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 Cardiologist

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Episode Transcript

(00:00):
I have chest pain and shortness of breath.
When I exercise, I had a heart cathand was told I need open heart surgery.
I know many patients get stents and that's it.
Is someone lying to me? Okay.
Stents and bypass are the two ways we can addresssignificant blockages of the arteries
that feed your heart muscle.

(00:22):
Some patients, in some patients stents,is clearly the right answer.
And another group of patients open heart surgery bypassis clearly the right answer.
Now, there is a major middle pointwhere there is a gray line
where a stents might be more reasonable,might be more reasonable, but you could do stents
and it's something that we have been studyingfor decades now, it all depends on the very specifics

(00:47):
of your anatomy, of how the vessel looks, how it bends,how much calcium there is,
how many vessels are affected, et cetera, et cetera.
So yes, if you want a second opinion,I think it would be a good idea.
Um, but like I said, a lot of the times,two options are reasonable,
but philosophically, even though two options are reasonable,there is always an optimal approach.

(01:12):
It's like in car racing, the perfect lap is out there.
You just have to go and and do it.
So yes, for most patients,one option is better than the other.
Um, sometimes it's really hardto determine exactly which one.