“Should you take aspirin every day? It’s a complicated question, actually. The quick answer depends on your risks. Aspirin has a lot of benefit. The benefit has been shown to be very clearly there for patients over the age of 45 or 50 to help reduce things like heart attacks in men, strokes in women. Now emerging evidence suggests that it can reduce the risk of colorectal cancer. So, aspirin is clearly helpful, and depending on how high your risk is, the greater the benefit is for you. The problem with aspirin is that there’s a downside, as well. Aspirin can lead to bleeding and so-called “major bleeding.” By major bleeding, we mean bleeds that send people to the hospital for either transfusions or admissions, typically in the stomach or the intestine. As you get older, the risk of bleeding goes up as well. Bottom line about aspirin is that it may indeed give you great benefit in reducing the risk of something bad happening to you, like a heart attack, stroke, or cancer. But it’s based directly on your cardiovascular risk and your age. Definitely something you want to talk about with your physician — either with your own primary care doctor or with myself or my colleagues at Mount Sinai Doctors in Brooklyn Heights.”

“Usually the most common symptoms of a heart attack are chest pain or chest discomfort. Usually, it’s heaviness or the sensation the chest, in the center part of the chest or to the left side. Sometimes you could feel an abnormal sensation in the shoulders or the neck or the throat, sometimes in the upper abdomen. Some people consider this as heartburn symptoms. Usually it’s associated with difficulty breathing or shortness of breath, and it can occur at rest or with minimal activity. Sometimes you can have profuse sweating, and sometimes you can have nausea or vomiting. Sometimes, elderly women can have a loss of consciousness or syncope. Usually women have atypical symptoms. When you have a concern of heart attack, you need to go to the nearest emergency room or a doctor. An electrocardiogram, or ECG, which shows the electrical activity of the heart, will help determine whether you are having a heart attack. When in doubt you need to seek a cardiologist. I’m a board certified cardiologist working at Mount Sinai Doctors in Brooklyn Heights. You could see myself or one of my colleagues to evaluate if you are concerned of symptoms of a heart attack. However any concern or suggestion of a heart attack, you should go to the nearest emergency room to seek prompt care.”

“Cardiac stress tests are used to evaluate the workload of your heart. Traditionally in the United States, a stress test is performed on a treadmill. Occasionally it is done on the bicycle, especially in the European countries. For people who cannot exercise, they can do something called pharmacological stress test – that means they can insert an IV or intravenous line in the arm and give you medication, which can increase your heart rate and also increase blood flow to the heart. Usually a stress test checks your heart rate and blood pressure and the workload. Once the patient can exercise more than nine minutes, we consider the patient is in a good heart healthy condition. However, if the patient cannot exercise significantly – either because of physical condition, because of arthritis, or other conditions – they do a pharmacological stress test. Normally, you do a treadmill test, along with imaging. Either by echocardiogram – we call it stress echocardiogram, where you put a little gel on the chest and image your heart and take a picture before and after the exercise, or you can do something called a nuclear stress test, where we inject something in the IV called isotope, which will take a picture of the heart and evaluate if there is any blood flow discrepancy addressed and post exercise. A cardiac stress test is a very important test to look at blood flow abnormalities to the heart, and it also gives you a suggestion to if you have a significant blocked artery. You can see myself or one of my colleagues who can help you understand more and schedule you for a cardiac stress test and see whether you’re at risk of significant heart disease.”

“This is a great question and, obviously, a very important distinction to make given that one is a very common condition easily treated and the other one is potentially a sign of a serious medical condition. So, most importantly are going to be the characteristics of the pain that you’re having. With reflux disease — heartburn — typically people are going to feel a sense of burning that usually starts either in the stomach. Maybe you get a burning sensation in the back of your mouth. Oftentimes this comes with either a cough or a sour taste — frequently linked with food or symptoms that you get when you wake up in the morning when you have that sense of heartburn. Chest pain due to heart disease can sometimes be similar. But more classically, it’s a pressure-like pain, like an elephant sitting on your chest so much so that it stops you from doing what you’re doing. Frequently linked with exertion. So, if you’re getting pain when you’re climbing stairs, walking down the street, exercising: 1) you should always stop and rest and 2) it may be linked to your heart, so at that point, you definitely want to make an appointment to see your doctor. If you’re ever getting pain in your chest on exertion that’s not getting better with rest, then you definitely want to call 911 and get emergently seen by a physician. Now if you’re concerned and you’re having chest pain with exertion for instance, but it’s kind of burning, it’s maybe not pressure, you definitely want to talk to your doctor because sometimes these pains can overlap. If you’re someone who’s at high risk for heart disease — you have diabetes or high blood pressure or you’re smoker or even if you’re over the age of 50 — it’s probably worth talking to your doctor about that. If you need to see a doctor, clearly you can see myself or any of my colleagues at Mount Sinai Doctors Brooklyn Heights.”

“Irregular heartbeat is also called arrhythmia. Usually, it is related to a fast heart rhythm. A heart rate or heart rhythm can be felt in your wrist with two fingertips, and usually a heart rate of 100 is considered a fast heart rate. The heart rate which is fast and irregular in elderly people could indicate significant heart disease. The common cause of irregular heartbeat, which is also called defibrillation, is seen in people with high blood pressure. Usually people with irregular heartbeat feel a fluttering sensation in their chest, also called palpitations. Sometimes excessive caffeine or coffee intake, alcohol, or nicotine can also cause an irregular heartbeat. Sometimes an irregular heartbeat in young people may not be a significant concern. However, if you have any concern, you need to seek a cardiologist.”

“The uncomfortable feeling in the chest during cold weather usually is related to changes in temperature and humidity. We are not clear exactly what’s the cause of this discomfort in the chest. But it is felt that the chest and the ribs rejoins the breastbone. It’s the cartilage called the joint space – that can swell up in cold weather and that can give you some uncomfortable feeling in the chest. However, if people have chest pain, especially when they’re shoveling snow and especially if they’re elderly, that could indicate that they could have a significant heart condition. If the discomfort in the chest increases while increasing workload and it has associated symptoms – difficulty breathing and nausea, vomiting – you should seek medical attention. Just a simple chest discomfort with cold weather could be just related to the cold weather and it should go away and it’s not of a concern.”