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Joseph Sclafani, M.D.  
Male, 34
Richmond, VA

Interests: Internal Medicine, arrhythmia
My Posts
Mar 31, 2014 in the Heart Rhythm Expert Forum - 4
Hello. Thank you for your question. Ventricular tachycardia, or VT, has a few potential causes. Coronary artery disease, or blockages in the arteries that supply the heart, is a common cause. That is why a stress test was ordered, to try and diagnose this as a potential problem. Another potential cause is a cardiomyopathy, or damage to the squeezing functi...
Mar 26, 2014 in the Internal Medicine Expert Forum - 1
Hello. Thank you for your question. Unfortunately, there is not a substitute for seeking care with a physician with a physical exam. I would be concerned about your propensity for soft tissue infections such as MRSA if you have an abscess in a different part of your body. Very Respectfully, Dr. S
Hello. Thank you for your question. If a patient of mine told me those readings I would tell him or her those are normal readings and he or she has nothing to worry about. I would recommend no dietary changes to them. I am not aware of lemon affecting blood pressure. Very Respectfully, Dr. S
Mar 19, 2014 in the Heart Rhythm Expert Forum - 1
Hello thank you for your question. If one of my patients asked if they should continue their home medications to include Atenolol in the presence of a dental procedure using Lidocaune and epinephrine I would go ahead and tell them to take the Atenolol. Very Respectfully, Dr. S
Mar 19, 2014 in the Heart Rhythm Expert Forum - 1
Hello. Thank you for your question. Technically a pulse rate of 99 beats per minute (bpm) does not constitute tachycardia or a rapid pulse rate. Also, if she was asymptomatic, I do not believe you need to look into the matter any further. Very Respectfully, Dr. S
Hello. Thank you for your question. Often times, patients may feel lightheaded or dizzy after standing. This is often due to a drop in blood pressure, not a rise in blood pressure. This is called orthostatic hypotension. Patients with this issue should be evaluated with orthostatic vital signs in their physician's office. Here, pulse and blood pressur...
Mar 03, 2014 in the Heart Rhythm Expert Forum - 2
Hello. Thank you for your question. The scenario you describe it not uncommon. The goal of evaluation syncopal episodes like yours is to capture the symptoms on an ECG or monitor when they occur to make a "symptoms-rhythm" correlation. When this cannot be achieved in the hospital while on telemetry, or on a Holter or an Event monitor with recurri...
Mar 03, 2014 in the Heart Rhythm Expert Forum - 8
Hello. Thank you for your question. Neither calcium channel blockers or beta-blockers are rhythm control agents. They are strictly rate control agents. Your observation that you remain in atrial fibrillation for a shorter period of time may be a coincidence. In general, paroxysmal atrial fibrillation becomes progressive over time. It sounds as if your ...
Mar 03, 2014 in the Heart Rhythm Expert Forum - 3
Hello. Thank you for your question. In general, patient's with tachycardia due to sinus tachycardia (a normal fast rhythm with a heart rate greater than 100 beats per minute (bpm)) for a few hours is not considered dangerous. Patients with prolonged tachycardia could theoretically develop a cardiomyopathy, which is a decrease in the squeezing function...
Thank you for your question. If a patient had rapid heart rates and complained of dizziness, I would be very concerned and perform a diagnostic evaluation. At a minimum this would consist of a history and physical exam, a resting electrocardiogram (ECG), and a Holtermonitor, which records your heart's electrical rhythm for a defined period of time (i....