Let’s get right to it and say that while chest pain, known as angina, can have many causes, it should never be ignored due to the possibility of it being a precursor for severe cardiovascular events. As such, if you are experiencing a medical emergency, be sure to dial 911 immediately or get to your nearest emergency room. If you have a non-emergent, persistent chest pain that cannot be explained away, be sure to visit your primary care specialist or cardiologist urgently to have it evaluated. Let’s explore some of the non-cardiac-related chest pain many of us will experience:
While the diagnosis of atrial fibrillation or Afib at your most recent ER visit may surprise you, it is not surprising to us. Many of our patients who end up requiring treatment for Afib only find out about their condition from an ER visit. The visit may have resulted from significant chest pain or palpitations that they thought were representative of a heart attack. Or, they may have been in the ER for a completely different reason, but heart irregularities were detected. Regardless, you should look at this diagnosis as an opportunity to avoid what can cause a follow-on life-threatening condition such as stroke or heart attack.
Being diagnosed with Afib at the ER does not make the condition any more dangerous than a diagnosis at the office or incidentally at a check-up with your primary care physician. Sometimes, this incidental diagnosis at the ER catches Afib at an earlier stage when it is more treatable and before it has progressed to something more persistent, which can be far more difficult to handle.
Because of the complexity of cardiac catheter ablation and the technology needed, ablations are performed in a specialized operating room at the hospital, known as an electrophysiology or EP lab. For many, despite the procedure being performed in the hospital, there is the opportunity to be discharged at the end of the day. However, several factors may require an overnight stay or longer for some patients.
When you think about atrial fibrillation or Afib, your mind probably conjures up pounding feelings in the chest, a sense of fluttering, uneasiness, and panic, wondering if you may have a severe heart concern or even a heart attack—however, not all cases of Afib present with these classic symptoms. When Afib is asymptomatic, it is known as silent Afib. It may seem odd to think that a fast or irregular heartbeat would not cause any symptoms at all, but it’s certainly possible and happens more often than you think.
The electrophysiology or EP lab is an incredibly advanced operating room at our hospitals. It allows for advanced diagnostics and treatment tools that we didn’t have just a couple of decades ago. This is especially beneficial for patients suffering from paroxysmal or occasional atrial fibrillation or Afib that has been difficult or impossible to diagnose through standard testing.
As you probably already know, Afib is a progressive disease. Typically, episodes begin sporadically with no pattern or timeframe for their onset. Many patients do not bring it up with their doctor or seek treatment. While it is estimated that upwards of 5 million Americans may be suffering from Afib, only a tiny fraction gets treated appropriately. As the condition is left untreated or undertreated, and the patient does not change their lifestyle, these episodes often become stronger and more frequent. Eventually, Afib can become persistent, making it exceptionally difficult to treat.
Electrophysiology is one of the most technologically advanced specialties in modern medicine. In our quest to make cardiovascular procedures ever more comfortable and minimally invasive, technologies have been developed that are truly mind-blowing. Of those, cardiac catheterization is one of the most transformative, as it has allowed us to perform a wide range of cardiac surgeries without the need for large incisions and long downtimes. Cardiac catheter ablation is a catheterization procedure that enables your electrophysiologist to visualize the heart in three dimensions, see all the electrical signals and pathways in real-time, and ultimately perform a catheter ablation procedure should it be necessary.
If you’ve stayed on top of the latest technology, you may know that new generation Apple watches now include a wearable and portable EKG. However, unlike the portable EKGs that we as electrophysiologists use, known as a Holter monitor, this is discrete and amazingly compact. Further, unlike a Holter monitor, the Apple Watch and other wearable technologies can monitor you for days, weeks or months – for as long as you wear the device.
By now, you probably know that lifestyle plays a part in the development and severity of atrial fibrillation or Afib, much like it can affect several other cardiovascular processes. And, with a full 30% of the adult US population being obese and upwards of two-thirds overweight, the need for improved diet has never been greater. Unfortunately, this distinct deterioration of our collective health has led to a significant increase in Afib, even in younger and seemingly healthier patients. Many patients look for the best diet program and with so many out there, it is difficult to choose the best.
One diet has withstood the test of time. It is neither extreme nor revolutionary – the Mediterranean diet. Researchers looking for the “fountain of youth” found that many people in Mediterranean countries live longer than their more central and Northern European counterparts. When they looked for a cause, it became clear that diet may play a significant role.
Now is as good a time as any to prepare yourself by knowing the signs and symptoms of stroke. This is especially true if you have atrial fibrillation or Afib which increases the risk of stroke by up to five times. We all know how devastating a stroke can be, both for the patient themselves and their caretaker. While some do recover from a stroke, knowing the signs and getting treatment early reduces the likelihood of significant long-term complications and even death.
It is important to understand what exactly a stroke is. A stroke occurs when a blood clot or plaque from an artery dislodges and travels to the brain. As the blood vessels get smaller, this impediment can occlude the blood vessel entirely. The part of the brain fed by this blood vessel begins to die very rapidly, hence the need for immediate care. Fortunately, today we are more prepared and able to treat strokes than ever before. With that said do not delay if you believe you are having a medical emergency.
When we discuss potential consequences of cardiovascular issues, the risk of stroke is high on the list. Stroke occurs when small blood clots from the cardiovascular system, or pieces of plaque from the arteries, enter the brain and block its tiny blood vessels. The part of the brain fed by the blocked blood vessel rapidly begins to die.
In my electrophysiology practice, one of the most important parts of treating cardiac arrhythmias especially atrial fibrillation or Afib is the prevention of stroke. Patients with Afib have a five times greater risk of stroke, not to mention a higher risk of heart attack and heart failure as well. We use technologies such as radiofrequency catheter ablation and cryoablation to address many treatable arrhythmias. We also use left atrial appendage occlusion devices such as the Watchman to seal blood clots in the heart, minimizing the risk that they travel to the brain.