Ask a Texas Heart Institute Doctor 
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Heart Doctor Recent Questions and Responses 

• What is the best pre-surgical clearance test to determine cardiac fitness?
  
• Was my workup sufficient to rule out a cardiac cause (38 year old female)?
  
• How should my tiny leak in my aortic valve be managed?
  
• What is n-stemi?
  
• Is my father experiencing side effects from blood thinners?
  
• I have an LAD muscle bridge.  Why would surgical repair not be offered?
  
• What is concentric remodeling of the left ventricle with adequate systolic function?
  
• Are there any robotic procedures for pulmonary valve replacement on a person with Tetralogy of Fallot?
  
• If diagnosed with left bundle branch block, is there a medication that can be taken for sleep?
  
• Will my bicuspid aortic valve require replacement?
  
• Does summer heat affect leaking heart valves?
  
• What is incomplete right bundle branch block? 
  
• What keeps coronary artery bypasses from leaking?
  
• Are my symptoms consistent with atherosclerosis?
  
• Does yawning have anything to do with an erratic heart rate or leaking heart valve?
  
• Which test will best evaluate a bicuspid aortic valve and an aortic aneurysm?
  
• What are your comments about RF/EMF/EMR and associations to heart arrhythmic issues?
  
• For a stress echo test, how do you determine if you use dobutamine or adenosine?
  
• How can I be sure my pacemaker is working?
  
• Is my left atrium too large for my age?  I delivered a baby 4 months ago.
  
• What are your recommendations for taking omega-3 supplements?
  
• Is 45.9 a good score on a heart scan?
  
• How different is heart valve replacement from CABG?
  
• My son had viral endocarditis with a noncompacted left ventricle.  Is he a candidate for stem cell clinical trials?
  
• Are there programs in Houston to lower cholesterol naturally (that follow up with blood tests to see if they are working)?
  
• Is Multaq better for afib than amiodarone?
  
• Is Agent Orange exposure in Viet Nam the culprit which caused my cardiomyopathy?
  
• I am athletic.  Should I be concerned about a false positive result on EKG?
  
• Should I have the Lariat procedure or Watchman device?
  
• Is there a relationship between myocardial bridges and sudden cardiac arrest?
  
• For a bicuspid aortic valve, is minimally invasive AVR or conventional AVR better?
  
• Is my lifestyle a significant contributory factor in/to my enlarged ascending aorta?
  
• Is there a different beta blocker that works as well as atenolol but without side effects?
  
• How can coughing cause my father's unusual episodes?
  
• Is a cold area above my elbow a sign of a blocked artery?
  
• What testing and treatment are available for microvascular ischemic disease in women?
  
• How should my mom's hernia after minimally invasive bypass surgery be corrected?
  
• Is it possible to have stroke-like symptoms with an aortic valve problem?
  
• Should I expect additional testing? I have stress-induced wall motion abnormalities on stress echo.
  
• Is it normal to have two beats together (since mine are not 'skipped' beats) ?
  
• What could cause my chest pain?
  
• Can iron supplementation cause heart damage?
  
• My EF went from 40 to 30-35 since February. Should I be concerned?
  
• What does inducible ischemia mean?
  
• Is it safe for someone with paroxysmal atrial fib (PAF) to take Aspirin 81 mg and Coumadin 5 mg?
  
• How serious is pericarditis and how is it treated?
  
• Are my health problems reversible since I have stopped the medications that caused them?
  
• Does Texas Heart Institute use stem cell therapies for treating heart disease?
  
• Will you answer my questions about Takotsubo cardiomyopathy, please?
  
• Would it be my best interest to request another stress test?
  
• Why aren't anti thrombotics used in management of endocarditis?
  
• What screening should my son have? A murmur was discovered today during his athletic physical exam.
  
• Can TAVR replace a mechanical aortic valve that was put in place 13 years ago?
  
• What can you tell me about hypertrophic cardiomyopathy?
  
• Do you have experience with anomalous origin of the coronary arteries?
  
• Does a normal EKG eliminate or reduce the chances of having diastolic heart failure?
  
• Do I have pulmonary hypertension and will it affect my ability to become pregnant?
  
• How long should I keep the IVC filter inserted?
  
• Do these echo results imply heart failure?
  
• Am I interpreting my CT angio score correctly?
  
• What should I do about bilateral apical pleural thickening?
  
• My 20-year-old daughter was diagnosed with rheumatic fever. How often should she have echoes?
  
• Is it okay to use Citalopram (Celexa) if one has an ascending aortic aneurysm and abnormal bileaflet valve?
  
• For coronary artery disease, is ballooning or stenting better?
  
• Is there any new treatment for long QT syndrome?
  
• Is it a complicated procedure to move the ICD to the RIGHT side? I'm to have radiation on the left.
  
• Is there a way to counteract the effect of blood-thinning medications such as Plavix and Xarelto?
  
• What treatment options are there for one who has long q-t syndrome and narcolepsy?
  
• Why is there a 3 month waiting period for an ICD for people in heart failure?
  
• What effect will very high blood pressure caused by sleep apnea have on my heart?
  
• Due to his HCM, my son can no longer play sports.  How can I help him cope?
  
• If I had a serious heart condition, would my 30 day MCOT be abnormal?
  
• Is 80% EF good or dangerous?
  
• What should I do about palpitations during my pregnancy?
  
• Will continued use of Effient benefit me?
  
• What can help my husband get back to normal after new onset atrial fib and a pacemaker?
  
• Does breast tissue prevent obtaining an accurate result from a nuclear stress test?
  
• During a heart ablation, is the patient put under anesthesia so they do not move?
  
• On chest x-ray, what is an aortic knob?
  
• Does high altitude affect atrial fibrillation?
  
• What are the signs and symptoms of a person having a congenital heart disease?
  
• When is an echocardiogram necessary?
  
• Can a man have a problem with his heart that doesn't show up on a nuclear stress test?
  
• I apparently have arteries growing around a blockage. What does that mean?
  
• Does this scenario require antibiotics?
  
• Does "possible anterior infarct, age undetermined" mean I may have had a heart attack?
  
• Though I no longer have palpitations, should I have a repeat of my cardiac tests since I formerly had NSVT?
  
• What determines if you are a candidate for the minimally invasive bypass surgery?
  
• What should I do for my newly diagnosed PDA?
  
• Can you explain if/when junctional rhythm is a serious issue?
  
• Any contraindication to my engaging in high intensity training and exercise?
  
• Why did my symptoms re: myocardial bridge show up now?
  
• How often should I have a nuclear stress test?
  
• Could my hyperthyroidism be the cause of my heart problems?
  
• What does 45% mean in an echo report?
  
• Can you explain when to have surgery for mitral regurgitation?
  
• Can a child receive a heart transplant from an adult?
  
• Should I be worried about my weight?
  
• Could my itching and rash have been from Plavix?
  
• Do I need to take statins?
  
• How is the heart stopped during open heart surgery?
  
• Is there a way for my mother to qualify for the Lariat procedure?
  
• The medication my doctor prescribed is making me feel worse. Can I safely stop it?
  
• Are my daughter's symptoms from arrhythmias, new medicine, or something else?
  
• In a coronary CT scan, what exactly does the LAD score and Plaque score mean?
  
• Are aspirin and Cardvas tabs appropriate treatment for mitral valve prolapse?
  
• Are there any channel blockers that won't cause serious side effects to gums?
  
• My LDL is 109. Should I take a statin?
  
• Is heart transplant a reasonable option for my father who is 67?
  
• What is the best way to treat my CHF and left ventricular prolapse?
  
• Are coronary artery disease, coronary heart disease, atherosclerotic heart disease and ischemic heart disease the same?
  
• When will the "Absorb" stent be available to the public?
  
• I have Incomplete Right Bundle Branch Block (IRBBB). Can I take Lexapro?
  
• Should I have repeat mitral valve surgery now?
  
• What is a normal down time for recovery after a Lariat procedure?
  
• How can one naturally lower an elevated CRP count?
  
• With a history of bypass surgery and no cardiologist immediately available to me now, how often should I exercise on a treadmill?
  
• If I defer ablation, do I have a greater chance of having a stroke?
  
• My father has a mechanical heart valve. Can he have an MRI for a shoulder problem?
  
• Please answer our questions about global hypokinesis.
  
• Is subcutaneous aortic valve replacement viable?
  
• How do you approach management of anomalous right coronary arteries?
  
• Am I likely to have a heart attack because of impaired coronary reserve?
  
• From a severity standpoint, is it okay to wait 6 weeks to have this evaluated?
  
• Do dental braces pose a higher risk for endocarditis in one who has had VSD repair?
  
• What has caused my EKGs to change over time, and must I ease up on my exercise?
  
• Can I safely stop Deplatt (medicine) prior to cataract surgery?
  
• I had an ablation but am still having problems. What should I do?
  
• May I continue exercising even though I have an ascending aortic aneurysm?
  
• May a patient safely take Allegra after coronary bypass and heart valve replacement surgery?
  
• Are my extra heart beats normal?
  
• My condition and history are complicated and high risk. Can you advise me how to proceed?
  
• What causes coronary spasm and how is it best managed?
  
• Is it prudent to delay more surgery until my aortic root aneurysm is 5.5cm?
  
• Could my esophagus be related to my dizziness?
  
• What surgery would most commonly be done for my daughter's large VSD?
  
• Do medicines reduce the percentage of blocked arteries?
  
• Can a 50% blockage of the LAD be treated with medicine instead of a stent?
  
• Where can I get information regarding anomalous origin of the right coronary artery?
  
• Can nervousness affect an EKG?
  
• Should my mother wait a month after her heart attack to have bypass surgery?
  
• Is it possible when RCA is blocked that it is supported by others?
  
• How can I know if my pain is a serious heart matter or PTS?
  
• Is it accurate that a structurally normal heart can generally withstand palpitations better than a heart which has defects?
  
• Is a heart rate of 146-155 too high when using an elliptical machine?
  
• Can a person have congestive heart failure with only slight cough and shortness of breath?
  
• Why do biologic valves break down faster in children or young adults?
  
• What does "prominent aortic knob" mean?
  
• Can Effient affect menstrual bleeding?
  
• Isn't my LV mass way above limits considering my entire heart weighs only 400g?
  
• What vessel is considered the "widowmaker" ?
  
• My heart speeds up, slows down, and frequently pounds.  Should I be concerned?
  
• I have Loeys-Dietz.  At what diameter would my aortic root warrant surgery?
  
• Is this considered an aneurysm or just consistent with acromegaly?
  
• What is the life expectance after successful repair of aortic dissection?
  
• How many times can a biologic heart valve be replaced?
  
• How long does it take to fully return to normal after open heart surgery?
  
• Is breathlessness normal after AVR?
  
• Do I have other options than a lung transplant?
  
• My heart disease may be related to radiation I had for breast cancer. How dangerous is this?
  
• Is hypokinesis of my left ventricle causing me to be cold?
  
• What is myocardial noncompaction?
  
• Can a cardiologist notice or initially see LVH on a 12 lead EKG?
  
• How do LA volume indices and LA diameter measurements relate to my mild mitral regurgitation?
  
• Can Wolff-Parkinson-White pathology be eliminated?
  
• What should I do for my chest pain?
  
• Is there a level of urgency with my husband's situation?
  
• For how long will repair with a Dacron sleeve protect a dissected aorta?
  
• Does your hospital do many aortic repairs?
  
• Is this artery amenable to PCI?
  
• What does 'loss of anterior precordial forces' mean in an EKG result?
  
• My mom's heart is working 25%.  Is this serious?
  
• Is robotic surgery safer than open heart surgery for aortic valve replacement?
  
• My test results have been inconclusive.  Is there something more definitive which could be done?
  
• Is it safe to juice?
  
• Are hiccups a side effect of warfarin?
  
• Should I have a pacemaker?  I am very apprehensive.
  
• Is a third open heart surgery possible for my father-in-law?
  
• Will donating blood reduce my blood pressure?
  
• Must surgery be delayed because of shingles?
  
• Can Ramipril be prescribed for a hypertensive woman who has diabetes?
  
• Is there any specific protocol to repeating echoes and/or cardiac MRI's if normal results occur when first done?
  
• Can stents be cleaned out if needed?
  
• Is it reasonable to have an echo done to evaluate my palpitations?
  
• Can left bundle branch block be reversed?
  
• How do I interpret my multiple, different results of Troponin T tests?
  
• How common is it for three heart valves to be replaced successfully?
  
• What is your opinion on estrogen replacement where heart health is concerned?
  
• What can be done to keep 'diabetic' arteries from getting smaller?
  
• Why do my mother's body and hands shake after heart bypass surgery?
  
• Why do I hear and feel my heart beat in my head?
  
• Which is the best hypertensive drug for a type 2 diabetic woman?
  
• What could be causing my slow heart rate and what should I do?
  
• Do you know what could cause pressure in my son's chest and head?
  
• Is the dyskinetic area of my ventricle likely to rupture?
  
• Is there any laparoscopic procedure that will fix a mitral valve hinge tear?
  
• Is it okay to stop blood thinners after having a tissue valve implanted?
  
• Can I sit up for an echocardiogram?
  
• What should I do about my ectatic coronary arteries?
  
• I have a thoracic aortic aneurysm. Can I continue my firefighting career?
  
• Should my diastolic pressure change when I stand up? 
  
• Could I have had a heart attack (shown on EKG) and not know it? 
  
• Could symptoms of a burning feeling in the chest be due to blockage?  
  
• Can a coronary blockage be caused by myocardial bridge?
  
• Can PFO closures be done successfully in diabetics?
  
• Do I have a severe heart problem?
  
• Is myocardial bridging hereditary?
  
• How safe do you consider Amiodarone to be?
  
• Can joint pain supplements also help to reduce inflammation that may cause heart disease?
  
• Is it possible to reverse my diastolic dysfunction or make it worse with exercise?
  
• Do I really need to be on a statin?
  
• Is it advisable to wait a few months to have my ICD implanted?
  
• Should we increase my father's metoprolol?
  
• Am I causing damage to my heart when I run?
  
• What is the general progression of mitral valve disease in a young healthy adult?
  
• What could be causing my husband's lack of energy a year after his heart attack? 
• May a patient reside in an assisted living facility while awaiting heart transplantation?
  
• Can you keep the left side of the heart from weakening when it is pacemaker dependent?
  
• Can the Lariat procedure aggravate atrial fibrillation? 
  
• Do statin drugs or neuroendocrine cancer contribute to arrhythmias (SVT episodes)?
  
• Can  you help me determine my probability for dilated cardiomyopathy (DCM)? 
  
• Does the TAVR procedure require taking drugs to prevent rejection?
  
• Do heart problems arise more often in multiple sclerosis (MS) patients? 
  
• If I have a 10% EF, why don't I have loss of energy?
  
• Is thickening of the heart wall a concern? 
  
• Should I have my sternal wires removed? 
  
• My bradycardia is getting worse.  What can I do?
  
• With mild aortic valve disease, can I push myself [running] without danger?
  
• Are there medicines or procedures to improve my EF which is 40%?
  
• Do I have a serious valve condition that will require surgery? 
  
• Why is MRI necessary when my cath showed normal coronaries and valves? 
  
• Since I have a history of arrhythmia, what is recommended for dental procedure anesthesia? 
  

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