Category Archives: Heart

Hypertrophic Cardiomyopathy – HCM

What is hypertrophic cardiomyopathy? — Hypertrophic cardiomyopathy is a condition that causes the muscle in the heart to get too bulky (figure 1). When this happens, the heart can have trouble pumping blood as well as it should. This can lead to symptoms, such as trouble breathing, chest pain, and fainting. Hypertrophic cardiomyopathy is caused by a genetic problem that runs in families.

What are the symptoms of hypertrophic cardiomyopathy? — Most people with hypertrophic cardiomyopathy have no symptoms. When symptoms do occur, they can start during childhood, the teenage years, or adulthood.

Symptoms can include:

Trouble breathing, especially during exercise

Trouble breathing that gets worse when you lie down and gets better if you sit up or stand

Chest pain, which sometimes gets worse with activity

Fainting or feeling like you might faint

Feeling as though your heart is beating very fast or skipping beats

Swelling in the feet, ankles, or legs

Is there a test for cardiomyopathy? — Yes. If your doctor or nurse suspects you have cardiomyopathy, he or she will probably order an “electrocardiogram” (also called an “ECG” or “EKG”) (figure 2). This test measures the electrical activity in your heart. It can show if your heart beats in a normal pattern and rhythm.

Your doctor might also order an “echocardiogram” (or “echo” for short) (figure 3). An echo uses sound waves to create an image of the heart. This test allows doctors to measure the thickness of the walls of the heart, measure the size of the spaces inside the heart — called chambers — and see how the heart pumps. Depending on your situation, you might also need other tests. Since hypertrophic cardiomyopathy runs in families, your doctor or nurse might suggest testing your family members for the disorder, too.

What problems can hypertrophic cardiomyopathy cause? — In many cases the condition causes no problems. But in some cases it can lead to:

Heart failure, a condition in which the heart does not pump as well as it should

Heart rhythm disorders

Heart block, a problem that keeps electrical signals from moving through the heart as they should


Infection of a heart valve


How is hypertrophic cardiomyopathy treated? — Many people with hypertrophic cardiomyopathy do not need treatment. Those who do need treatment can get different kinds depending on what symptoms they have and how severe their condition is.

Treatments can include:

Medicines to relieve chest pain or trouble breathing

Medicines to control the heart’s rhythm

Surgery to implant a device called an “implantable cardioverter-defibrillator,” or “ICD.” (This device keeps the heart beating normally.)

Surgery or other treatments to remove parts of the heart muscle. (This is done only when medicines do not work.)

What if I want to get pregnant? — Talk to your doctor before you start trying to get pregnant. Most women with hypertrophic cardiomyopathy are able to have normal pregnancies. But some need to change their medicines before they start trying to have a baby.

Is there anything I can do on my own to protect my heart and my health? — Yes. You should be careful to always drink enough water. People with hypertrophic cardiomyopathy sometimes have problems, such as fainting, when they do not get enough fluids. On the other hand, some people with hypertrophic cardiomyopathy have to be careful if they have too much salt and water. Ask your doctor about how much salt is OK to have in your diet.

It’s also important that you ask your doctor what types of physical activity are safe for you. In many cases, people with hypertrophic cardiomyopathy need to avoid some kinds of activity.

Heart Block

What is heart block? — Heart block is a condition that affects the electrical system that controls the heartbeat. Mild types of heart block can cause your heart to beat more slowly than normal or to skip beats. More serious types can cause your heart to stop beating. Without emergency treatment, serious heart block can be fatal.

What causes heart block? — Heart block happens when the electrical signals that tell the heart to beat either get slowed down or stopped. Most people with heart block get it from a disease, surgery, or medicine that damaged their heart. In rare cases, people are born with heart block.

What are the symptoms of heart block? — The symptoms depend on the type of heart block a person has. There are 3 types of heart block:

First degree – This is the mildest type of heart block. Often, people with this type have no symptoms.

Second degree – This type is more serious than first degree. Symptoms include:


Feeling dizzy

Feeling tired

Trouble breathing

Chest pain

Third degree – This is the most serious type of heart block. It can cause the same symptoms as second degree, but they will be more severe. In some cases, third degree heart block can be life threatening.

Is there a test for heart block? — Yes. Your doctor or nurse will probably do a test called an electrocardiogram (also called an “ECG” or “EKG”). This test measures the electrical activity in your heart (figure 1).

You might also need other tests to see if another condition is causing your slow heartbeat.

Should I see a doctor or nurse? — If you have trouble breathing or have chest pain that lasts for more than a few minutes, call for an ambulance (in the US and Canada, dial 9-1-1).

If you do not have these problems, but you often notice your heart beating slowly or skipping beats, talk to your doctor or nurse.

How is heart block treated? — The treatment depends on the type of heart block you have. Often, people who have first degree heart block do not need treatment. But people who have third degree heart block and some people who have second degree heart block need a pacemaker. A pacemaker is a device that goes under the skin near a person’s heart. It sends electrical signals to the heart that help it beat at a normal rate.

Can heart block be prevented? — People who have heart disease are more likely to get heart block. Doing things that keep your heart healthy can help prevent heart disease. This includes:

Eating a healthy diet. This involves eating lots of fruits and vegetables and low-fat dairy products, but not a lot of meat or fatty foods.

Walking or doing a physical activity on most days of the week.

Losing weight, if you are overweight.


Atrial Fibrillation

Dr. Oller talks about atrial fibrillation.

What is atrial fibrillation? 

— Atrial fibrillation is the most common heart rhythm problem. The condition puts you at risk of stroke, heart attack, and other problems. Another term for atrial fibrillation is “A-fib.”

In people with A-fib, the electrical signals that control the heartbeat are abnormal. The top 2 chambers of the heart stop pumping blood as strongly as normal. When this happens, the blood can start to form clots. These clots can travel to the brain through the blood vessels, and cause strokes. In some people, A-fib never goes away. In others, A-fib can come and go, even with treatment. If you had A-fib in the past, but have a normal heart rhythm now, ask your doctor what you can do to keep A-fib from coming back. Some people can reduce their chances of having A-fib again by:

Controlling their blood pressure

Not drinking a lot of alcohol in 1 sitting (limit to 1 to 2 drinks in 1 day)

Cutting down on caffeine

Getting treatment for an overactive thyroid gland

Getting regular exercise

Losing weight (if they are overweight)

Reducing stress

What are the symptoms of atrial fibrillation? 

— Some people with A-fib have no symptoms. When symptoms do occur, they can include:

Feeling as though your heart is racing, skipping beats, or beating out of sync

Mild chest “tightness” or pain

Feeling lightheaded, dizzy, or like you might pass out

Having trouble breathing, especially with exercise

Is there a test for atrial fibrillation? — Yes. If your doctor or nurse suspects you have A-fib, he or she will probably do a test called an electrocardiogram. This test, also known as an “ECG,” measures the electrical activity in your heart.

How is atrial fibrillation treated?

 — In some cases, A-fib goes away on its own, even without treatment. But many people do need treatment.

Treatment can include 1 or more of these:

Medicines to control the speed or rhythm of the heartbeat

Medicines to keep clots from forming

A treatment called “cardioversion” that involves applying a mild electrical current to the heart to fix its rhythm

Treatments called “ablation,” which use heat (“radiofrequency ablation”) or cold (“cryoablation”) to destroy the small part of the heart that is sending abnormal electrical signals

A device called a pacemaker that is implanted in your body and sends electrical signals to the heart to control the heartbeat

What will my life be like? 

— Most people with A-fib are able to live normal lives. Still, it is important that you take the medicines your doctor prescribes every day. Taking your medicines as directed can help reduce the chances that your A-fib will cause a stroke. It’s also a good idea to learn what the signs and symptoms of a stroke are.

Dr. Carlo Oller Board Certified Emergency Physician Please visit my website, make sure you subscribe, comment, and share! That is the best way to show your support.

Aortic Stenosis

What is aortic stenosis? — Aortic stenosis is a condition in which one of the valves in the heart, called the aortic valve, doesn’t open fully. The heart valves keep blood flowing in only 1 direction. When the heart valves work normally, they open all the way to let blood flow through them.

Blood flows from a chamber of the heart called the left ventricle, through the aortic valve, into a large blood vessel called the aorta. The aorta carries blood to the rest of the body. In aortic stenosis, the aortic valve gets stuck and does not open fully. This makes the valve opening narrow. When this happens:

Not as much blood can flow out of the heart to the rest of the body.

The heart has to work much harder than usual to pump blood to the rest of the body. Over time, this can cause heart problems.

Aortic stenosis usually happens in adults. But some people are born with aortic stenosis.

What are the symptoms of aortic stenosis? — Early on, most people have no symptoms. They usually find out they have aortic stenosis after their doctor or nurse hears a heart murmur on a routine exam. A heart murmur is an extra sound in the heartbeat that doctors or nurses hear when they listen to the heart with a stethoscope.

When people do have symptoms, they can have:

Shortness of breath

Dizziness or fainting

Chest pain

These symptoms usually happen with physical activity. Let your doctor know if you have any of these symptoms.

Is there a test for aortic stenosis? — Yes. To check for aortic stenosis and see how severe it is, your doctor might order an echocardiogram (or “echo”). This test uses sound waves to create a picture of your heart as it beats. It shows the size of the heart chambers, how well the heart is pumping, and how well the heart valves are working. If you have aortic stenosis, your doctor might repeat this test over time to see if your condition changes.

To get more information about your heart, your doctor might order a test called cardiac catheterization, or “cardiac cath.” For this, the doctor puts a thin tube into a blood vessel in your leg or arm. Then he or she moves the tube up to your heart. When the tube is in your heart or blood vessels, he or she will take measurements. The doctor might also put a dye that shows up on an X-ray into the tube. This can show if any of the arteries in your heart are narrowed or blocked. This part of the test is called “coronary angiography.” Your doctor might order a test called an electrocardiogram (ECG). This test measures the electrical activity in your heart. Some people with aortic stenosis will also have a chest X-ray. A chest X-ray can show the size and shape of your heart. It can also show changes in your lungs from aortic stenosis or other diseases.

How is aortic stenosis treated? — Treatment depends on your symptoms and how severe your aortic stenosis is. If your aortic stenosis is not severe and you have no symptoms, you will likely not need any treatment. But your doctor will follow you to see if your aortic stenosis gets worse or you start to have symptoms.

If your aortic stenosis is severe and you have symptoms, you will likely need treatment. Treatment can include:

Surgery to replace your aortic valve – During surgery, the doctor will remove your narrowed valve and replace it with a valve that opens normally. This new valve can be made from metal or from tissue from a pig, cow, or horse. In some cases, a new valve comes from another person. Your doctor will talk with you about the benefits and downsides of each option.

A procedure to put in a new aortic valve without surgery − The procedure is called “transcatheter aortic valve implantation” (TAVI) or “transcatheter aortic valve replacement” (TAVR). This might be an option for some people who can’t have valve surgery, or who are at risk for problems if they have valve surgery.

A procedure to open the aortic valve – For this procedure, a doctor inflates a balloon in the narrowed aortic valve to try to open it. This procedure is used in children and young adults, because it is helpful in these people. This procedure is usually not as helpful in older adults.

Medicines – There are no medicines to treat the aortic valve stenosis itself. Your doctor might prescribe medicines to treat your symptoms. He or she will also make sure your blood pressure and cholesterol level are under control.

Can I play sports? — If your aortic stenosis is mild or you have little or no symptoms, you can probably play sports. But if your aortic stenosis or symptoms are more serious, your doctor might recommend that you limit your physical activity.

What if I want to get pregnant? — If you want to get pregnant, talk with your doctor or nurse. Depending on your aortic stenosis and symptoms, he or she might recommend treating your aortic stenosis before you get pregnant.

Dr. Carlo Oller Board Certified Emergency Physician Please visit my website, make sure you subscribe, comment, and share! That is the best way to show your support.

Prinzmetal angina

Prinzmetal’s or Prinzmetal angina  (also known as variant angina, angina inversa, or coronary vessel spasm) is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than directly by atherosclerosis (buildup of fatty plaque and hardening of the arteries). It occurs more in younger women. screen-shot-2016-07-20-at-9-31-52-am Dr. Carlo Oller Board Certified Emergency Physician Please visit my website, make sure you subscribe, comment, and share! That is the best way to show your support.