ANGINA: What It Feels Like, Duration, Triggers…

What does the chest “pain” of angina feel like and how long, or short, might be the duration? What are possible triggers?

Below are articles on this site about angina. You’ll note that a few of the titles are similar; however, a different cardiologist was interviewed for those.

Physical Activity

Duration of Symptoms


Digestive Connection

For additional articles on heart disease and cardiac symptoms, type the keywords of your interest into the “TYPE IN A SYMPTOM” box in the upper right portion of any page on this site.

PANCREATIC CANCER: Virtual Death Sentence

Pancreatic cancer has one of the worst prognoses of all the cancers. But this doesn’t mean that risk factors and other elements of this disease aren’t known or suspected.

Below are links to articles about this disease.

-  Pancreatic Cancer Risk Goes Up with Smoking

Premature Ventricular Contraction Fear: Should You Worry?

Are PVCs worth being scared out of your wits over? Below are links to some of the premature ventricular contraction articles on this site—there are actually many more articles.

If you don’t find what you’re looking for in the articles below, then just type in the keywords into the “TYPE IN A SYMPTOM” search box in the upper right of any page on this site.

Are PVCs Connected to GERD in any Way?

STEVIA Raw Chocolate Coconut Balls Simple Recipe

Finally, a simple recipe for Stevia raw chocolate balls that do not taste like “date” balls nor are overwhelmed with a coconut taste.

You will need:
-     12 level tablespoons almond meal (not “ground almonds,” but meal; this is very finely ground almonds)
-     8 level tablespoons coconut shreds
-     8 level tablespoons raw cacao powder
-     6 level tablespoons coconut oil
-     3 organic Medjool dates, pitted
-     8 packets Stevia (SweetLeaf brand; yes, it makes a difference)
-     One-quarter teaspoon pure vanilla extract

One of the things that makes this recipe for Stevia raw chocolate coconut balls so unique is that it doesn’t require that many dates. Other recipes on the ‘Net call for a lot of dates relative to other ingredients, and as a result, the balls end up tasting “datey” or even like cornflakes.

Instructions for Stevia Raw Chocolate Coconut Balls
In a big bowl, put all the dry ingredients first. A “level” tablespoon is literally level, not heaping. To make it level, scoop up enough of the dry ingredients so that the spoon is heaping. Then with a butter knife, skim it across the rim of the spoon (and please, use a standard measuring spoon, not a soup spoon).

The purpose of heaping the spoon is to make sure no air pockets are formed when you skim. In fact, skim by “bouncing” the knife as you go.

After the dry ingredients, put in the coconut oil (never refrigerate; not necessary; it has an extremely long, if not indefinite, shelf life as long as it’s securely sealed). If you put the coconut oil in before the dry ingredients, the dry ingredients will stick to the spoon—unless you don’t mind cleaning up the spoon first.

With a butter knife, scoop out the oil (assuming it’s solid; it liquefies if room temperature is 76 degrees) and stuff into the tablespoon, then skim the surface. Make sure there are no air pockets. Skim really good so that the surface of the oil is flush or even with the rim of the spoon. With butter knife, then dig it out thoroughly and put in the bowl.

Add the Stevia. I’ve tried other brands of Stevia, and trust me, SweetLeaf is the best. The other brands are bland and don’t do much for sweetening.

Add the vanilla extract.

With a food processor, grind up the dates. IMPORTANT: Grind up so that the end product has almost the consistency of peanut butter, in that it’s spreadable. 

It doesn’t have to be creamy smooth, but almost so. If there’s a chunky-particle appearance to it, it needs more processing.

Add this spreadable date goop to the bowl.

With a sturdy steel or wooden mixing spoon, mix everything by aggressively pressing the bottom of the spoon, from the edge of the bowl towards the center, rotating the bowl with the other hand.

If your food processor can handle mixing all the ingredients, then process the dates first (so that you can visually confirm spreadability), then add the remaining ingredients. My food processor can’t handle powder; it jams the blades.

But if you’re mixing in a bowl by hand (electric mixers won’t work), you must be patient and aggressive; it takes some elbow grease. Just keep furiously mixing, and you’ll note that the clumps of coconut oil and dates will NOT be evenly distributed. Press on these with the spoon to further break them down and distribute them throughout the dry mix. You don’t want any one ball to have a large clump of just date or coconut oil in it.

Keep mixing till it looks like everything is evenly distributed, no isolated clumps of date goop or coconut oil.

IMPORTANT: The final mixture will appear too dry to form into balls. Do NOT add anything. If you add even another one-quarter tsp of vanilla, the balls may be too sticky.

Grab enough of the mix to mold, between two rotating palms, a ball. With fingers, first compact the mix a little, then begin rolling—and use enough mix to make balls almost the size of a ping pong ball.

This recipe makes 12 balls, depending on the size you roll them.

Again, the mix will appear too dry to mold into balls, but it will mold very nicely and they will hold in place. [If you want the balls to be sticky enough to roll in coconut shreds, almond meal or chia seeds, add another quarter teaspoon of vanilla. If this doesn’t quite do it, add another quarter teaspoon.]

Once nicely molded, place on a plate and refrigerate for later on if you prefer them cold, but they taste just divine at room temperature. In fact, when refrigerated, these Stevia raw chocolate coconut balls take on a denser quality, but at room temperature, have a consistency resembling non-refrigerated squares of fudge.

These Stevia raw chocolate coconut balls are SUPER good for your body! And DAMN, you won’t believe how great they taste!

Causes of Waking with Racing Heart After Falling Asleep

Waking in the middle of the night with a racing heart can have minor to serious causes.

Have you been awakening in the middle of the night to find that your heart is racing? Below is information for both men and women.

"One of the common causes is simply sinus tachycardia or a fast, normal rhythm,” says cardiologist Dr. Pam Marcovitz, MD, medical director of the Ministrelli Women's Heart Center, at Beaumont Hospital, Royal Oak. “This condition does not need to be treated and does not regularly reoccur.”

In other words, it’s just something that occurred while you happened to be asleep, and the change in pulse was enough to awaken you. This same situation can happen during the day but go unnoticed if you’re up and about.

If you’re noticing these incidents, document when they occur and record your pulse, to see if over time, there’s a pattern or if these incidents of a “racing” heart are happening less frequently—or more frequently—than it seems.

Another possible cause of awakening with a racing heart in the middle of the night is atrial fibrillation, says Dr. Marcovitz. A-fib is a potentially serious disorder, as it can increase the risk of blood clots and cause symptoms including faintness.

During an A-fib episode, the heart rate bounces all over the place; it’s not steady. In sinus tachy, the sped-up rate is steady, as in, for instance, a steady rate of 110 beats per minute (which may fluctuate a few beats up or down every minute).

In A-fib, the pulse is not steady, and a heart rate monitor would show the numbers quickly jumping from (for instance) 110 to 174 to 142 to 170 to 94 to 152. Do not try to diagnose yourself with A-fib.

“Feeling frightened and/or having a dream or nightmare, especially if the dream involved running or physical activity, whether you remember it or not, is another possible cause” of being awakened in the middle of the night with a racing heart, says Dr. Marcovitz.

“This late night response, however, should only occur very occasionally. If it occurs more frequently, including throughout the day, see your doctor for possible connection to a heart monitor, which will evaluate for treatable causes,” including A-fib.

Another possible cause is a panic attack while you’re asleep. Yes, this can happen. Years ago I was dreaming I was with my brother; nothing too eventful was playing out, but in the dream I became aware that my heart was pounding—and fast. This then awakened me—and my heart was racing and pounding.

What I believe happened was during the REM stage of sleep (rapid eye movement; dreaming), my body physically had a spontaneous panic attack, and it worked its way into the dream I just happened to be having, kind of like how the need to urinate can work its way into a dream (e.g., you’re searching for a restroom but can’t find one).

So, I literally awakened with a racing heart. I was so afraid for my heart that I called 9-1-1 and an ambulance took me to the hospital. I was 28 and worked out regularly with weights, played “A” level volleyball, jogged—and once a week hiked rigorously. But a panic attack tends to invalidate all that.

In the ambulance my heart rate was in the 130s. At the ER it turned out that my heart was just fine (according to an EKG, stethoscope exam and troponin test).

Other Causes of Awakening in the Middle of Night with a Racing Heart
“Sleep apnea, anxiety and high blood pressure may also cause a person to awaken with a fast or racing heart rate,” says Dr. Marcovitz. “These are potential causes for which a person should be evaluated."

PVCs after Eating Not Caused by Food

A cardiologist says that PVCs or heart palpitations after eating are not caused by the food or the physical act of eating.

"Blood flow is shunted to the intestine after eating, so we can digest our food,” says cardiologist Dr. Pam Marcovitz, MD, medical director of the Ministrelli Women's Heart Center, at Beaumont Hospital, Royal Oak.

“More blood also flows to the digestive organs. This is usually not a cause of palpitations or PVCs after eating."

So why do some people experience PVCs after eating?
They should make a documentation of this when it occurs: time of day, who was present with them during the meal, the planned activity after the meal, and any other stressors that were present while eating or shortly after.

PVCs can be brought on by anxiety and stress. Do they usually occur after a meal with people you were arguing with? Do they usually occur after the last bite, and within how many minutes? Do they usually occur when the after-meal planned activity is something stressful, like going over your bills?

Eating, in and of itself, and food, do not cause premature ventricular contractions. The rhythm control center of the heart is not tied to the digestive system.

Are PVCs Connected to GERD in any Way?

There is probably a link between PVCs and GERD.

PVC stands for premature ventricular contraction, and GERD refers to gastroesophageal reflux disease.

Are PVCs associated with GERD?
"I think they are,” says cardiologist Dr. Pam Marcovitz, MD, medical director of the Ministrelli Women's Heart Center, at Beaumont Hospital, Royal Oak.

She continues, “I find a lot of people who have GERD tell me they have PVCs. When you lay down at night, if you have GERD, small microscopic droplets of food may travel up the esophagus into airways, thus causing PVCs."

The link between heart “palpitations” and acid reflux may also occur via other pathways. For instance, both the “skipped heartbeat” sensation and acid reflux can be caused by anxiety. So the symptoms, then, have a common cause in this case, but the symptoms do not act upon each other.

Do your PVCs calm down when you take a medication for heartburn? Which usually comes first, a bout of GERD or a string of PVCs? Take a note of timelines, concurrent stressors and your activities at the time the symptoms act up. Over time you may discover a common denominator that can help you relieve yourself of these issues.

Strong Heartbeat Awareness: Causes & Solutions

Dang, there goes that “cardiac awareness” again: You REALLY feel your heart beating, or maybe this goes on for long stretches of time—even though you’re not physically exerting yourself.

"Some people are just more aware of their heartbeat than others,” says
cardiologist Dr. Pam Marcovitz, MD, medical director of the Ministrelli Women's Heart Center, at Beaumont Hospital, Royal Oak. This awareness applies equally to men and women.

“People also seem to notice their heartbeat when they lie down to go to sleep at night, because they are quiet,” continues Dr. Marcovitz. “If you're heart rate is normal, it might simply be a heightened awareness, rather than a stronger than average heartbeat.”

Has your heartbeat always been strong or noticeable, but only recently you’ve been growing concerned about it?

“Becoming vigilant about noticing your heart rate may cause anxiety in and of itself, which in turn can increase heartbeat,” says Dr. Marcovitz. “Some people are prone to panic attacks and hyperventilation, which can cause a stronger heartbeat.

“To address these challenges, take some deep breaths.  If you're hyperventilating, breathe into a paper bag. Simply try to relax."

Deadlifts on Back Day or Leg Day: Here’s How to Decide!

Because deadlifts recruit the back as well as the legs, should this compound exercise be done on your back day, or on your leg day? I’m a certified personal trainer. And in all honesty, the answer to this question depends on what works best for you.

I do deadlifts on my leg day. But that’s just my preference. DLs fit right in after my barbell squats. Before the barbell squats I do dumbbell squats. Every other week I leave out the barbell squats because I have two leg programs.

On the days that my deadlifts follow the dumbbell squats (no-barbell-squat days), I’ve noticed that I have no more strength and stamina than I do when the deadlifts follow the barbell squats. Very interesting.

In short, if you feel comfortable performing deadlifts on your leg days, go for it, because this multi-joint exercise recruits the entire legs.

The reason I don’t do deadlifts on back days is because my back routine is tough enough without adding a whole-body killer to it. Your own back regimen might be filled with grueling chin-up and pull-up routines, not to mention in addition to that, T-bar rows, bent-over dumbbell rows and lat pull-downs. The last thing you want facing you is a deadlift regimen.

Doing this whole-body exercise before your latissimus and rhomboid routines may very well disrupt those routines. However, deadlifts at the conclusion of your back session won’t go very well, either, as your lats, lower traps and rhomboids will be exhausted, though your legs will be fresh.

You can try the deadlifts in the middle of your back routine. This will provide a little respite to your reeling lats and rhomboids, but DLs have a way of fatiguing the entire body and this can have a noticeable effect on the remainder of your back routine.

It’s not wrong to do deadlifts on back days, and it’s not wrong to do them on leg days. It’s whatever seems to work best for you. I used to do my heavy DLs on my chest days, even, as a nice diversion from hammering away at my chest, to give those muscles a little break. But it ultimately began feeling like just too much, so I moved them to leg days.

Best Pull-up Workout for Women, even Weak Ones

Here is the premier pullup workout for women—even “weak” women. As a personal trainer and fitness enthusiast, I’ve always wondered why it’s rare to see women doing pullups. But then again, it’s rare to see men doing pullups. In a crowded gym, you’ll see only a handful of men doing pullups; pullups are naturally difficult.

Pullups are a totally unnatural motion for the human body; we are not orangutans. We are natural-born runners, not body-weight pullers. Nevertheless, women can become adept at pullups. Women can learn pullups as well as any man. Women have lighter body weight to pull up.

Pullup workout for women
In order to become skilled at pullups, women must get comfortable hanging their body weight. This is very difficult for most women who aren’t even overweight, because, again, we are not orangutans.

A woman carries most body weight below her waist, and this creates something of a drag when hanging or doing pullups. Men, on the other hand, often have short legs relative to their upper body, and therefore, less drag.

Pullup workout for women: hanging
Place hands on bar and semi-hang body. Use stool if bar is too high. Semi-hang body, feet barely touching floor, for 30 seconds to get body used to pulling action. Do five, 30-second hangs once or twice a week. Over time, a woman will be able to hang completely.

Pullup workout for women: lat pull-downs
Also known as lat pull-overs, and every gym has a lat pull-down bar on a cable machine. Other versions of lat pull-down machines exist, but the bar version most closely simulates a pullup. Set weight heavy so that one can barely do 6 to 10 repetitions.

Honestly, this has to be difficult. An easy pull-weight will not prepare a woman for pullups, ever. But begin the lat routine with lighter weights to warm up muscles and joints. Do several sets.

Pullup workout for women: Gravitron or pull-assist machine
This machine helps a woman pull upwards by “removing” some body weight. If you weigh 130 and set pin at the 75-pound mark in the weight stack, your pulling-up weight will be 55 pounds. 

Most gyms have these easy to use machines. Set the assist weight, step up onto platform, grab bars overhead, and start pulling. The platform assists you.

Pullup workout for women: actual pull-ups
When you get good at doing lat pulls that are close to your body weight, try a real pullup. Don’t be discouraged if you can’t even do one. Just try it. The trying alone counts as part of the workout.

Over time, a woman will be able to complete a full pullup and try a second rep. As weeks pass, the second pullup will be completed, and the woman will be able to attempt a third pullup. Before she knows it, the hardworking woman will be knocking off pullups while the men watch in amazement!