Questions ?
Answers to your questions about cardiology issues
It is perfectly normal for a diagnosis of a heart condition or the prospect of surgery to raise questions. Often, the right answer at the right time can dispel that uncertainty.
In this section, I’ve compiled the most common questions we encounter every day at my practice at Metropolitan General and in Nea Smyrni. My goal is to provide clear explanations so that you know what to expect and how to manage your health with confidence.
Section 1: Prevention, Nutrition & Daily Life
What can I do in my daily life to prevent a cardiac event?
Prevention is built on controlling three "silent" enemies: blood pressure, cholesterol, and blood sugar. Quitting smoking is the single most important step you can take. Add 30 minutes of brisk walking per day and reduce your salt and processed fat intake, and you will be you will be actively fortifying your arteries.
How important are weight loss and dietary changes?
Every kilogram you lose reduces the effort your heart exerts to pump blood. The Mediterranean diet, legumes, olive oil, fish, fruit, is not a diet plan, it is a form of therapy. It reduces vascular inflammation and helps maintain HDL ("good") cholesterol levels.
How can I raise my HDL ("good") cholesterol without medication?
HDL is raised primarily through aerobic exercise and diet. Consuming omega-3 fatty acids (oily fish, walnuts) and replacing animal fats with olive oil are both highly beneficial, as is quitting smoking for good.
Is red wine good for the heart, or is that a myth?
There is a grain of truth to it, due to resveratrol, an antioxidant. However, any benefit applies only to moderate consumption; one glass per day. Exceeding that amount raises blood pressure and increases the risk of arrhythmias.
How often should I check my blood pressure?
If you have no diagnosed hypertension, a check every six months is sufficient. If you are on medication, measurements should follow a schedule we set together, typically 2–3 times per week at different times of day, to give us a complete picture of how well it is controlled.
If my mother or father had a heart condition, am I at risk too?
Family history plays a significant role. If a first-degree relative (parent or sibling) had a cardiovascular event; especially before age 55 for men or 65 for women, your own risk is elevated. This does not mean something will necessarily happen to you, but it does mean we need to be more vigilant: more frequent check-ups, stricter prevention, and potentially earlier intervention if needed.
I have diabetes — how does that affect my heart?
Diabetes is one of the most serious risk factors for cardiovascular disease. People with diabetes have a significantly higher likelihood of developing coronary artery disease. Additionally, diabetes can mask typical symptoms, you may not feel the classic chest pain. For this reason, if you have diabetes, we need to monitor your blood pressure, lipids, and blood sugar together as a unified prevention package.
Can stress and anxiety actually damage my heart?
Yes and this is not an exaggeration or purely psychological. Chronic stress raises blood pressure, accelerates heart rate, and can promote vascular inflammation. A sudden, intense emotional shock can even trigger angina or a heart attack. Taking care of your mental health is not a luxury, it is part of your cardiac prevention plan.
How often should I see a cardiologist?
It depends on your profile. If you are healthy with no risk factors, an annual check-up is sufficient. If you have hypertension, high cholesterol, diabetes, or a family history, more frequent monitoring is needed; typically every 3–6 months. After a stent or cardiac event, follow-up becomes even closer, especially during the first year.
Section 2: Conditions, Symptoms & Tests
Which symptoms require an immediate visit to the Emergency Department?
Do not delay if you experience: pressure, burning, or a squeezing sensation in the chest that does not subside; pain radiating to the jaw, back, or left arm; sudden shortness of breath; cold sweats; or intense nausea. In a heart attack, time is myocardium.
Are heart attack symptoms different in women?
Yes and this is a significant pitfall. Women often do not experience the typical chest pain. They may present with extreme fatigue, nausea, pain in the upper abdomen, or back pain. These symptoms are frequently misattributed to anxiety or gastroenteritis.
What is a cardiac echocardiogram and what is a Holter rhythm monitor?
The echocardiogram (Triplex) is an ultrasound that shows us the structure of the heart; valves, walls, and size. The Holter is a device you wear for 24–48 hours that records your heart rhythm under real-life conditions (sleep, work, stress), detecting arrhythmias that do not appear on a standard ECG.
What is Atrial Fibrillation?
Atrial fibrillation is the most common arrhythmia in adults. The heart beats irregularly and often faster than normal, which can cause palpitations, fatigue, or dizziness. Most importantly, it increases the thromboembolic risk. For this reason, beyond rhythm control, anticoagulant therapy is often required for protection.
What is a pacemaker and when is one needed?
A pacemaker is a small device implanted under the skin that "corrects" an excessively slow heart rate. Think of it as an assistant that ensures your heart always beats at the right rhythm. The implantation is a brief procedure performed under local anesthesia, and the vast majority of patients return to normal life within a few days.
I feel my heart "skipping beats." Is that normal?
These "skips" are usually premature contractions. In most cases they are benign and caused by fatigue, caffeine, or stress. However, if they become frequent or are accompanied by dizziness, a Holter monitor evaluation is needed to rule out a pathological cause.
Can I exercise if I have a heart condition?
Not only you can; you usually should, provided it is done correctly. Exercise is "medicine" for the heart, but if a condition is present, an assessment must come first. We will perform a stress test together to see how your heart responds to exertion, and I will then give you a personalized plan covering what you can do, at what intensity, and how often.
Section 3: Interventional Cardiology (Stents & Recovery)
Is angioplasty painful, and how long does it take?
The procedure is not painful. It is performed under local anesthesia at the wrist or groin, with mild sedation to keep you relaxed. It typically lasts between 30 and 60 minutes. You will be awake and able to talk to our team throughout.
What is a stent and how long will it stay in my artery?
A stent is a tiny metal mesh that keeps the artery open. It remains permanently in place and within a few months becomes covered by your own tissue (endothelium), effectively becoming part of the vessel wall.
Which medications must I never miss after a stent?
Antiplatelet agents, commonly referred to as "blood thinners." If you skip them, there is a risk of a clot forming inside the stent. These medications are your safeguard to keep the artery open and blood flow unobstructed.
Can a stent become blocked again?
Rarely, but yes, this is called restenosis. Modern drug-eluting stents have dramatically reduced this risk. Adherence to medication, smoking cessation, and control of cholesterol and blood sugar are your best defenses. If you experience chest pain or shortness of breath again, do not ignore it contact us immediately.
When can I return to work, exercise, and sexual activity?
After a planned procedure, you can return to office work within 3–5 days. Sexual activity is generally permitted after one week. For intense exercise, you will need to wait 2–4 weeks and complete a stress test first.
Can I travel or go to the mountains?
Air travel is permitted shortly after the procedure. For high-altitude destinations (above 1,500 m), caution is advised in the early period, as lower oxygen levels make the heart work harder. Discuss this with me before planning such a trip.
What is cardiac rehabilitation, and is it needed after a stent?
Cardiac rehabilitation is a structured program combining gradual physical activity, patient education, and psychological support. Think of it as a "school" that teaches you how to live better after a cardiac event. It is not mandatory for everyone, but for many patients it makes a significant difference, both physically and psychologically.