manage the symptoms. If your symptoms worsen, you need to contact your cardiologist right away.
Worsening symptoms can indicate a change in your condition, and therefore; a change in your treatment protocol. If you are regularly seeing a heart specialist, clear and consistent communication is vitally important to your ongoing care.
Always say something about symptomatic changes.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
Posted on January 22, 2014
Commonly Run Tests For Sharp Chest Pain
Chest pain is a unique symptom because while it should not be ignored; it should also not be compartmentalized. It is a telltale sign that can mean many things. That’s why cardiologists have developed a specific battery of tests for chest pain.
They are:
- Physical exam
- Blood tests
- EKG
- X-rays
- Scans
Within this diagnostic cross-section, there’s an answer to be found.
Two-Prong Approach to Cardiac Crisis Management
Tests for chest pain were primarily developed for three reasons:
- To quickly and effectively diagnose a problem in a cardiac emergency
- To learn more about heart function
- To narrow the field so that non-emergent chest pain could be adequately treated
A standard diagnostic protocol is followed whether you are in the emergency room or attending a follow-up appointment at a cardiac clinic.
Tests for chest pain will always begin with the physical exam. If you exhibit obvious signs of distress, such as, paleness and profuse sweating, your symptoms will be treated as possible earmarks for surgical intervention. Gripping the symptoms together can be an indication of heart attack, dissecting aneurysm, or pulmonary embolism.
This is just one example of why a physical examination is vitally important before jumping to any conclusions.
Always present Supporting Evidence
The physical examination usually results in a diagnostic hypothesis. The hypothesis then needs to be proven, that is what the remaining tests for chest pain provide – supporting evidence.
Blood tests can indicate things like: renal function, heart attack enzymes, or syphilis; all verifiable causes of chest discomfort.
An EKG offers a window into how your heart is functioning. Based on the view from this test, a cardiologist can develop a more decisive diagnostic plan. Different scans and test that are completed from this point on can better pinpoint the underlying cause of chest pain.
A series of follow-up x-rays are usually next on the list. Upon review, the films have the best chance of locating several likely suspects and giving your heart specialist the best chance that locating and resolving your heart problem as effectively as possible.
Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site. Call us at (212) 367-8000.
