Top Doctors: 5 facts about a racing heart
When your pulse quickens, it's easy to fear that something's wrong.
There might be nothing wrong, but a racing heart, felt in your wrist, could be a sign that you need medical care -- maybe even right away.
Here's what you should know:
1. A RACING HEARTBEAT MAY BE PERFECTLY NORMAL
"Not every racing heart is an abnormality," said Dr. Louise Spadaro, a cardiologist at St. Francis Hospital in Roslyn. "It may simply reflect the body's normal response to a stimulus or stress. If you're excited, scared or nervous, that will naturally drive the heart rate up."
Still, if you feel your heart is racing, "the most important thing to do is to sit or lie down," said Dr. Rohan D. Bhansali, director of clinical cardiology at Long Island Jewish Medical Center in New Hyde Park. "Racing heartbeats can occasionally be a prelude to fainting, even if they are not due to a change in heart rhythm."
If you're driving, he said, pull over if you feel palpitations until the symptoms go away.
2. SYMPTOMS THAT SHOULD SEND YOU TO THE EMERGENCY ROOM
Seek emergency care immediately if your racing heartbeat comes with such symptoms as lightheadedness, fainting, chest pain, severe shortness of breath or an inability to breathe, Spadaro said. You should also go to the emergency room if you can't lie flat because you feel as if you're filling up with fluid, she said.
In some cases, though, it's OK to simply get in touch with your physician.
"If the palpitations are otherwise well tolerated and there are no other symptoms, you should notify your doctor so that an electrocardiogram can be done, especially if this is the first time it's happened," said Dr. Sei Iwai, a professor of clinical medicine and director of the Complex Arrhythmia Ablation Program at Stony Brook University Medical Center.
3. MANY CONDITIONS CAN CAUSE A RAPID PULSE
Bhansali noted that fever, infection, dehydration and low blood sugar are among the possible causes of a racing heartbeat. "Less commonly, it can be due to something that requires urgent medical attention, such as a blood clot in the lungs or an abnormal heart rhythm," he said.
An abnormal heart rhythm, also known as an arrhythmia, can have a variety of causes. A common one is an electrical glitch in the heart. This can cause atrial fibrillation, a condition that older people often have and that can cause the heartbeat to spike. Electrical glitches also can lead to several types of supraventricular tachycardia, a name for rapid heartbeats that are based in the upper part of the heart.
4 SOMETIMES SELF-TREATMENT WORKS
People with certain types of rapid heartbeats that are based in the upper chambers of the heart may have options to slow down their pulse, Spadaro said. They can throw cold water on their face, massage their neck to stimulate a crucial nerve, or bear down really hard, as if they're trying to have a bowel movement.
However, "always ask your doctor first," she cautioned. "These maneuvers only work for very specific types of upper chamber tachycardias it could be dangerous to not seek the type of medical help you may need right away." The techniques won't relieve all kinds of rapid heartbeats, including those caused by atrial fibrillation, Spadaro said.
5 MOST RACING HEARTS CAN BE SLOWED
"For the majority of types of rapid heartbeats, we can abolish them and make them go away," Spadaro said. "And for a good number of them, we don't necessarily make them go away, but we make them less pronounced, less symptomatic and maybe decrease the frequency with which they occur."
In many cases, doctors treat racing heartbeats by dealing with the underlying issue -- dehydration or low blood sugar, for instance -- or with medication, Bhansali said.
In some cases, doctors can fix electrical malfunctions in the heart through a procedure called radio-frequency ablation, which uses heat to destroy malfunctioning tissue. "The procedure is safe, highly effective and generally requires no long-term medication use," he said.
To be effectively treated, of course, you first need to be correctly diagnosed. And Iwai said that doesn't always happen.
For instance, he said, people may be diagnosed as simply having anxiety when they actually suffer from irregular heartbeats. "In young patients with no heart disease, this is often a supraventricular tachycardia, which is almost always curable," he said.
Cardiologists
This is the first installment of a 26-week series in which Newsday presents Castle Connolly's list of top LI doctors.
Dr. Larry Altschul
540 Union Blvd.
631-669-2555
Dr. Maliakal Joseph Anto
8 Greenfield Rd.
516-496-7900
Dr. Rohan Dilip Bhansali
Oncology Building
27-05 76th Ave. 4th Fl.
718-470-7330
Dr. Mark G. Borek
Stony Brook Cardiology
101 Nicolls Rd.
HSC Bldg. Fl. 16, Rm 080
631-444-1066
Dr. William J. Breen
43 Crossways Park Dr.
516-938-3000
Dr. David L. Brown
Stony Brook Univ. Med. Center
Div. Cardiology
Health Sci. Ctr. T16-080
Stony Brook
631-444-9970
Dr. Kul Chadda
South Nassau Comm. Hosp.
Electrophysiology Svcs.
1 Healthy Way
516-632-3418
Dr. Mathew T. Chengot
Amityville Heart Ctr.
129 Broadway
631-598-3434
Dr. Michael D. Chesner
325 W. Park Ave.
516-432-2004
Dr. Marvin Cramer
225 Community Dr., Ste. 130
516-504-0474
Dr. Ronald D'Agostino
1129 Northern Blvd., Ste. 408
516-627-2121
Dr. John Dervan
220 Belle Mead Rd., Ste. A
East Setauket
631-941-2273
Dr. Robert J. Dresdale
225 Community Dr.
Ste. 130
516-504-0474
Dr. Ari M. Ezratty
100 Port Washington Blvd.
516-570-6907
Dr. Thomas Falco
1279 E. Main St.
Riverhead
631-727-2100
Dr. Frederick S. Fein
120 Mineola Blvd., Ste. 500
516-663-4480
Dr. Aaron Gindea
800 Community Dr.
516-627-6622
Dr. Louis W. Gleckel
2 Ohio Dr.
516-622-6060
Dr. Steven Mark Goldberg
1010 Northern Blvd., Ste. 110
516-390-2430
Dr. Henry Esteban Gomez
Long Island Cardiovascular
1129 Northen Blvd., Ste. 408
516-627-2121
Dr. Mark A. Goodman
975 Stewart Ave.
516-222-8610
Dr. Stephen J. Green
Dept. Cardiology
300 Community Dr.
516-562-4100
Dr. Steven M. Greenberg
Arrhythmia Center
100 Port Washington Blvd.
516-562-6672
Dr. Ronnie Hershman
1 Hollow Lane, Ste. 103
516-869-5400
Dr. Rajiv Jauhar
270-05 76 Ave., 4th floor
718-470-7330
Dr. Mansoor Jelveh
875 Old Country Rd., Ste. 102
516-935-8877
Dr. Allen Jeremias
Stony Brook Univ. Med. Ctr.
26 Research Way
631-444-1069
Dr. Barry M. Kaplan
LI Jewish Med. Ctr.
Div. Cardiology
270-05 76th Ave.
718-470-7330
Dr. Steven M. Kobren
NYU Great Neck Medical
488 Great Neck Rd.
Great Neck
516-482-6747
Dr. Jerome Koss
3003 New Hyde Park Rd.
Ste. 406
New Hyde Park
516-358-5401
Dr. Justine S. Lachmann
120 Mineola Blvd., Ste. 500
516-663-4481
Dr. Michael A. Masciello
540 Union Blvd.
631-669-2555
Dr. Michael A. Matilsky
Three Village Cardiology
210 Belle Mead Rd.
East Setauket
631-689-1400
Dr. Guy L. Mintz
287 Northern Blvd., Ste. 211
Great Neck
516-482-3401
Dr. Thomas A. Nicosia
1615 Northern Blvd., Ste. 301
516-627-9355
Dr. Thomas W. Pappas
155 Northern Blvd., Ste 330
Manhasset
516-726-7575
Dr. Michael Poon
Stony Brook Health Sci. Ctr.
Level 4, Rm. 120
Stony Brook
631-444-5400
Dr. Philip D. Ragno
1401 Franklin Ave.
516-877-2626
Dr. Edward V. Rutkovsky
2035 Lakeville Rd., Ste. 101
New Hyde Park
516-328-9797
Dr. Carl Schreiber
70 Glen St.
516-484-7893
Dr. Steven Shahram Shayani
200 Old Country Rd., Ste. 278
516-877-0977
Dr. Richard A. Shlofmitz
100 Port Washington Blvd.
Ste. 105
516-390-9640
Dr. Hal A. Skopicki
Univ. Physicians at Stony Brook
3001 Expressway Dr. N.,
Ste. 200B
631-444-9600
Dr. Sergio Sokol
Five Towns Heart Imaging
650 Central Ave., Ste. K
516-804-8590
Dr. Louise A. Spadaro
St. Francis Hospital
VIZZA Bldg., Rm. 101
100 Port Washington Blvd.
516-562-6653
Dr. William Tenet
1155 Northern Blvd., Ste. 330
Manhasset
516-627-4330
Dr. Ira L. Weg
158 Hempstead Ave.
516-593-3541
Dr. Marc Weinberg
West Carver Med. Assocs.
200 W. Carver St., Ste. 8
Huntington
631-421-0020
Dr. Steven M. Zeldis
200 Old Country Rd., Ste. 278
Mineola
516-877-0977
CARDIAC ELECTROPHYSIOLOGY
Dr. Sei Iwai
285 Sills Rd., Ste. 12-C
631-444-3575
Dr. Ram L. Jadonath
300 Community Dr.
Manhasset
516-562-2300
Dr. Joseph H. Levine
100 Port Washington Blvd.
Roslyn
516-622-1011
Dr. Eric J. Rashba
Stony Brook Univ. Med. Ctr.
Cardiology
101 Nicolls Rd.
HSC Bldg. 16th Fl., Rm. 080
Stony Brook
631-444-3575
Interventional Cardiology
Dr. Meyer H. Abittan
St. Francis Hospital
The Heart Center
100 Port Washington Blvd.
Ste. G-03
Roslyn
516-627-1155
Dr. Andrew D. Berke
100 Port Washington Blvd.
Roslyn
516-365-2211
Dr. Andrew Lituchy
100 Port Washington Blvd.
Ste. G-05
Roslyn
516-365-4888
Dr. Lawrence Ong
North Shore Univ. Hosp.
Dept. Cardiology
300 Community Dr.
Manhasset
516-562-4100
Dr. George A. Petrossian
1405 Old Northern Blvd. 1st fl.
Roslyn
516-484-6777
How they were picked
Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college, board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.
Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/ nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.
Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)
Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly. com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.
To see the whole list . . .
Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.
