Chest Pain, Shortness of Breath, or High Blood Pressure? When to See a Cardiologist

Heart disease is the leading cause of death in the Bronx. It is the leading cause of death in New York City. It is the leading cause of death in the United States. You have heard this statistic so many times that it has lost its ability to alarm you — and that is precisely the problem.

In the South Bronx, where rates of hypertension, diabetes, and obesity are among the highest in the state, cardiac disease does not just affect the elderly. I see patients in their thirties and forties with advanced coronary artery disease. I see patients who have been walking around with dangerously high blood pressure for years because they felt fine, had no regular provider, or could not get a cardiology referral through their plan.

I’m Dr. Priya Sharma, a board-certified cardiologist at Moses Medical Center. I trained in internal medicine at Mount Sinai Hospital and completed my cardiology fellowship at Montefiore Medical Center — both institutions that taught me to treat the communities that need cardiology most, not just the ones that can most easily access it. I speak English and Hindi, and I am currently accepting new patients.

Symptoms That Require a Cardiologist — Not Just Your PCP

Your primary care provider is your first line of defense. They manage blood pressure medications, order screening labs, and monitor risk factors over time. But certain symptoms warrant a direct referral to cardiology, and waiting months for that referral can be dangerous.

See a cardiologist promptly if you experience:

• Chest pain or pressure, especially with exertion, that resolves with rest
• Shortness of breath that is new, worsening, or occurs with minimal activity or lying flat
• Heart palpitations — a sensation of your heart racing, skipping, or pounding — that last more than a few seconds or are accompanied by dizziness
• Fainting or near-fainting spells without an obvious cause
• Swelling in your legs, ankles, or feet that is new or worsening
• Unexplained fatigue that limits your ability to do activities you previously handled easily

Go to the emergency room immediately if:

• Chest pain is severe, crushing, or radiating to your jaw, arm, or back
• You are experiencing sudden shortness of breath at rest
• You have chest pain accompanied by sweating, nausea, or lightheadedness
• You lose consciousness

A note for women: Heart disease symptoms in women are frequently more subtle. Women are more likely to experience fatigue, nausea, jaw pain, or back pain as their primary cardiac symptoms rather than the classic “elephant on your chest” presentation. If something feels wrong, trust your body.

Red Flags vs. Routine Monitoring

Not every chest twinge is a heart attack, and not every shortness of breath is heart failure. Part of a cardiologist’s job is distinguishing between benign and dangerous presentations. Here is a general framework:

Likely needs urgent evaluation:

• Symptoms triggered by physical exertion and relieved by rest (classic angina pattern)
• New-onset shortness of breath in someone with diabetes, hypertension, or smoking history
• Palpitations lasting longer than 30 seconds with associated symptoms
• Any episode of syncope (fainting) without clear cause

Appropriate for routine cardiology referral:

• Blood pressure consistently above 140/90 despite medication adjustments
• Family history of heart disease before age 55 (men) or 65 (women)
• Abnormal EKG or echocardiogram found during a routine visit
• Elevated cholesterol that has not responded to lifestyle changes or first-line medications
• Diabetes with evidence of early organ damage (protein in urine, retinal changes). Diabetic patients with cardiovascular risk should also be vigilant about wound healing — a non-healing wound in a diabetic patient can escalate rapidly.

Likely does not need cardiology (but ask your PCP):

• Brief, sharp chest pain that lasts seconds and is not associated with exertion
• Palpitations that occur rarely, last a few seconds, and are not accompanied by other symptoms
• Occasional shortness of breath clearly related to anxiety or deconditioning

When in doubt, ask. The cost of an unnecessary cardiology visit is inconvenience. The cost of a missed cardiac event is catastrophic.

What a Cardiac Workup Includes

If you come to Moses Medical Center for a cardiology evaluation, here is what a typical initial workup looks like:

1. History and physical exam. I will spend time talking with you — about your symptoms, your family history, your medications, your diet, your stress levels, and your activity. This conversation tells me more than any test.

2. Electrocardiogram (EKG). A quick, painless test that records your heart’s electrical activity. We do this in the office during your visit. It can reveal arrhythmias, evidence of prior heart attacks, and structural abnormalities.

3. Blood work. Through our on-site lab, we can run a comprehensive metabolic panel, lipid panel, BNP (a marker for heart failure), thyroid function, and HbA1c in a single visit. No separate lab appointment. No chasing down results.

4. Echocardiogram. An ultrasound of your heart that shows how well your heart chambers are pumping, whether the valves are functioning properly, and whether there is any structural disease. This is typically scheduled as a separate visit and takes about 30-45 minutes.

5. Stress testing. If your symptoms suggest coronary artery disease, I may order a stress test — either exercise-based (treadmill) or pharmacological (medication-induced) for patients who cannot exercise. This evaluates blood flow to your heart under exertion.

6. Holter or event monitoring. For intermittent palpitations or arrhythmias that do not show on a single EKG, you may wear a portable heart monitor for 24 hours to 30 days to capture the abnormal rhythm.

Not every patient needs every test. The workup is tailored to your presentation, risk factors, and what we find at each step.

Common Conditions We Manage

At Moses Medical Center, the most common cardiac conditions I see include:

• Hypertension (high blood pressure) — particularly uncontrolled hypertension requiring multi-drug regimens and close monitoring
• Coronary artery disease — narrowing of the heart’s blood vessels, managed through medications, lifestyle modification, and referral for intervention when needed
• Heart failure — a condition where the heart cannot pump efficiently, requiring careful medication management and regular follow-up
• Atrial fibrillation — an irregular heart rhythm that increases stroke risk and requires anticoagulation decisions
• Valvular heart disease — problems with heart valves that may be monitored or referred for surgical repair
• Hyperlipidemia — high cholesterol requiring statin therapy and advanced lipid management

For patients whose cardiac risk factors include obesity, our medical weight loss program uses GLP-1 medications with demonstrated cardiovascular benefits.

For conditions requiring procedures or surgery — cardiac catheterization, stenting, bypass, or valve replacement — I work closely with our hospital partners at St. Barnabas Hospital, Lincoln Medical Center, and Jacobi Medical Center. These are institutions I know and trust, and I coordinate directly with the interventional and surgical teams to ensure continuity of care.

Insurance and Access

We accept MetroPlus, Fidelis Care, Healthfirst, Amerigroup, and most other Medicaid and Medicare plans, including Medicare Advantage plans from Aetna, UnitedHealthcare, Humana, and Empire BCBS. For details on what each Medicaid plan covers and how referrals work, see our Medicaid coverage guide.

At Moses Medical Center, you do not need a separate cardiology referral to be seen — though some managed care plans require one for coverage purposes. If you are unsure, call us at (646) 741-2111 and our front desk team will verify your benefits and referral requirements before your appointment.

Do Not Wait

The Bronx has lost too many people to heart disease that was detectable and treatable. If you have symptoms, risk factors, or a family history that concerns you, do not put it off. A cardiology evaluation is not a commitment to bad news — it is a commitment to knowing where you stand and having a plan.

Book an appointment with Dr. Sharma online, call (646) 741-2111, or walk into Moses Medical Center at 871B Westchester Ave, Bronx, NY 10459. We are open weekdays 8 AM to 6 PM and Saturdays 9 AM to 2 PM.

Your heart has been working for you every second of your life. It deserves attention.