Alberto Chavira

1. Avoid stopping the medicines prescribed for you without first discussing it with your doctor 2. Avoid a sedentary lifestyle. Gradually and safely become more fit. 3. Avoid unhealthy foods or excessive food intake. If obese lose weight, perhaps would that help of GLP1 inhibitors 4. Avoid alcohol, especially when it leads to reckless behavior. 5. Avoid excessive physical activity that you have not trained for - helping the neighbor push his car, training too vigorously too early, etc. I have seen people have heart attacks after such activities. 6. Avoid fear of sex with known and trusted partners. Avoid sex with new partners not well known to you, especially if drinking. 7. Avoid missing scheduled appointments with your doctors. 8. Avoid sudden stressful situations such as angry outburst, heated arguments - do not start such exchanges and walk away if somebody else starts them. 9 avoid being fearful of having had a heart attack. If you survived the first 90 days, your mortality rate is similar to your peers who have not had a heart attack. 10. Enjoy life !

This could certainly be a heart attack. 50% of middle-age males have some degree of athero seclerosis (cholesterol plaque in the coronary arteries, hardening of the arteries, cholesterol deposits in the coronary arteries, are some of the lay terms that are used to describe this condition). The symptoms you described are compatible with a heart attack. If I had you on the phone in my office I will tell you to call 911 and get yourself to an emergency room immediately. Of course, it could be a number of other things, fairly numerous to enumerate, so I will not do that. Basically you need a thorough and complete evaluation immediately. And the emergency room life-threatening conditions will be ruled out included in a heart attack, but there are other serious conditions that could cause you about symptoms. And no life or any conditions are discovered, a tentative diagnosis would be made, perhaps tentative treatments would be started, and a more deliberate and complete evaluation would be carried out, either I've been admitted overnight to an oxidation unit, being admitted to the hospital for more prone stay, or just as likely, be sent home.

A rapid heart rate may represent an arrhythmia which in a 23-year-old with no known form of heart disease is unlikely to be life-threatening or serious. However there are exceptions. The only way to answer your question is for you to have an evaluation by a cardiologist which would include monitoring of your heart rhythm, and echocardiogram to assess for structural heart disease, and possibly a stress test to try to provoke an arrhythmia. Of course prior to all of this you would have a history and physical examination, as well as basic labs. Sorry I cannot provide you with a more definitive answer. Alberto Chavira, MD Cardiologist

I am an adult cardiologist and cannot speak to your complaints expertly. My advice to you is to call 911 and be transported to an emergency room immediately.

Alberto Chavira, MD

Some arrhythmiashy may be diagnosed with an EKG. This is possible when the arrhythmia is present continuously. However, many arrhythmias are sporadic. This type of arrhythmia occurs and then resolve spontaneously not to recur for again for days, weeks, or months. These types of arrhythmia are very hard to document with an EKG because the vast majority the time patients with paroxysmal arrhythmias are in a normal rhythm.

Dr. Chavira

Elevated triglycerides can contribute to a person experiencing a heart attack. Other risk factors are high blood pressure, diabetes, high bad cholesterol, low good cholesterol, obesity, unhealthy diet, and sedentary lifestyle, to name the most common risk factors.

It depends where the arrhythmia is originating, from the top of the heart chambers (atria) or from the lower chambers (ventricles). Arrhythmias arising from the atria are usually much more benign and treatable than arrhythmias arising from the ventricles. It also depends on the underlying condition of the heart. The more severe the underlying heart condition is, the more dangerous the arrhythmias are. There are several medications that are safe and effective in treating atrial arrhythmias. Ventricular arrhythmias are more serious and harder to treat. Drug therapy in this setting is not as safe. Medications particularly in ventricular arrhythmias may make the arrhythmias worse. It is the responsibility of the prescribing doctor to prescribe those medications that are safe and carry little risk of harm.

The most common cause of breathlessness after an angioplasty is the medications that are given to keep a clot from forming inside the recently deployed stent. A successful angioplasty usually does not cause breathlessness.

60 to 100 beats per minute

There are many, many heart murmurs that can occur. Some murmurs are quite benign and will never affect the patient's health. Other murmurs are quite malignant and have a high incidence of mortality. To answer the question regarding your friend, you would have to know what is causing the murmur.

Alberto Chavira, M.D.

A holter monitor monitor is an EKG which is attached to the patient and can record 24 to 48 hours EKG of the patient's heart rhythm. The most common use of a holter monitor is to detect episodic arrhythmias. An arrhythmias is an abnormal heart rhythm, some of which are life-threatening. An EKG records 12 seconds of the heart's rhythm. To diagnose an episodic arrhythmia requires that it be captured on an EKG. This can be very difficult to do as so many arrhythmias are episodic in nature. That is, they may occur once a day, once a week, once a month, once every 3 months, etc. The odds of capturing one of these episodic arrhythmias on a routine 12 second EKG is extremely small. Longer monitoring is required. A 24 to 48 holter monitor provides longer monitoring of the heart rhythm.

The following is a short tutorial of what an EKG is. Every time the heart beats, it generates an electrical signal. An EKG is a record of those signals. A normal heart generates a variety of patterns seen on EKG. An abnormal heart generates different electrical patterns, which can be differentiated from a normal pattern. One of the most important findings on the EKG is the recording of the rhythm of the heart. Again, a normal rhythm generates a recognizable pattern. An abnormal heart rhythm generates a different kind of pattern.

This short answer is yes. Patients who have had diabetes for a number of years with experience the same frequency of cardiovascular complications (heart attacks, heart failure) as patients who have had a heart attack but who do not have diabetes. Diabetes is sometimes referred to as a Coronary Artery Disease equivalent. In my practice, if someone has said diabetes for any number of years, I assume that they have coronary artery disease and I treat them as such.

Preventing another heart attack is multi-factorial. The first step is to control what are called risk factors for having a heart attack. The most common risk factors are diabetes, hypertension, high cholesterol, and smoking. Obesity, a sedentary lifestyle, and an unhealthy diet are 3 common risk factors that are referred to as lifestyle risk factors. Addressing these risk factors requires the patient to begin to live a healthier lifestyle. Other risk factors are obstructive sleep apnea, depression, and inadequate sleep. And then there are the unknown risk factors.This is when a patient has a heart attack and has no known risk factors and lives a healthy lifestyle.

A weak heart can lead to what is called heart failure. This means that the heart is not able to circulate enough blood for the body's needs. One of the effects of heart failure is the body starts to retain water
The lung
are very sensitive to the excessive amount of water .
build-up in the lung tissues. The symptoms that can develop from this are many such uh as.
1.Shortness of breath at rest
2 Shortness of breath when you are exerting yourself.
3. Waking up at night very short of breath
4.Unable to sleep without multiple pillows to keep your head elevated. Trying to sleep without those pillows causes shortness of breath
5. Dry cough
6. Swelling of your lower extremities
7.unexplained fatigue

Hope this helps.
Dr. Alberto Chavira