Asim Hameedi, MD

10/05/2026

The Legs Can Tell Us a Lot About the Heart ❤️

Peripheral artery disease (PAD) is sometimes thought of as simply a circulation problem in the legs. In reality, it is a manifestation of systemic atherosclerosis and an important marker of overall cardiovascular risk.

Patients may notice calf, thigh, or buttock discomfort while walking that improves with rest—a classic symptom known as intermittent claudication. Others may have significant disease with surprisingly few symptoms.

One of the simplest tests we have is the ankle-brachial index (ABI), which compares blood pressure at the ankle with blood pressure in the arm. An abnormal ABI can identify lower-extremity arterial disease and help determine its severity.

Why does this matter to a cardiologist?

Because atherosclerosis rarely respects anatomical boundaries. A patient with PAD may also have increased risk for coronary artery disease and stroke.

Treatment therefore goes beyond improving circulation in the legs. It includes aggressive attention to:

• Cholesterol
• Blood pressure
• Diabetes
• Smoking cessation
• Regular physical activity
• Appropriate antiplatelet and vascular-protective therapy when indicated

PAD is not just a leg problem—it is a cardiovascular warning sign.

Asim Hameedi, MD, FACC, CBNC
Cardiovascular Medicine
Queens Medical Health Wellness P.C.

09/28/2026

❤️ Heart Disease Often Begins Long Before You Feel It

One of the biggest misconceptions about cardiovascular disease is that if you feel well, your heart must be healthy.

Unfortunately, high blood pressure, high cholesterol, diabetes, and atherosclerosis can progress quietly for years before causing symptoms.

As a cardiologist, I believe some of the most important steps we can take happen before chest pain ever begins:

• Know your blood pressure.
• Know your cholesterol and blood sugar.
• Pay attention to your family history.
• Reduce excess sodium and highly processed foods.
• Make vegetables, fruits, legumes, whole foods, and fish a regular part of your diet.
• Stay physically active and avoid sitting for prolonged periods. Even a short walk after meals is a good habit.
• Make adequate sleep and stress management part of cardiovascular prevention.
• Don't wait for symptoms before discussing your cardiovascular risk with your physician.

A heart attack can happen in minutes, but the atherosclerotic process behind many heart attacks develops over many years.

Prevention is not one dramatic change. It is the accumulation of better decisions made consistently over time.

Asim Hameedi, MD, MS, CBNC
Cardiovascular Medicine

09/28/2026

❤️ A Normal Ejection Fraction Doesn’t Always Mean a Completely Normal Heart

Many patients are reassured when they hear, “Your heart’s ejection fraction is normal.” And while that is certainly good news, ejection fraction is only one measure of heart function.

Modern echocardiography can also measure something called Global Longitudinal Strain (GLS). This allows cardiologists to evaluate how well the heart muscle itself is contracting and may reveal subtle abnormalities even when the ejection fraction is still normal.

GLS can be particularly helpful when evaluating conditions such as hypertrophic cardiomyopathy, cardiac amyloidosis, and other diseases affecting the heart muscle.

The important message for patients is simple:

A normal ejection fraction is reassuring—but understanding heart health sometimes requires looking beyond a single number.

Regular cardiovascular evaluation, especially for people with symptoms or significant risk factors, can help identify heart disease earlier and guide appropriate treatment.

Asim Hameedi, MD, MS, MBA, CBNC
Cardiovascular Medicine

09/22/2026

The Cholesterol Test Many Patients Have Never Had: Lipoprotein(a)

We routinely check LDL cholesterol, but there is another cardiovascular risk marker that deserves more attention: Lipoprotein(a), or Lp(a).

Unlike LDL cholesterol, Lp(a) is largely determined by genetics and is relatively unaffected by diet and exercise. An elevated level can help identify cardiovascular risk that may not be apparent from a routine lipid panel.

The 2026 dyslipidemia guidelines recommend measuring Lp(a) at least once to identify individuals at increased risk for atherosclerotic cardiovascular disease.

Why does this matter?

A patient may exercise regularly, have a reasonable LDL level, and still have significant inherited cardiovascular risk. Knowing that Lp(a) is elevated can influence how aggressively we address the risk factors we can modify—particularly LDL cholesterol, blood pressure, diabetes, smoking, weight, and physical activity.

One of the most important lessons in preventive cardiology is that a “normal” standard lipid panel does not always tell the entire story.

Prevention begins with understanding risk before the first cardiovascular event occurs.

Have you ever had your Lp(a) checked?

09/16/2026

Should CABG Quality Be Measured Beyond 30-Day Outcomes?

When we evaluate outcomes after coronary artery bypass grafting (CABG), much of our quality reporting appropriately focuses on operative/30-day mortality and major perioperative complications.

These are essential measures. But are they enough?

The fundamental purpose of CABG is not simply for the patient to survive the operation. It is to achieve effective and durable myocardial revascularization.

That raises an important question:

Should graft patency become a more prominent longitudinal quality metric after CABG?

A patient can have an uncomplicated operation, leave the hospital, and still experience early graft failure without that event necessarily appearing in traditional surgical quality metrics.

In interventional cardiology, we routinely examine outcomes such as stent thrombosis, restenosis, target-lesion failure, target-vessel revascularization, MI, and repeat revascularization. Perhaps CABG quality assessment should similarly place greater emphasis on the durability of the revascularization itself.

Routine invasive angiography at 3, 6, and 12 months would clearly be impractical and difficult to justify in asymptomatic patients. But with modern coronary CT angiography (CCTA), could graft patency at a standardized interval—perhaps 12 months—be incorporated into prospective registries or representative surveillance cohorts?

Any such measure would require careful risk adjustment. Patency depends on much more than surgical technique: conduit type, target-vessel size and stenosis, competitive flow, distal runoff, diabetes, smoking, lipid control, antiplatelet adherence, and progression of native coronary disease all matter.

Still, I believe the question is worth asking.

Operative mortality tells us whether the patient survived the procedure.
Long-term graft patency helps tell us whether the revascularization remained successful.

Perhaps the next generation of CABG quality measurement should incorporate both.

I would be interested to hear the perspectives of cardiac surgeons, interventional cardiologists, imagers, and outcomes researchers:

Should risk-adjusted graft patency at 6 or 12 months become part of how we assess the quality and durability of CABG?

09/15/2026

**Cardiovascular prevention should begin before the first cardiovascular event.**

One of the most important messages from the 2026 dyslipidemia guidelines is a shift toward identifying cardiovascular risk earlier and treating it more precisely.

We now have better tools to look beyond a single cholesterol number.

The updated approach includes:

• Assessing both 10-year and 30-year cardiovascular risk with the PREVENT equations beginning at age 30
• Measuring lipoprotein(a), or Lp(a), at least once in a lifetime
• Using coronary artery calcium selectively when the decision about treatment remains uncertain
• Considering ApoB in appropriate patients
• Returning to specific LDL-C goals based on cardiovascular risk

For patients at very high risk for ASCVD, the LDL-C goal is **

09/10/2026

09/10/2026

❤️ **High blood pressure often causes no symptoms—but the heart still feels the effects.**

Hypertension is one of the most important modifiable risk factors for cardiovascular disease. Over time, uncontrolled blood pressure can contribute to:

• Left ventricular hypertrophy
• Heart failure
• Atrial fibrillation
• Coronary artery disease and heart attack
• Stroke
• Chronic kidney disease

One of the challenges in clinical practice is that patients may feel completely well even when their blood pressure is significantly elevated.

That is why knowing your numbers matters.

For many patients, home blood pressure monitoring can provide valuable information beyond a single office reading. Proper technique is important: sit quietly for several minutes, keep your feet on the floor and your arm supported, and use a validated upper-arm blood pressure monitor.

**Hypertension is often silent. Prevention should not be.**

09/01/2026

A Wound on Your Foot That Won’t Heal Could Be a Circulation Problem

A sore or ulcer on the foot that does not heal should not be ignored—especially in people with diabetes, high blood pressure, high cholesterol, or a history of smoking.

One possible cause is peripheral artery disease (PAD), a condition in which narrowed or blocked arteries reduce blood flow to the legs and feet.

Warning signs can include:

• Leg or calf pain when walking
• A foot that feels colder than the other
• Sores on the toes or feet that heal slowly
• Changes in skin color
• Weak or absent pulses in the feet
• Pain in the foot, particularly at rest

When circulation becomes severely reduced, it can progress to chronic limb-threatening ischemia, which puts the foot and leg at risk.

The good news is that early diagnosis and treatment—including medications, risk-factor control and, when necessary, procedures to restore blood flow—can help heal wounds and prevent amputation.

If you have diabetes or vascular disease, check your feet regularly. A wound that isn't healing deserves medical attention.