Dr. Alexander Postalian | Asked and Answered
Dr. Alexander Postalian from The Texas Heart Institute Center for Cardiovascular Care answers patient questions about cardiovascular health.
Submit your questions in the comment section to be featured in the next episode of Asked and Answered.
Read more about our specialties: www.texasheartmedical.org/edu
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I pass out many times a year, usually when it is hot outside or if I must stand for a long time. What’s wrong with me?
"The most likely cause is a degree of “dysautonomia” – most of the time this is benign. Sometimes, we can use medications to help out during flare-up periods."
- Dr. Alexander Postalian, General and Interventional CardiologistRead more about our specialties: hhttps://www.texasheartmedical.org...
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How long does it take to become a cardiologist? Maybe I can do it.
"4 years of college, 4 years of med school, 3 years of internal medicine, 3 years of cardiology, 1-2 years of subspecialty training. Yes, you can do it."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheart.org/education-professionals/
Submit yo...
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Do I need open heart surgery after a heart catheterization?
"Some patients only need stents, some absolutely can only get bypass surgery, and there is a large gray area – talk to your doctor (or multiple doctors if needed)."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheartmedical.org/our-specialties/ca...
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My blood pressure is always higher when I go to the doctor or dentist, but normal at home. Do I need to worry?
"What matters most is your average blood pressure, not occasional (small peaks). However, sometimes medication is needed if you are deemed to be at high risk of intermittent elevation."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheartmedical.o...
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I have high cholesterol and DO NOT want to take statin poison, how can I get the cholesterol shots?
"Statins are beneficial and harmless to most patients. In patients that cannot take them, or if the numbers are bad despite being on them, many alternatives exist – including multiple types of injections."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www...
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I was told I have mitral valve prolapse, but a recent echocardiogram showed nothing – who’s messing up here?
"Mitral valve prolapse has varying severity, and different thresholds to call it such depending on the reader. The likelihood is that your valve is (mostly) normal."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheartmedical.org/our-specialties/h...
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I feel my heart “jumping” inside my chest every now and then. Whenever I get an ECG, I am told it is normal. Do I need to worry?
"The most common reason for this is your heart “skipping beats”, which is benign. However, dangerous arrhythmias can be ruled by performing rhythm monitoring with a patch."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheartmedical.org/our-specia...
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My doctors checked my lipoprotein(a) and it was SKY HIGH. What does this mean?
"Lipoprotein (a) is a type of “bad” cholesterol that does not show up during usual lab work. Meds to treat it are coming, but for now we just focus on reducing other risk factors."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheart.org/heart-hea...
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I had a calcium score of 732, and my nuclear stress test was apparently “normal”. I feel nothing. What’s going on?
"A calcium score shows the amount of calcified cholesterol plaque in the arteries of your heart, a nuclear perfusion study tells us if that plaque is obstructing blood flow to your heart muscle." - Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart...
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I have severe aortic stenosis due to a bicuspid aortic valve, can I have the replacement through my groin?
"While we are very good at doing aortic valve replacements through the groin, this is still not the current strategy for patients under the age of 60. Maybe in the future."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: https://www.texasheartmedical.org/our-specia...
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Is there such a thing as too much exercise? I heard that marathons are not good for you.
"Going past your limits for prolonged periods of time (such as marathons and triathlons) is probably not good for your heart and joints. Be as active as you can, without overdoing it."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.org/heart...
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I am a 62 year-old woman trying to live healthier in general. How much am I supposed to exercise?
"The official recommendation is 150 minutes of exercise per week. Moderate activity such as brisk walking, walking on an incline, light jogging, cycling, elliptical, and some weight training."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.o...
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I want to take the injection Amy Schumer used to lose weight – how do I get it, and is it safe?
"This likely refers to GLP1 agonists. The medications are generally safe. The most frequent side effects is gastrointestinal “upset” stomach. Unfortunately, they can be expensive and are in short supply."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www....
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My blood pressure is all over the place – Do I need to be doing something differently?
"Blood pressure varies a lot during the day. We care about the average numbers over a period of days and weeks."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.org/heart-health/heart-information-center/topics/high-blood-pressure-hypertension...
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What do people really mean by healthy diet?
"Avoid simple carbohydrates (sweets, sodas, rice, pasta, potatoes, tortillas, arepas…) and “bad” fats (butter, bacon – animal fat). Favor lean protein (grilled fish, chicken) and vegetables. Watch the salad dressings as well."
- Dr. Alexander Postalian, General and Interventional Cardiologist
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I feel a weird sensation in my chest, I was told it could be atrial fibrillation.
"Atrial fibrillation is a very common arrhythmia that increases the risk for having fast heart rate and strokes, hence we use medications to prevent both. Using procedures to treat it is also an option."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.t...
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My coronary calcium score was 232. Do I need to have a stent placed in my arteries?
"The coronary calcium score is a marker of plaque in the arteries of your heart. It helps us know how aggressive we need to be with medication or lifestyle changes but does not help us decide if you need procedures performed."
- Dr. Alexander Postalian, General and Interventional Cardiologist
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I had labs and I saw that my lipoprotein(a) was elevated. Should I be freaking out?
" Lp(a) increases the risk of heart attacks, strokes, and other cardiovascular issues such as aortic stenosis. We are still learning about it. If it is high, your doctor might start paying closer attention to your risk factors and start treatment earlier."
- Dr. Alexander Postalian, General and ...
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I was told I had a heart attack years ago. How low should my cholesterol be?
"The LDL (“bad”) cholesterol should be under 100 mg/dL for most people. But under 70 mg/dL (and perhaps under 55 mg/dL) for patients with history of heart attacks."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.org/heart-health/heart-inform...
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My dad had a heart attack in his 50s. I am 27. When should I get checked?
"While we should always pay attention to our health, you should probably start having a closer look at your cardiovascular status after age 30."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.org/heart-health/heart-information-center/topics/...
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My husband snores like a rhino on steroids, and sometimes stops breathing at night.
"This is probably obstructive sleep apnea, which can have negative effects in your cardiovascular system. A sleep study is probably a good idea."
- Dr. Alexander Postalian, General and Interventional Cardiologist
Read More: https://www.texasheart.org/heart-health/heart-information-center/topics...
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How Often Do I Need to Get a Stress Test?
"Stress tests may not be routinely needed every single year, it depends on the specific situation."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: www.texasheartmedical.org/our-specialties/nuclear-stress-test/
Submit your questions to be featured in the next episo...
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I Always Get Random Chest Pains, Am I Going To Drop Dead?
"Chest pain can be a sign of a serious condition, but there are many reasons to have chest pain, including low-risk ones. The characteristics of the pain, and your overall cardiovascular risk, matter in the interpretation of the pain."
- Dr. Alexander Postalian, General and Interventional Cardiol... -
I Feel My Heart Stop For a Few Seconds and Restart With a Thump
"These are most likely premature heart contractions or "skipped beats". Using a rhythm monitor could help diagnose this issue."
- Dr. Alexander Postalian, General and Interventional CardiologistRead More: www.texasheartmedical.org/our-specialties/heart-rhythm-disorders-arrhythmia/
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