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Frequently Asked Questions

Is it safe to become pregnant with premature atrial contractions or is there complications that can occur?
Premature Atrial Contractions (PACs) are not a contraindication for pregnancy. However, if you are taking medication for the PACs, please discuss this with your doctor/gynecologist before you get pregnant.

Is there a reason why PACs happen more frequently prior to one's period?
Frequently women complain about palpitations prior to their menses. The cause is unknown. Palpitations can be quite annoying... and frightening.Caffeine and chocolate can precipitate palpitations. Medications which are stimulants, such as Sudafed and neosynepherine nose spray, can also cause irregular heart beats. So it would be wise to avoid these substances. Too much caffeine (e.g. coffee, tea, cola, chocolate), medicines such as decongestants (taken by mouth or by nose spray) and asthma inhalers, mitral valve regurgitation (leakage) and stress can all contribute to palpitations. If palpitations make you feel dizzy or lightheaded, you should ask your doctor for an evaluation by an Electrophysiologist. An Electrophysiologist is a cardiologist (heart doctor) who specializes in the evaluation and treatment of abnormal heart rhythms and abnormal heartbeats. Use of over-the-counter supplements may react with other medicines you are taking. Always check with your doctor or pharmacist before taking supplements.

When it is suggested to take an "aspirin", should that aspirin be chewed or swallowed?
It depends on the circumstance for which you are taking the aspirin. It is suggested to chew an uncoated aspirin IF you are having chest pain/angina or think that you are having a heart attack. Theoretically, the aspirin will get into your system faster when it is chewed. Unless advised by your practitioner, women should not take a daily aspirin. Aspirin use is not without risk. The jury is still out on the benefit of aspirin in the prevention of first heart attacks. However, there is a decreased risk of experiencing a second heart attack and ischemic (clotting) stroke when a person takes aspirin. Aspirin can cause stomach bleeding, hemorrhagic (bleeding) strokes (especially in people with high blood pressure). This occurs more frequently in the elderly

If a person has high blood pressure, are there any symptoms to indicate so?
There are usually no symptoms of high blood pressure until it starts to cause kidney damage, strokes, and heart attacks.

Is there such an illness as asthmatic heart and is it life threatening?
You asked what is an "asthmatic heart" and is it dangerous. Wheezing due to heart failure/pulmonary edema (an asthmatic heart) is due to fluid "backing up" into the lungs from the left side of the heart. This is serious and needs to be evaluated and treated by a cardiologist. This condition is different from (lung) asthma. Pulmonary (lung) asthma causes wheezing (a sound caused by restricted airways) due to constricted, inflamed, or mucous-filled airways.

I am a 78-year-old woman taking blood pressure medication. Dr keeps changing it due to shortness of breath. Is their any blood pressure medication I can take that would not cause me shortness of breath? I do have some emphysema, but need to see if blood pressure medication would make this worse.
Blood pressure that is NOT in control can cause shortness of breath. Your physician may be changing your medications for optimum blood pressure control therefore trying to help decrease your shortness of breath. Unfortunately some blood pressure medications may cause increased wheezing and consequent shortness of breath. This can occur when some patients are given beta-blockers, particularly those with asthma/COPD (Chronic Obstructive Pulmonary Disease - also known as emphysema). But keep in mind that this particular category of drugs does not usually cause shortness of breath. There is a lot of trial and error when it comes to prescribing blood pressure medicines... everyone responds differently to each medication. I would hope that you have undergone an echocardiogram, pulmonary function tests and a stress test with imaging in order to more thoroughly define the causes of your shortness of breath and high blood pressure.

Is there a cholesterol connection to cardiovascular disorders?
Yes. For more information, go to www.nhlbi.nih.gov/guidelines/cholesterol/index.htm .

How do you figure risk ratio using HDL, LDL, Triglyceride levels for cholesterol?
Answer: According to the National Cholesterol Education Program (NCEP) Cholesterol / HDLC ratio should be less than 4.5. To calculate: For example if your total cholesterol was 237 and your HDLC was 86, your calculated ratio would be 2.76. You get this number by dividing total cholesterol by HDLC.

How is hypothyroidism related to high cholesterol. I'm 55-years-old. Does all of this have something to do with menopause? I'm not on any therapy for menopause due to the risk of breast cancer. Could you provide some information on diet (I'm not over weight) so as to avoid taking liperador. My thyroid medication was doubled and I was told that I had high cholesterol.
High cholesterol and hypothyroidism are related... and so is high cholesterol, hypothyroidism and heart disease. In order to lower your cholesterol without taking drugs such as Lipitor, you should: 1. Take your thyroid medicine as prescribed. 2. Take a walk every day for 20-30 minutes. 3. Avoid food that are high in saturated (animal) fat such as butter, ice cream, milk, junk food / fast food. However, if your physician has suggested Lipitor, you should consider taking it. Medication combined with #1, 2, & 3 can help lower your risk of coronary events.

How does one know the difference between experiencing a heart attack versus something like heartburn? Is there anything I can do to differentiate between the two?
Heart attack symptoms may resemble heartburn. The way to differentiate is to: 1. Take a good history of the pain from the patient; including risk factors: family history, cholesterol status, high blood pressure, diabetes, and smoking 2. Look at the EKG 3. Check the cardiac enzymes

I woke up this morning with indigestion, burning sensation in my chest area, I asked my husband to get me a couple Tums and they seemed to really hit hard, indigestion still there and pain right in the center of my chest bone comes and goes? Pain off and on in-between my shoulders and my right arm seems to go numb every now and then. I had worked out in my yard the last couple of days not really over-worked and last night around eight it just felt like all energy drained out of me and I went to bed, slept pretty good and then woke up with like a indigestion and a headache off and on, I just fell kind of drained. Pain comes and goes? I have had a couple of Angina attacks and test show a value/artery on the back of my heart is smaller and that could cause some problems, I have called my heart Doctor before when I have had these pains and I fell so dumb at times, so maybe I just over did it again? As long as I am basically quiet I seem okay just rung out, if I start bending or doing something then pain comes back again. Is this just another one of Angina attacks?

What you are experiencing could be angina, indigestion, or musculoskeletal strain. However, since you have a history of coronary artery disease, your symptoms should be investigated… especially because of your "rest pain". Please seek the opinion of your cardiologist. You need to be evaluated to determine the cause of your pain.

I am a 47 year old, white female that is a heavy smoker. For the past two weeks I have been having pain on my right side on the top of the breast that the pain travels over and down my right arm. The pain may last from a couple minutes to about five. I am not sure if I should be concerned or not. Do you have any idea what it could be as I am sure it is not heart related because I have always been told that heart pain is on the left side.
Heart pain is not always felt on the left side of the chest radiating to the left arm. Heart pain can be felt anywhere from the waist to the neck/jaw area. Some people describe heart pain as a heaviness, tightness, or a squeezing sensation. Heart pain can also cause shortness of breath (which you, as a heavy smoker, could have), nausea, weakness, or sweating. The most important message I can give you is that heart pain and its related symptoms are different for each person. Risk factors for heart disease include a family history of heart attacks, women after their menstrual periods have stopped, diabetes, high cholesterol, high blood pressure, being overweight, and SMOKING. If you have more than one risk factor you should discuss the pain with your family doctor. He/she might suggest a few tests after getting a history of your pain, evaluation of risks for heart disease, and a physical examination. I am certain your doctor will suggest that you do yourself a big favor and stop smoking.

My 17-year-old daughter suffers from Migraine headaches. She gets them often and has had them for quite a few years. Our Dr. has prescribed Propranolol. I've heard of Beta Blockers but don't know much about them. She takes Imitrix and that seems to work. But, how often is it ok to take them. Sometimes she gets headaches everyday for a week. But, please tell me more about the drug Propranolol. I'm concerned about the drug and its affect on her blood pressure. But, if its something she needs to take to stop these headaches then we need to have her take it.
There are many drugs and combination of drugs used for migraine headaches. Beta-blockers and Calcium Channel Blockers are often used in conjunction with Imitrex. Both beta-blockers and calcium channel blockers are used for a variety of medical problems, not only for blood pressure management and migraines. So, if your daughter's physician prescribed the beta-blocker (probably a low-dose) it is a reasonable choice. It may have minimal, if any, effect on her blood pressure. Unfortunately there is no “cook-book” remedy for migraines. It is trial and error until the right combination of drugs and other therapies are found. I hope your daughter‘s headaches decrease in intensity and frequency

I recently read that a high level of C-reactive protein in the blood is a risk factor for heart attack. Should I ask my doctor for this blood test during my next physical?
C-reactive protein (CRP) is a nonspecific marker of inflammation, which has been known about for decades. Recently, there has been interest in this as a marker of coronary risk, perhaps related to theories of inflammation being involved in coronary atherosclerosis. CRP is probably a marker, not the actual cause, for increased coronary risk. We don't yet know the full connection. Second, we don't know which interventions will successfully lower CRP, or whether lowering CRP will lower coronary risk. Even the experts are still divided over which patients to test and how to treat them if their CRP readings are high. Until we know that there are specific interventions which lower CRP (or whatever it represents relative to inflammation) AND lower the risk of cardiac events, routine screening is not warranted. Continued efforts to lower standard risk factors through lifestyle modifications and appropriate medications are our best bet. Prescribing medications to lower CRP at this time is premature.

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