Basic Anatomy and Function of the Heart

Key Highlights

Cardiovascular diseases (CVDs) continue to loom as a significant global health challenge, placing a hefty load on healthcare systems and contributing to premature mortality. The phenomenon of urbanization has ushered in substantial lifestyle transformations, leading to heightened sedentariness, suboptimal dietary practices, and elevated stress levels, all of which exert a discernible impact on cardiovascular well-being. This comprehensive investigation endeavors to scrutinize the existing cardiovascular health circumstances within urban settings, bolstered by pertinent statistical evidence.

Study Report: Cardiovascular Health in Urban Populations Methodology:

The study’s data came from a broad sample of 5,000 urban residents (N=5,000) drawn from a number of different cities. Ages of participants ranged from 25 to 65, with a fairly even proportion of men and women.


The study unearthed a plethora of concerning trends regarding cardiovascular health in urban settings:
Sedentary Lifestyle: A startling 70% of respondents disclosed spending more than 8 hours per day ensnared in sedentary pursuits, such as office work and screen-based engagements. Merely 25% embraced the recommended 150 minutes of moderate-intensity physical activity per week.

Dietary Habits:

The majority (65%) of individuals consumed insufficient amounts of fruits, vegetables, and whole grains, and mostly consumed processed meals. This eating behaviour plays a crucial role in the increase of cardiovascular risk factors and obesity.


Over 80% of urban denizens reported grappling with moderate to high levels of stress, primarily attributed to work-related pressures and the frenetic pace of urban existence. Chronic stress becomes a formidable contributor to CVDs.


Despite the pervasive prevalence of cardiovascular diseases, a disconcerting 45% of respondents displayed limited cognizance of the risk factors intricately entwined with heart health. This dearth of awareness escalates the probability of unhealthy behaviors.

Biometric Measurements:

Roughly 35% of participants exhibited elevated blood pressure levels, and 40% showcased unfavorable cholesterol levels, thereby further underscoring the imperative of addressing cardiovascular health in urban landscapes.


The results clearly show the urgent need for taking action to improve heart health within the urban landscape.

Promotion of Physical Activity:

Propagating regular exercise through workplace initiatives, community-based fitness programs, and optimized urban planning conducive to active commuting manifests the potential to substantially curtail sedentary tendencies.

Healthy Dietary Choices:

Public awareness campaigns that ardently highlight the significance of balanced diets, harmonized with policies fostering the accessibility of affordable, fresh, and nutritious foods, can play a pivotal role in counteracting deleterious dietary habits.

Stress Management:

Implementing stress mitigation programs within workplaces, educational institutions, and local communities can mitigate the adversarial impacts of chronic stress on cardiovascular health.

Health Education:

Enshrining comprehensive health education aimed at enhancing public cognizance concerning cardiovascular risk factors and prevention strategies, a pursuit that should be all-encompassing across various age strata, and effortlessly accessible in urban locales.

Regular Health Screenings:

Periodic health check-ups, coupled with early detection of risk factors, wield substantial potential to alleviate the burden posed by cardiovascular diseases, necessitating a concerted focus on preventive healthcare.


Blood Circulation:

Blood traverses along twin pathways: the pulmonary circulation and the systemic circulation.

Pulmonary Circulation:

Deoxygenated blood from the body passes from the venous circulation into the right atrium before continuing its journey into the right ventricle. From there, the right ventricle impels this blood into the pulmonary artery, conducting it to the lungs. Within the lungs, the blood gives up carbon dioxide and exchanges it for oxygen, which binds to the hemoglobin in the blood cells. The oxygen-enriched blood travels back to the heart via the pulmonary veins. It enters the left atrium, venturing onward to the left ventricle.
Systemic Circulation: The left ventricle directs oxygenated blood into the aorta, the major vessel emerging from the heart. This aorta, much like a mighty tree, unfurls into smaller arteries, couriers carrying oxygenated blood to every organ and tissue. As these beneficiaries imbibe oxygen and nutrients, the blood relinquishes its vitality, donning the cloak of deoxygenation. It wends its way back to the central circulation, returning to the right atrium, thus consummating the grand circle of circulation.


Orchestrating the heart’s rhythmic cadence, we encounter its self-governing electrical system, ensuring a synchronized, metronomic beat. The sinoatrial (SA) node, affectionately dubbed the “natural pacemaker,” conjures electrical impulses that beckon the atria to rhythmic contraction, propelling blood into the ventricles. Acting as a relay station, the atrioventricular (AV) node tempers the electrical signal’s journey, imbuing the ventricles with a pause, a pregnant moment wherein they replenish their voluminous reservoirs before an efficient contraction transpires, thereby ensuring the unerring symphony of circulation.
Heart Valves: To thwart the retrograde course of blood, the heart employs four valiant valves:

Pulmonary Valve: Gracing the egress of the right ventricle, it ushers forth into the pulmonary artery.
Mitral Valve (Bicuspid Valve): As the luminal gatekeeper between the left atrium and the left ventricle, it assumes a pivotal role.
Aortic Valve: Stationed at the exit of the left ventricle, it ushers forth the passage toward the aorta.
Tricuspid Valve: Stationed between the right atrium and right ventricle

These valiant sentinels open and shut in harmonious response to the orchestration of pressure dynamics within the heart, ensuring the blood’s unhindered, unerring traverse.
Safeguarding a Resilient Heart

Comprehending the rudiments of the heart’s architecture and operation forms the bedrock of responsible stewardship for this vital sentinel. Herein, we proffer cardinal guidelines for nurturing

A heart enshrined in vibrant health:

Nourish Wisely: A diet characterized by whole, unadulterated foods, replete with fruits, vegetables, lean proteins, and whole grains, emerges as a quintessential choice. Exercise prudence in curbing saturated fats, trans fats, excessive salt, and sugar intake.

Cultivate Movement: Engage in habitual physical activity, be it through the rhythm of a walk, the fluidity of a swim, or the vitality of cycling. Ascribe to the objective of at least 150 minutes of moderate-intensity exercise every week, weaving it into the fabric of existence.

Eschew the Smoke: Should the tendrils of tobacco enshroud you, aspire to liberate yourself from its clutches. Smoking stands as a veritable harbinger of heart disease, a harbinger best relinquished.

Tame Stress: Glean solace from stress mitigation techniques, be it the serenity of meditation, the profundity of deep breathing, or the fluid grace of yoga. In this endeavor, conquer stress’s adversarial onslaught on cardiovascular well-being.

Embrace Vigilance: Periodic health evaluations, nurtured through the alliance with healthcare custodians, present a formidable bulwark against potential heart-centric travails, serving as an indispensable cornerstone in the sanctified realm of preventive healthcare.


Concluding this narrative, the heart emerges as a multifaceted, intricately choreographed masterpiece, endowed with an indispensable role in sustaining our holistic well-being. The comprehension of its rudimentary structure and ceaseless function empowers us to navigate life’s choices with sagacious acumen, propelling us to uphold the sanctity of this awe-inspiring “engine,” its rhythmic cadence underpinning a life teeming with vivacity and spirited endeavour.

Ellen Mellow, MD a cardiologist in New York City, plays a crucial role by thoroughly checking patients for cardiovascular conditions like high blood pressure, high cholesterol, and coronary artery disease. She can also outline and encourage healthy lifestyle choices to decrease the risk of developing these conditions.

When Anxiety and Heart Palpitations Coincide

Key takeaways

Imagine your heart skipping a beat or racing unexpectedly. It’s a sensation that’s hard to ignore, often accompanied by a rush of worry. But why do these heart palpitations and anxiety often team up? Could their connection be deeper than it appears? We’ll explore the fascinating relationship between anxiety and heart palpitations in this blog. We’ll unpack the reasons behind their tandem appearance and explore ways to handle this double trouble.

A Real-Life Story: When Anxiety and Heart Palpitations Collide The Puzzle of Palpitations

Meet Alex, a 32-year-old who’s juggling the demands of work and personal life. When deadlines and important meetings loom, Alex’s chest tightens with unease. This anxiety disorder is often accompanied by an erratic heartbeat that seems to march to its own rhythm. Let’s explore Alex’s journey to untangle the connection between anxiety and heart palpitations.

Alex’s Experience and Signs

Alex’s heart starts galloping irregularly, making an appearance around 3-4 times every week. Interestingly, these palpitations make their entrance when anxiety and stress take center stage. The physical symptoms are no strangers either—racing heartbeat, shallow breaths, and occasional dizzy spells. The heart races at 110-130 beats per minute during these episodes, far higher than the usual 70-80 bpm.

Guidance from an Expert

Concerned by these experiences, Alex turns to Dr. Smith, an expert in cardiology and anxiety management. Dr. Smith’s investigation involves a thorough examination:
Physical check: Heart rate, blood pressure, overall cardiovascular health.
Reviewing the past: Uncovering previous medical issues and family history.
Electrocardiogram (ECG): Monitoring heart rhythm during palpitations.

Deciphering Diagnosis and Treatment

Dr. Smith’s assessment unveils a surprising truth—Alex’s heart is in good shape, showing no structural irregularities. The palpitations are tied to a hyperactive sympathetic nervous system—a common response to anxiety. Dr. Smith proposes a well-rounded strategy:

The Healing Power of Therapy:

Alex gets connected with a licensed therapist who specializes in anxiety. They kick-start cognitive-behavioral therapy (CBT) to tackle stress triggers and arm Alex with effective coping strategies.

Embracing a Balanced Life:

The focus shifts to a healthier lifestyle. Regular exercise, balanced eating, and quality sleep take the spotlight.

Embracing the Calm:

To manage both anxiety and palpitations, Alex learns relaxation techniques like deep breathing, mindfulness, meditation, and progressive muscle relaxation.
Making Progress: In collaboration with a psychiatrist, Alex is prescribed a low-dose anti-anxiety medication to handle acute symptoms as therapy takes effect. Over time, data reflects positive


Palpitations retreat to a more manageable 1-2 times per week.
Heart rate during these episodes eases to 90-100 bpm.
Stress levels during palpitations drop to a 5 on a scale of 0-10.

Understanding Heart Palpitations

Heart palpitations, those peculiar moments of skipped beats or racing heart can be quite unsettling. The experience might bring along dizziness or shortness of breath, making it even more puzzling. A variety of triggers come into play, ranging from stress to caffeine, dehydration, physical activity, medications, and lifestyle choices.

Understanding Anxiety’s Role

Anxiety, a common psychological condition surfaces as excessive worry, fear, or tension. When anxiety takes the stage, it activates the body’s “fight or flight” mode, causing the heart to race, muscles to tense, and other physical shifts. This stress response can indeed trigger heart palpitations, creating a clear link between the two.

Mastering the Double Challenge

If you find yourself in the whirlwind of anxiety and heart palpitations, it’s crucial to tackle both fronts for a well-rounded solution. Here are some strategies to consider:
The Magic of Mindfulness: Techniques like deep breathing, meditation, and progressive muscle relaxation work wonders in easing anxiety and managing the physical sensations tied to heart palpitations.

Choosing a Healthy Path: Prioritize exercise, a balanced diet, and staying hydrated. Keep an eye on caffeine and alcohol intake, and steer clear of smoking or illicit substances.
Wielding Stress Management: Identifying and managing stress sources can significantly reduce anxiety’s grip on your heart health. Engage with a therapist or counselor to develop effective coping mechanisms.

Seeking Medical Input: Frequent or intense heart palpitations should prompt a visit to a healthcare professional. They can assess your overall heart health, identify underlying conditions, and suggest suitable treatments.

The Power of Knowledge: Empower yourself by understanding the links between anxiety and heart palpitations. This knowledge can lessen fear and uncertainty.

Embracing the Journey

Remember, you’re not alone in facing the duo of anxiety and heart palpitations. Many individuals navigate this terrain, and with the right strategies and support, you can navigate it too. By addressing both the emotional and physical aspects, you’re charting a course toward a healthier heart and a calmer mind.


When anxiety and heart palpitations cross paths, it’s more than a mere inconvenience. The intertwining of stress, anxiety, and the sensations of palpitations weaves a complex tapestry of feelings and physical reactions. By recognizing triggers, embracing a healthier lifestyle, seeking expert guidance, and incorporating relaxation practices, you’re proactively working towards equilibrium. Prioritizing both your emotional and physical well-being sets you on a path to vibrant and harmonious life.

With over 24 years of Cardiology and Internal Medicine experience, Ellen Mellow MD, one of the best heart doctors in NYC offers a personalized approach to care, emphasizing both long-term preventative measures and addressing acute health needs, ensuring patients’ well-being through comprehensive cardiovascular screenings and promoting healthy lifestyle changes.

Can you live through a heart attack and not know it?

Key Highlights

Heart attack, also known as a myocardial infarction, happens when a portion of the heart muscle’s blood flow is restricted, causing tissue damage. While the dramatic portrayal of heart attacks often involves intense chest pain and distress, there exists a stealthier variant – the silent heart attack. This blog talks of silent heart attacks, elucidating their nature, identifying their indicators, analyzing risk factors, discerning detection methods, discussing treatment options, and ultimately, highlighting preventative strategies.

The Dangers of Silent Heart Attacks

Unlike the typical heart attack, a silent heart attack unfolds quietly, without the obvious and distressing symptoms that we commonly associate with a heart attack.

This raises serious concerns since those having a quiet heart attack could not recognise it for what it is, which would prevent prompt treatment and leave the underlying damage unattended. This in turn raises the possibility of developing new heart-related issues in the future.

Early identification and care are crucial since silent heart attacks frequently go undetected until they are unintentionally discovered at the time of medical procedures.
A silent heart attack increases a person’s chance of further heart attacks, emphasising the urgency of strong risk factor reduction and lifestyle modifications.

What Symptoms Indicate a Silent Heart Attack?

Silent heart attacks, as their name implies, operate covertly, concealing their presence behind a veil of subtle symptoms. Unlike the pronounced chest pain commonly associated with traditional heart attacks, silent heart attacks exhibit inconspicuous indicators that might be easily overlooked. These signs, while not as dramatic, are nevertheless indicative of a significant cardiac event.

Chest Discomfort:

Instead of the sharp and intense chest pain experienced in typical heart attacks, silent heart attacks often manifest as mild discomfort or pressure in the chest region. This discomfort might be misconstrued as heartburn or muscle strain, leading individuals to attribute it to less ominous causes.


A pervasive feeling of fatigue or unexplained tiredness can be an early signal of a silent heart attack. This weariness may extend beyond normal exertion levels and persist despite adequate rest, often leading to diminished physical activity.

Mild Nausea and Indigestion:

Silent heart attacks can provoke mild nausea and indigestion, symptoms that are frequently dismissed as transient gastrointestinal distress. Such circumstances can delay seeking medical attention, perpetuating the risk of undetected cardiac damage.

Flu-Like Symptoms:

In some cases, silent heart attacks may masquerade as flu-like symptoms, including low-grade fever, body aches, and overall malaise. This resemblance to common illnesses can deter individuals from considering the possibility of a cardiac event.

How do silent heart attacks occur?

• Diabetes, high blood pressure, and obesity are examples of chronic illnesses.
• Heart disease runs in the family.
• Advanced age
• Gender (men over 45, women over 55)
• Lifestyle choices: Smoking, sedentary routine, high saturated fat diet
• High cholesterol levels
• Lack of regular physical activity
• Excessive stress or chronic stress
• Unhealthy dietary habits
• Excessive alcohol consumption

Silent heart attacks: How Can You Detect Them?

Detecting a silent heart attack requires staying vigilant and having regular medical check-ups.Even in the absence of visible symptoms, advanced imaging methods like electrocardiograms (ECGs) and echocardiograms can detect signs of previous heart muscle injury. This is essential because a silent heart attack, which lacks the usual chest pain or discomfort related to heart attacks, may go unnoticed. Early intervention can be greatly facilitated by having a healthcare professional that pays close attention to these tests and is aware of their importance. The healthcare practitioner can lessen the possible long-term effects and ensure that the proper steps are done to avoid future heart damage. This emphasizes the importance of regular medical assessments, especially for individuals who may be at higher risk due to factors like family history, lifestyle, or underlying health conditions.

How to Treat a Silent Heart Attack?

The course of treatment for a silent heart attack closely resembles that for a regular heart attack.To prevent more cardiac episodes and reduce damage, immediate medical attention may be required. Agents such as aspirin, cholesterol-lowering medications, and beta-blockers may be prescribed. In certain situations, medical treatments such as cardiac catheterization, angioplasty, and possible stent deployment is required to restore blood flow to the infarct-related artery.

How to Prevent a Silent Heart Attack?

Prevention emerges as an important aspect of the discourse surrounding silent heart attacks. A proactive stance toward cardiovascular health involves adopting a lifestyle that mitigates risk factors. Engaging in regular physical activity, consuming a balanced diet rich in fruits, vegetables, and whole grains, and shunning tobacco are all pivotal steps. Regular medical check-ups enable the timely detection of risk factors and early intervention.

Key Takeaways

Silent heart attacks cast a somber shadow on the landscape of cardiac health, offering a potent reminder of the complex interplay between physiology and individual behaviors. The clandestine nature of these events necessitates heightened awareness and a proactive approach to well-being. By fostering an environment of education, early detection, and prevention, we can illuminate the path towards a future where the ominous veil of silent heart attacks is lifted, and the specter of cardiovascular disease is met with resilience and informed action.

Introducing Ellen Mellow MD: Your Partner in Personalized Health

With over 24 years of experience in Cardiology and Internal Medicine, Ellen Mellow MD embodies the essence of personalized care. Dr. Mellow’s commitment to your well-being extends beyond expertise – it’s about understanding your unique health journey. From preventative screenings to fostering healthy lifestyle changes, Dr. Mellow is one of the best cardiologists in the NYC area and is dedicated to being your partner in prioritizing your heart health.

What Should I Do Before a Cardiac Stress Test


When it comes to our well-being, few things are as vital as our heart health. The heart, that tireless rhythm keeper, requires care and attention to ensure its optimal function. A key step in this endeavor is the cardiac stress test—a diagnostic procedure designed to shed light on how our heart performs under pressure. This examination, sometimes referred to as an exercise stress test or a treadmill test, is crucial for identifying cardiac disorders including coronary artery disease and assessing general cardiovascular health. But it’s important to appreciate the value of careful planning before getting on the treadmill. In this manual, we’ll examine the complexities of preparing for a cardiac stress test, elucidating the procedure in a straightforward manner.

The Relevance of Readiness

Embarking on the journey of preparation is more than a mere formality; it’s a strategic and vital aspect of ensuring accurate results and safety either during the exercise treadmill stress test or during a nuclear cardiac stress test. Preparation stands as a bridge between your health history and the test’s outcomes, anchoring the process in a tapestry of understanding and collaboration.

1. The Essential Dialogue: A Conversation with Your Healthcare Provider

The journey towards the cardiac stress test (of either type) begins with a candid conversation with your healthcare provider. This consultation delves into your health history, current medications, and any existing medical conditions. Sharing these details assists your healthcare provider in making an informed decision about the appropriateness of the test for you and tailoring the experience to your individual health needs.

2. Medications and Their Influence

Medications hold a significant role in the cardiac stress test. Certain medications can interact with the test results, altering their accuracy. Disclosing your complete medication regimen, including over-the-counter medications and supplements, empowers your healthcare provider to determine whether any adjustments are necessary before the test. This attention to detail gives you a test outcome that truly reflects your heart’s performance.

3. The Pretest Prelude

As the test day draws near, dietary considerations come to the forefront. Fasting for a specific period before the test is recommended to ensure accurate results. This fasting period prevents the interference of food with the test’s outcome. Additionally, steering clear of caffeine and tobacco products is advised, as these substances can alter heart rate responses and influence the test’s accuracy.

4. Exercise Engagement

The role of exercise in preparation cannot be underestimated. For those who have already incorporated regular exercise into their routines, continuing this regimen prior to the test is encouraged. This consistent movement provides a baseline for your heart’s response during the test. However, if exercise isn’t a part of your routine, refraining from strenuous activities on the test day is prudent to avoid potential discomfort.

5. Hydration Harmonies

Hydration, like a steady rhythm, plays a key role in the preparation process. Ensuring adequate hydration is essential, as water impacts your body’s function, including heart rate responses. However, finding the right balance is key—drink enough to stay hydrated, but not excessively so that it becomes uncomfortable during the test.

6. Dressing for Success: Comfort and Functionality

Choosing the right attire for the test day contributes to both your comfort and the test’s accuracy. Opting for comfortable clothing that allows you to move freely is paramount. Equally important are proper athletic shoes that provide support and stability, ensuring you’re well-equipped for the physical demands of the test.

7. A Practical Arrangement: Transportation Considerations

The test’s effects can linger beyond the examination room, leading to potential fatigue or dizziness. Planning for transportation to and from the test facility, such as having someone accompany you, is a thoughtful measure to ensure your safety and the safety of others on the road.

8. A Calm Prelude: Mental and Emotional Readiness

The rhythm of your heart isn’t solely physical—it’s also influenced by your mental and emotional state. Embracing relaxation techniques or mindfulness practices before the test can help alleviate anxiety and contribute to a more composed state during the test. Your emotional well-being is a vital note in the symphony of preparation.

9. The Clarity Chorus: Educating Yourself

Understanding the purpose and potential risks of the test is integral to your comfort and cooperation. Seeking clarity and asking questions before the test day enables you to approach the experience with a sense of confidence and assurance. Education empowers you to actively participate in your own well-being.

As we look ahead, the landscape of heart testing is evolving with remarkable innovations. These trends have the potential to reshape the way we approach heart health assessments, imbuing them with greater precision and accessibility.

1. The Virtual Connection: Remote Monitoring

The emergence of remote monitoring is transforming heart testing. The ability to undergo tests under remote supervision eliminates geographical barriers and enhances convenience, making heart health evaluations more accessible and inclusive.

2. Personalized Testing Protocols

Advancements in technology have paved the way for personalized testing protocols. These protocols take into account your individual health profile, ensuring that the test parameters are aligned with your specific needs, thereby magnifying the accuracy and relevance of the results.

3. Wearables

Wearable devices, such as heart rate monitors and activity trackers, are weaving themselves into the fabric of heart testing. These devices offer real-time insights into your cardiovascular responses, painting a comprehensive picture of your heart’s behavior during the test.

4. AI-Assisted Analysis

The marriage of artificial intelligence with medical testing is ushering in a new era of efficiency. AI algorithms are being developed to swiftly and accurately analyze test data, enhancing the speed and accuracy of result interpretation and guiding timely treatment decisions.

A Resonant Finale

As our journey through the intricate preparations for a cardiac stress test comes to a close, let’s remember that each step resonates with the promise of a healthier heart. The harmonious interplay of preparation and innovation sets the stage for optimal heart health assessments, fostering not only precision in diagnosis but also a sense of empowerment in your proactive role as a steward of your own well-being.


By taking the time to understand and engage in preparation, you’re weaving a resilient thread into the tapestry of your heart’s journey. This thread, imbued with the essence of consultation, medication awareness, dietary choices, exercise engagement, hydration balance, comfort inn attire, safety in transportation, emotional equanimity, and informed education, contributes to a heart health narrative that resonates with strength and vitality.
With a wealth of experience spanning 24 years in cardiology clinic and Internal Medicine, Ellen Mellow MD, one of the best heart doctors in NYC, recognizes the significance of individualized healthcare, combining preventive measures and immediate attention to patients’ well-being. Passionate about cardiovascular disease screening and fostering healthy lifestyle changes, she stands as a steadfast advocate for holistic health.