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Can Nuclear Stress Tests Miss Severe Coronary Artery Disease?

Feb 24, 2011

Nuclear stress tests can miss severe coronary artery disease; former president Bill Clinton’s nuclear stress tests were normal, five years running, completely missing the severe coronary artery disease that eventually required quadruple bypass surgery.

Yes, nuclear stress tests can miss severe coronary artery disease. I consulted with cardiologist Dr. Steven Shayani, Medical Director of Outpatient Services for Mount Sinai Hospital and Long Island Heart Associates.

Dr. Shayani explains, “Nuclear stress tests may show normal perfusion even if there are multiple blockages, because this type of imaging modality looks at the relative changes/differences in myocardial perfusion.” (Perfusion means flow of blood through vessels.)

“If there are multiple obstructions in the arteries,” continues Dr. Shayani, “The overall image of the heart may appear to be normal — the obstructions appear to be a normal part of the heart. Therefore, the defects may not be detected. It is when one part of the heart is normal and another part is obstructed that the images will allow the clinician to clearly see a defect.”

Nuclear stress tests measure perfusion (flow of blood through the heart) while the heart is at rest, and while it is stressed. A commonly known form of nuclear stress test involves walking on a treadmill. While the patient walks, images of his heart are studied to see if impaired perfusion is detected (a contrast dye is used to make the blood vessels more visible). Sometimes a stationary bike is used.

A nuclear stress test may also be done with a pharmaceutical agent that taxes the heart. Images of the heart are taken while at rest, and under stress.

In the case of former president Bill Clinton, his exams indicated a normal heart, but ultimately, his nuclear stress tests missed what turned out to be severe coronary artery disease. This is truly scary, because one would think that of all people, a former U.S. president would have the best health care! This should include preventive, not just mitigating.

Though the former president’s quadruple bypass was a success (Sept. 2004), this in no way downplays the failure of his medical team for relying upon only nuclear stress tests, which proved to miss significant disease in the coronary arteries.

Does this mean that for coronary heart disease screening, you should skip the nuclear stress tests and jump right into a CT calcium score test or CT angiogram ? It is best to discuss options, including blood tests , with your cardiologist. He will need accurate information about your lifestyle habits and family history of heart disease.

Though nuclear stress tests can, indeed, reveal coronary artery disease, these kinds of exams can miss severe coronary artery disease; after all, look what happened with a former U.S. president.

For the original story, click here.

The Mount Sinai Medical Center and Long Island Heart Associates Launch New Program for Diabetes and Heart Disease Patients

February 9, 2011

(New York, NY) – The Mount Sinai Hospital and Long Island Heart Associates have developed a new service for its patients on Long Island. The Diabetes and Cardiovascular Care Partnership is a new innovative service launched by The Mount Sinai Hospital with Long Island Heart Associates, one of its affiliate locations, in order to assist in managing patient care for those with diabetes and heart disease. With close to two million New Yorkers diagnosed with diabetes and the inherent relationship to heart disease, this new program provides Long Island residents a location for quality care without having to travel far to receive it.

This program, located in Mineola, ensures that patients are meeting the American Diabetes Association standards of care in order to minimize risks from diabetes. Doctors, educators, and coordinators work together to ensure proper diabetes care and education is accomplished. Patients in the program are screened for an eye examination, podiatric attention, wound development and healing, chronic kidney disease classification and cardiovascular care. The patient will be referred for specific care contingent upon the priority which is established during the assessment. Each person will have a specific plan and any barriers such as misinformation/cultural difference, inability to obtain medication or testing supplies, or dealing with depression will be addressed. Throughout the entire process it is important to note that the patient remains a patient of the primary care physician.

Additional information as well as interviews are available with qualified physicians from Mount Sinai and Long Island Heart Associates and Certified Diabetes Educators along with patients in the program.

For the full story, click here.

Finally – A Better Butter

Physicians say Butterfi has health benefits for those watching their diet

January 21, 2011

If you’ve been told to watch your butter intake and eat margarine instead, physicians say you now have a better option.

Butterfi, which is real butter made with organic inulin fiber, reduces the calories, cholesterol, fat and salt normally found in butter by a whopping 35 percent.

“You also get three grams of soluble fiber in every serving as well as reducing the things that tend to give butter a bad reputation,” says Kelly Cox, Butterfi inventor, and resident of Cloverdale.

Cox’s company, Think Nutrition, makes Butterfi with real cream, inulin and kosher salt. It comes in 8 oz. tubs with a picture of a rare blue butterfly on the label as well as a statement to eat butter responsibly.

“People have heard about the detriments of butter, but they’ve also heard about the detriments of margarine, so I wanted to provide an alternative which is healthy,”  said Cox.

Steven Shayani, M.D. F.A.C.C., cardiologist, believes that Butterfi is beneficial for a heart-healthy lifestyle. He is founder of New York Heart Research Foundation and director of the Long Island Heart Associates, and Outpatient Services at Mt. Sinai Hospital in New York.

“We always advise our patients to live a heart-healthy lifestyle,” said Shayani.  “Butterfi is lower in calories, lower in sodium, and higher in fiber than margerine and regular butter, so this is a great alternative for health concious people.”

Frank Barnhill, M.D., family physician and author of Mistaken for ADHD, agrees, and talks about one additional benefit — the safety for diabetics.

“Butterfi does not cause increases in blood sugar and triglycerides (blood fat levels) making it a consideration in both low fat and diabetic diets,” Barnhill said.

“Butterfi not only provides the real taste of butter, but does so with a significant reduction in total calories, sugar calories and fat grams along with a healthy dose of fiber and a subtle sweetness.

“These latter benefits are from inulin, which are also been shown to improve calcium and magnesium absorption and promote the growth of beneficial intestinal bacterial in ways similar to probiotics,” continued Barnhill.

“All in all, Butterfi should be considered a healthy, better tasting alternative to butter and butter substitutes,” Barnhill noted.

Chefs in the area are using Butterfi too. “We serve Butterfi on our tables, and customer’s rave about the taste so much we can’t keep in stock in our store,” says Lisa Hemingway of Fresh Restaurant in Santa Rosa. “When I use it on vegetables, it’s literally dreamy.”

Butterfi is considered a functional food with medicinal properties, just like iodized salt, and Cox is no stranger to functional food.

The son of the man who invented Ultra Rice, a fortified rice which sustains life in developing nations, Cox grew up around parents who worked tirelessly to create better and healthier foods from existing foods.

Cox’s father ultimately gave the patents he had on Ultra Rice to the world community, and the Bill and Melinda Gates Foundation donated $10 million to sustain those in developing nations with Ultra Rice, which has Vitamins A and D.

Cox himself has three patents, including the one on Butterfi, another for the new whipping cream he’s coming out with, as well as the cream for coffee.

“The whipping cream whips twice as fast as regular whipping cream, is real cream and holds the peaks twice as long, which I know will make all cooks happy,” said Cox. The cream also has one-half the fat and calories of regular whipping cream.

Butterfi is in the national distribution chain at Whole Foods, locally at Shelton’s Market, Andronico’s, Molsberry’s and about 10 other markets in Marin and Sonoma counties.

“I use Butterfi and it’s the best tasting butter I’ve ever had,” said Bonnie Shelton, co-owner of Shelton’s Market in Healdsburg.

If you’re on the fence at all between margarine and Butterfi, there is one final benefit – no trans fats.

The trans fat in margarines is actually harmful to your health, and consumers may not be aware that companies who claim “zero trans fats” on their margarine labels are actually able to put .5 grams trans fat per serving into their margarines, according to the website.

The Mayo Clinic website says that any trans fat delivers a double barreled whammy to your cholesterol level, simultaneously reducing the good cholesterol (HDL) and raising the bad cholesterol (LDL).

Butterfi has been on the market about a year and a half, thanks to investor Cheryl Amos, President of Think Nutrition.  The company has a North Bay plant in Petaluma which makes Butterfi in four favors – regular butter, cinnamon, garlic and chocolate.

“Butter has been made in the same way for 4,000 years,” said Cox. “I learned how to take a food and make it better because of what I was surrounded by growing up. I knew I could come up with a product that was still butter, but healthier and more tasty.”

For the original story, click here.

Dr. Steven Zeldis Is Listed Again as One of Long Islands Top Cardiologists

June 30, 2010

(Mineola, NY) As the Director of Cardiac Imaging at Long Island Heart Associates a clinical affiliate of The Mount Sinai Medical Center in Manhattan, Dr. Zeldis continues to provide innovative clinical advances on Long Island. As the former Chief of Cardiology and Director of Continuing Medical Education at Winthrop University Hospital, Dr. Steven Zeldis has been practicing medicine for over 35 years and continues to be named among the Top Cardiologists of Long Island.

Long Island Heart Associates (LIHA) was founded by Steven Shayani, M.D., F.A.C.C. and has served Nassau County and the Long Island and Queens area since 1994. LIHA was the first private cardiology practice on the East Coast with the GE Ultrafast Cardiac CT Imaging machine. “Dr. Zeldis’ medical expertise has helped us increase the awareness of CT Imaging as a key tool in the prevention and diagnosis of cardiac disease,” stated Dr. Steven Shayani, Medical Director of Long Island Heart Associates.

The treatment and diagnosis provided by Dr. Zeldis is unprecedented and includes the use of the most modern medical technology. Dr. Zeldis stated, “I am proud to be able to offer patients the latest advances in cardiology, and preventative care which improves our patients’ well being.” A graduate of Yale Medical School and the University of Pennsylvania, Dr. Zeldis has developed a state of the art diagnostic facility in echocardiography and cardiovascular CT. Results of which help cardiologists provide outstanding cardiology care. Dr. Zeldis sees cardiology patients at the Long Island Heart Associates location in Mineola, New York.

For the full story, click here.

Light the Night Walk

The Long Island Heart Associates and the New York Heart Research Foundation to Participate in the Leukemia & Lymphoma Society “Light the Night Walk” at Eisenhower Park

October 16, 2009

(Mineola, N.Y.)- Today, Long Island Heart Associates and the New York Heart Research Foundation will participate in the annual “Light the Night Walk” for the Leukemia & Lymphoma Society Melville Chapter.  The walk will take place at Eisenhower Park, East Meadow, NY on October 16, 2009 from 5:30 p.m. -8:30 p.m. (registration begins at 5:30 p.m. and the walk will commence at 7:30 p.m.).  The fundraiser is a patient focused event in which participants walk during the night holding lighted red and white balloons.  The red balloons represent supporters and the white balloons represent survivors.  Long Island Heart Associates and the New York Heart Research Foundation is lending their support to those who are suffering with Leukemia and/or Lymphoma.

“As one of the largest most influential cardiology groups on Long Island, we are proud to participate in events such as this that give back to the members of our community,” stated Dr. Steven Shayani, Medical Director at Long Island Heart Associates.  “As a fellow non-for-profit specializing in cardiac clinical trials, it is especially important that we lend a hand to organizations that are making the strides that we are,” stated Patty Hodnette Research Coordinator at the New York Heart Research Foundation.

For the full story, click here.

Mount Sinai Medical Center partners with Long Island Heart Associates to open new cardiovascular center on Long Island

September 11, 2009

The Mount Sinai Medical Center has joined with Long Island Heart Associates in an affiliation agreement that will bring world-class clinical and surgical cardiovascular care to patients on Long Island.

“The clinical and diagnostic expertise at Long Island Heart Associates made it an ideal match for our cardiovascular center of excellence, Mount Sinai Heart,” said Wayne E. Keathley, President and Chief Operating Officer of The Mount Sinai Hospital. “Together we will offer patients on Long Island the most advanced and innovative therapies for heart disease available today.”

The new affiliation will streamline services for patients, who will gain access to world-renowned heart specialists and the most modern screening and imaging centers without the hassle of making appointments or waiting for them.

“The seamless communication and coordination of services between the two organizations will translate into quicker access to renowned physicians, faster test results, and a more satisfying experience for patients,” said Mr. Keathley.

Long Island Heart Associates has served the area since 1994 and currently has nine physicians in six locations in Long Island and Queens. It offers patients state-of-the-art diagnostic care, an on-site nuclear lab, 24-hour pre-operative clearance, a hotel-style sleep lab, and the resources of the New York Heart Research Foundation.

Mount Sinai Heart, one of the nation’s leading centers for cardiac research and clinical care, will appoint a representative to Long Island Heart Associates offices to meet with patients and coordinate their care at Mount Sinai. A Mount Sinai cardiologist will also consult with patients at Long Island Heart Associates offices on a regular basis. Transportation will be provided to and from Mount Sinai’s Manhattan campus for patients undergoing certain procedures.

“Long Island Heart Associates is now affiliated with the best academic medical center in New York City,” said Steven Shayani, MD, Medical Director of Long Island Heart Associates. “Our patients have access to the latest and most advanced cardiovascular research, education and treatment. By complementing our resources with Mount Sinai’s, we are truly providing our Long Island patients with the very best care available anywhere in the world.”

For the original story, click here.

News Medical

The Mount Sinai Medical Center has joined with Long Island Heart Associates in an affiliation agreement that will bring world-class clinical and surgical cardiovascular care to patients on Long Island.


Long Island Heart Associates’ Dr. Steven Zeldis receives the distinguished honor of being listed as one of Long Island’s top cardiologists.

associated content

Long Island Heart Associates’ Medical Director, Dr. Steven Shayani, talks about why nuclear stress tests may not always detect coronary artery disease.


Dr. Steven Shayani of Long Island Heart Associates discusses the heart health benefits of Butterfi, a new type of butter with less calories, cholesterol, salt and fat than normal butter.