Chest Pain: Is It Ever Normal?

Chest pain can have causes that span a wide range of conditions, from minor to severe. A healthcare provider can ensure your chest pain is appropriately diagnosed and treated.

Heart disease is the No. 1 cause of death in the United States, with heart attacks striking more than 800,000 people each year. Given this fact, it’s perfectly normal to feel concerned when chest pain strikes.

The good news is most chest pain is harmless and resolves on its own. However, there are signs you should never ignore with chest pain. When in doubt, visit a healthcare provider.

The skilled team at Central Park West Physicians on New York City’s Upper West Side provides top-quality primary and internal medicine. We take a comprehensive approach to investigating and diagnosing chest pain.

While a heart attack is the first thought that comes to mind for many people who experience unexplained chest pain, there are often non-life-threatening explanations. 

Chest pain without heart involvement

Chest discomfort isn’t always a sign of heart issues. Often, it originates from unrelated conditions, including:

  • Muscle strains or bruised ribs
  • Heartburn and acid reflux symptoms
  • Gastritis
  • Respiratory conditions like asthma and bronchitis
  • Digestive issues such as gallstones or stomach ulcers
  • Psychological factors, including panic attacks
  • Lung infections like pneumonia

The nature of this pain differs from that experienced during a heart attack, but distinguishing them can be difficult if the sensation is new to you. Our team can accurately identify the root cause of your discomfort.

Heart-related chest pain

Several cardiac conditions can lead to chest pain. Here are a few common issues:

Coronary artery disease

CAD is the most common type of heart disease. It occurs when fatty deposits block coronary arteries. That causes arteries to narrow, making it more difficult for your heart to circulate blood throughout the body.


This condition involves inflammation of the heart muscles, potentially leading to arrhythmias, fatigue, and swelling in the legs, alongside chest pain. Viral infections can make myocarditis worse, causing fever and joint pain.


This condition is characterized by inflammation around the heart, often causing sharp or stabbing pain that may intensify with actions like lying down or swallowing.

Heart valve disease 

Symptoms of heart valve disease can develop slowly or progress quickly. HVD occurs when one of the heart’s valves doesn’t work properly. That can lead to symptoms like chest pain, abdominal swelling, dizziness, and irregular heartbeat.

Aortic dissection 

An aortic dissection is a rare but severe condition where the aorta’s inner layers tear, causing intense chest or back pain, shortness of breath, and even loss of consciousness. It’s an emergency situation requiring immediate medical intervention.


Angina is a consequence of arteries that are narrow or partially blocked. This type of chest pain often happens during physical activity, when the heart must increase the demand for oxygenated blood. Angina usually subsides with rest. 

When to worry about chest pain

Understanding when chest pain is a cause for concern is crucial for timely medical intervention.

Certain characteristics of chest pain are red flags you shouldn’t ignore. If the pain is sudden, severe, and accompanied by pressure or a squeezing sensation in the chest, it could signal a heart attack. 

Similarly, chest pain that radiates to other areas such as the arms, back, neck, jaw, or stomach, especially if coupled with shortness of breath, dizziness, or cold sweats, requires urgent care. These symptoms might also be accompanied by nausea or vomiting. 

Another red flag is chest pain that intensifies with physical activity or doesn’t subside with rest, as that can be a sign of serious cardiac issues.

Additionally, chest pain that’s new, different from previous heart pain (if you have a history of heart problems), or lasts longer than a few minutes should never be ignored.

That’s especially true for individuals with risk factors such as a family history of heart disease, high blood pressure, high cholesterol, diabetes, obesity, or a history of smoking. 

Getting to the root of your chest pain

Call us at our Manhattan office or request an appointment online today to get to the root of what’s causing your chest pain.

How We Can Help You Lose Weight and Sustain the Results

Millions of people struggle to lose weight every year, but the fight to keep the weight off and stay healthy is just as important. Read on to see what we can do to help you not just shed pounds, but stay slimmer and healthier.

Weight gain among Americans is a problem that has only gotten worse in recent years, with an overall obesity rate of over 20% in all 50 states as recently as 2022. As many as 17 of those states have rates as high as 35%, and in general over two-thirds of the US population are considered to be either overweight or obese. 

With the rise in weight also comes higher risks of chronic diseases that can be dangerous to your health, and losing weight is a solution to help with lowering that risk. However, the struggle of not only shedding pounds but keeping the weight off is far more challenging than it sounds, as millions of people trying to do it discover every year. 

Achieving a healthy body through weight loss is possible, and if you live in the Upper West Side of Manhattan, New York, Dr. Haleh Milani and her dedicated medical team at Central Park West Primary care and Cardiology Physicians can help.

Now let’s examine the importance of weight loss for your health, the reasons trying to lose weight can be difficult, and what we can do to both help you shed pounds and keep them off.

The importance of weight loss

When you’re overweight, you’re carrying extra fat, water, bone and muscle, and this can be the result of more than just eating fatty foods and not working out. Often your weight is affected by several issues, including metabolism, genetics, family history, and environmental factors as well as what you put into your body.

Whatever the reason for the extra weight, having it raises your chances of dealing with a variety of conditions, like hypertension, diabetes, cardiovascular disease, digestive problems, breathing problems, certain types of cancer, and gallstones. 

Often, a loss of just five percent of your body weight can help a great deal in lowering your risks of the various conditions mentioned, as well as ease up the pressure the pounds put on your bones and joints.

Why losing weight is difficult

Losing weight is not something where one solution is perfect for everyone, as a variety of factors affect your weight aside from diet and exercise. 

Difficulty sleeping, dealing with high levels of stress, lack of guidance about how to do it properly, and changes resulting from menopause or general aging can also affect weight gain. This also means that as you get older, your metabolic changes and other related issues can also make losing weight an uphill battle. 

Lifestyle choices, like desk-based jobs, inactivity, high alcohol consumption, lack of motivation, or emotional eating due to depression can play a role in weight loss regardless of age.

How we can help sustain weight loss

The important thing about losing weight and keeping it off is that the choice to start this path needs to be a long term goal. Millions of people who start a weight loss regimen and lose a few pounds tend to relapse, or rely on fad diets which are generally not sustainable. Here are some ways we can help you lose weight and stay thinner:

Start you on a customized exercise regimen

Exercise is key for burning calories and reducing weight, and getting into a routine you do daily will make a world of difference in making changes sustainable.

Start you on a sustainable, healthier diet plan

Diet is another important factor in your weight and overall health, so customizing a nutritional plan that fits your specific needs will not only give your body what it needs to function better, but to help your exercising be more impactful.

Start a weight lifting regimen

Losing weight also means losing muscle, so getting into weight training can help you maintain muscle mass while getting rid of the unhealthy fats you can do without.

Keep you hydrated

Drinking water daily can not only reduce the calories you take in; it can also increase the amount you burn during the day.

This is a lifelong journey that we can help you start on the right foot, so if you’re ready to lose weight and stay thinner and healthier, make an appointment with Dr. Milani and her team at Central Park West Primary Care and Cardiology Physicians today to get started.

What a Stress Test Can Tell You About Your Heart

Your heart is an organ you literally can’t live without. It pumps blood through your veins, arteries, and blood vessels throughout the body, and illnesses that block the arteries can lead to heart disease. Read on to find out how stress tests help.

Heart health is vital. After all, this fist-shaped organ is central to so much of how your body works. Its atria, valves, and ventricles are connected to your vast network of arteries, veins, and blood vessels to deliver oxygen, and numerous other nutrients throughout your body, pumping 2,000 gallons of blood and beating 115,000 times daily.

Heart disease is the leading cause of death among both men and women, and across most ethnic and racial demographics, with 695,000 American deaths from the disease in 2021 alone.

To determine whether you’re at risk for this illness or are struggling with the symptoms, diagnostic methods like stress tests are very helpful and can make a difference in your subsequent care. Let’s examine the benefits of this health screening by looking at how your heart works, the types of heart disease you can get, and what stress tests do to help.

If you live in the Upper West Side of Manhattan, New York, and you’re struggling with heart problems, Drs. Haleh Milani, Maria Paliou, and Elaine Kang and their dedicated medical staff at Central Park West Primary Care and Cardiology Physicians can help.

How the heart works

This cardiac organ is the center of the circulatory system, and is composed of four chambers, two upper atria, and two lower ventricles which are separated by tissue called the septum for the atria and valves for the ventricles. 

The atria are the part that receive blood (the right side takes in deoxygenated blood that goes to the lungs), and the ventricles discharge newly oxygenated blood through your body. 

Think of your heart as the major pump that pushes blood through your veins like a plumbing system, where the right amount of pressure moves everything normally so your cells can get the oxygen and nutrients they need when they need them. Heart problems are often the result of blockages or too much or too little blood pressure.

Types of heart disease

This is the general term that describes a range of issues that affect your heart’s health, which can affect different parts of the organ and how they work. Dealing with heart problems means trouble sending nutrients through your body, and the conditions that can do that include:

  • Coronary artery disease: the most common form of heart disease, this is when fatty deposits cause your heart’s blood vessels to narrow
  • Arrhythmias: another name for irregular heartbeat, whether it’s beating too fast or doesn’t have a regular beating pattern
  • Cardiomyopathy: a condition where abnormal heart muscles are unable to properly pump blood to the rest of the body
  • Pericardium: this is the term for fluid-filled sacs that can develop and surround your heart
  • Heart failure: this condition results from problems with the heart squeezing and relaxing properly
  • Congenital heart disease: this is the term for heart problems that you’ve been dealing with since birth

There’s also a number of heart valve diseases that keep blood from flowing the way it should, like valvular stenosis, valvular insufficiency, and valvular atresia.

How stress tests help to diagnose them

Also referred to as a cardiac exercise test or cardiac stress test, this is an in-office screening that places you on a treadmill or stationary cycle where your vitals are taken and are monitored while you run. Your heart needs physical activity to keep things working efficiently, and this test keeps you active while testing how your heart is working under various levels of stress. 

This method can help determine how healthy your circulatory and cardiovascular systems are, by monitoring blood oxygen levels, pulse, blood pressure, and heart rate. This way, you can confirm coronary artery disease and various other heart diseases, and even observe the progression of congestive heart failure.

Stress tests are a reliable tool to check your heart health to help formulate a plan of action for care. If you’re struggling with heart problems and you need to get screenings like stress tests to diagnose problems, make an appointment with Drs. Milani, Paliou, and Kang, and their team at Central Park West Primary Care and Cardiology Physicians today.

Why You Should Monitor Your Active Heart Rate

Physical fitness is a vital part of maintaining overall health. Keeping your heart in good shape — and specifically, keeping your active heart rate at healthy levels — is one benefit of routine exercise. Learn more about monitoring your heart rate.

Your heart works 24/7 to pump blood throughout your body via about 60,000 blood vessels, at a rate of 100,000 beats per day and one and a half gallons of blood per minute. Heart disease is the leading cause of death around the world, and lots of things we do affect how healthy our hearts are, including what we eat and how active we are.

One way to keep track of heart health is through monitoring your active heart rate. This can show how efficiently your heart is working and point to possible problems if the levels are out of normal range.

To further explore the importance of active heart rate, let’s better understand how it works, what a good baseline is, and how to maintain a healthy one.

If you live in the Upper West Side of Manhattan, New York, and you need to keep an eye on your heart health, Drs. Haleh Milani, Maria Paliou, Elaine Kang, and our dedicated team at Central Park West Primary Care and Cardiology Physicians can help.

Understanding how heart rate works

In a healthy body, the heart gives you the amount of blood you need to perform any task, and how much you’re doing at a given moment determines how fast your heart beats. 

Your heart rate, also known as your pulse, is the measure of how many times your heart beats per minute. This number varies from person to person and can change for different reasons, including age, medication use, body position, weight, and emotional state.

Determining a good baseline heart rate

The general way of measuring your pulse is by determining your resting heart rate, which in most adults should be between 60-100 beats a minute. The closer to the lower rate, the more efficient your heart is at overall cardiovascular fitness. In fact, athletes may have an even lower resting heart rate than the target mentioned — closer to the 40 beats a minute range.

Checking your pulse is the simplest way to get this information. To do so, place your index and third fingers on your neck to the side of your trachea (windpipe). To do it on your wrists, two fingers should be placed over your radial artery, between the bone and tendon on the thumb side of your wrist.

How to maintain a healthy active heart rate

Routine exercise is a highly effective way to keep your active heart rate at good levels, as it allows your heart to pump more blood and oxygen through your body. The key, however, is to not overdo it and place too high a strain on the organ. Also note the target heart rate zone will change with age. 

If the goal is to just keep the heart in good shape, moderate to vigorous aerobic activity between 3-5 days a week, or a mix of the two at least two days a week, can help a great deal in that regard. Exercises that work all of the major muscle groups will also keep the heart pumping within healthy levels.

Your active heart rate is vital to your heart’s health, and if that rate is too high or too low, you should make an appointment with our team at Central Park West Primary Care and Cardiology Physicians today.

Dr Milani is an assistant clinical professor of medicine at Columbia university Medical Center with a teaching appointment at Columbia / Cornell and Mount Sinai Hospitals in New York."
She is the Founder of Central Park Physician and has been in private practice at this location for almost 20 years .
On multiple Consecutive years she has earned numerous prestigious awards for her dedication to patient care and Quality.

We are Included in the TOP New York Doctors and Castle Connolly ,in addition to the US World News .

We continue to practice medicine in a compassionate, comprehensive manner prioritizing patient needs as our goal.

Dr Milani lives in the Upper West side with her family and is at times seen at a local restaurant enjoying a meal or riding a bicycle through the park.

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Dr. Paliou is a compassionate and patient-oriented endocrinologist assisting her patients in Central Park West Physicians’ NY office. Dr. Paliou is affiliated with the Metropolitan Hospital Center in New York City, where she serves as the chief of endocrinology. She is also an assistant professor of medicine at New York Medical College.

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Dr. Elaine Kang is board certified in Family Medicine. She graduated from New York Medical College in 2006 and she completed her residency at Beth Israel Residency in Urban Family Practice, New York, NY. Dr. Kang is a leader in the field of women's health. She completed the Physicians for Reproductive Health and Choice Leadership Training Academy to provide advocacy and leadership in the reproductive health field. In addition to her work at Early Options, she currently works in urgent care with CItyMD, in the Emergency Department at North Central Bronx and Jacobi, and provides coverage with the Institute for Family Health, precepting residents and providing healthcare for the homeless.
She has also helped with international disaster relief services in Haiti and for hurricane Katrina in New Orleans. She is currently on the Public Health Commission for the New York State Academy of Family Physicians(NYSAFP) and co-leader of the the New York County Chapter of NYSAFP.

Dr. Kang provides full scope family medicine services throughout new york - including contraception, routine well woman exam and primary care for all ages and genders.

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