Friday, January 23, 2015

A Trip to the Cardiologist

I see a lot of anxiety associated with a first time visit to the cardiologist.  Chest pain, palpitations, fainting, and shortness of breath can all be scary symptoms related to heart disease.

Or they may not be.

I may surprise you when I say this:  More often than not, for patients who come in for an initial consultation for one of these symptoms, the cause is not cardiac.

Chest pain can be due to many things other than the heart -- a pulled muscle, esophageal reflux, anxiety or stress.  While palpitations may be an arrhythmia, they may be due to anxiety and stress.  And the most common cause of fainting is a vasovagal event, which is completely benign and improved with lifestyle changes.

A common scenario is a patient who comes in with symptoms that after a thorough evaluation I determine is not related to his heart, but that same patient has multiple uncontrolled cardiac risk factors.  A typical patient would be a middle-aged man with chest pain that is burning in nature and worse with eating spicy food and worse at night.  We determine that his pain is due to esophageal reflux and is not due to his heart.  HOWEVER.... he has uncontrolled diabetes and high blood pressure, smokes, doesn't exercise, and eats poorly.  So, once I reassure him that his chest pain is not coming from his heart, we discuss the uncontrolled risk factors that are the true threats to his heart health.

That said, I see some pretty serious stuff.  I'm sending one recent new patient for urgent heart valve surgery.  Another in all likelihood has pretty severe coronary artery disease, so we're getting him tested very quickly before we proceed to more invasive exams.

My point is this:  Being referred to a cardiologist can be scary, but doesn't necessarily mean you have a life-threatening heart ailment.

8 comments:

Casey McClung said...

Hello- I am searching for a cardiologist who actually cares about diet- someone like you, but who practices in the San Francisco Bay Area.
I had a stent placed in my RCA in March 2013- I had been a vegetarian and exercised 4-5xweek for 20 years. My doctor said I was doing everything right and to not change a thing...but take these pills for the rest of my life. It didn't make sense to me so I searched the internet and stumbled upon Dr Esselstyn. I have been following a no-oil, plant based whole food diet ever since and couldn't be happier. But, I have paroxysmal supraventricular tachycardia, and am taking Sotalol- now my triglycerides are up, but the tachycardia hasn't stopped.
Would you be able to point me in the right direction- how can I find someone like you- a cardiologist who understands the effect that diet and lifestyle have on health? I really want to partner with my physician, and would appreciate any advice! Casey

VeganHeartDoc said...

Casey -- Congratulations on all you have accomplished! Unfortunately, I don't know of any plant-based cardiologists in the San Francisco Bay area. But if you do find one, please let me know!

Tony Bisceglia said...

You'll love this hilarious Vegan link!! http://www.gary-tv.com/garymain/video/humor/the-honest-waiter/

Tony

bryan flake said...

I am often stressed and get chest pains all the time. It is good to know that I might not be as in dire straights as I thought I was. However, I am sure it would be best to get checked out by my doctor. Are there specific tests that I can request he run to make sure that I am okay?
http://www.heartdocs.com/staff.html

bryan flake said...

I am often stressed and get chest pains all the time. It is good to know that I might not be as in dire straights as I thought I was. However, I am sure it would be best to get checked out by my doctor. Are there specific tests that I can request he run to make sure that I am okay?
http://www.heartdocs.com/staff.html

Kristine Mendoza said...

I had the same reaction when my PCP referred me to the Cardiologist. Good that there was nothing to worry about after being checked out. Thank you Dr. Shenkman, I love reading your blogs. I was so surprised when I found out how athletic my Dr. is, hehe!

Kristine Mendoza

Neeta Gangurde said...

I was actually looking for Cardiologist in California area but while searching that i came across your site. & i found the info whatever i was looking for.

David Beckham said...

I am very happy to see your blog, very good article for audience,

Each year, cardiac complications and diseased occur within 30 days after major non cardiac surgery in more than 10 million people worldwide.

Today, however, the tether is fraying. How can we use technology to bring
Cardiologist database in USA closer to patients rather than making them more remote?

Small tips to avoid heart attack

• Take responsibility for your health. ...
• Know your risks. ...
• Don't smoke or expose yourself to second-hand smoke. ...
• Maintain a healthy blood pressure. ...
• Monitor your cholesterol (blood lipids). ...
• Limit your calories. ...
• Make exercise a daily habit. ...
• Pick your pills wisely.