Dr. Aseem Desai

12/04/2025

Most Heart Rate Spikes Are Stress, Not Danger. Here’s How to Tell the Difference.

“Take your own pulse first.” It’s one of the earliest lessons I learned in training.

Before reacting to a monitor, a number, or an alert, pause long enough to feel your own heartbeat. That moment of orientation often tells you more than the data in front of you.

One of the most common questions I hear today is:
“My watch said my heart rate was high. Should I be worried?”

Wearables are helpful, but they don’t provide context. And most of the heart-rate spikes people see are stress responses, not signs of heart disease.

Here’s a simple 5-check framework I share to help people understand what their body may be doing in real time.
(Not medical advice. Just practical guidance.)

1. Context
Stress, rushing, standing up fast, caffeine, dehydration, or even late-night scrolling can raise the pulse more than people expect.

2. Pulse Quality
Strong or weak. Steady or jumpy.
A strong, fast pulse often reflects stress.
A weak or thready one deserves closer attention.

3. Pattern
A gradual rise usually points to stress.
A sudden start-and-stop pattern is more characteristic of arrhythmias.

4. Reset
One slow breath.
A sip of water.
Recheck in 2–3 minutes.

5. Baseline
Your lived “normal” matters far more than a single HRV score.

Your heart communicates through patterns, timing, and sensation; not just numbers.
Understanding those signals begins with a simple rule: take your own pulse first.

If this resonates, I write weekly about pulse, stress, and how to understand your body’s early signals. Happy to connect or share more.

12/04/2025

Take your own pulse first.
It’s one of the first things I learned in medicine. Before reacting to a number or an alert, pause long enough to feel your heartbeat. Your body gives you information your wearable can’t.

One of the questions I hear most often is:
“My watch said my heart rate was high. Should I be worried?”

The truth: most spikes are the nervous system responding to stress, not the heart signaling danger.

Here’s a simple 5-check guide to help you understand what’s happening in the moment.
(Not medical advice. Just practical orientation.)

1. Context
Stress, rushing, standing up fast, caffeine, dehydration, late-night scrolling… all can raise the pulse more than people expect.

2. Pulse Quality
Strong or weak. Steady or jumpy.
A strong, fast pulse usually reflects stress.
A weak or thready one deserves attention.

3. Pattern
Gradual rise = stress response.
Sudden start/stop = more like an arrhythmia pattern.

4. Reset
One slow breath.
Small sip of water.
Recheck in 2–3 minutes.

5. Baseline
Your “normal” matters more than your HRV score.

Your heart speaks in patterns, not just numbers.
Understanding it starts with taking your own pulse first.

If this helps you, save it for later or share it with someone who gets anxious when their watch spikes. For deeper tools and stories on how to read your body’s signals, my Pulse newsletter is in the link in my bio.

https://open.substack.com/pub/draseemdesai/p/take-your-own-pulse-first-13d?r=2tftra&utm_medium=ios

A simple 5-check guide to understand a high heart rate in context.

11/04/2025

🎶 The Weekly Pulse • One Track • One Truth • One Tool

Topic: The Pulse of Letting Go — how release restores rhythm

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🎵 Track: Let It Be – The Beatles
“And when the broken-hearted people living in the world agree, there will be an answer, let it be.”

The melody rises like a slow exhale — soft, surrendering, but steady.

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🫀 Story:
Last week a patient named Maria came in with a heart that had been racing for months. The monitor showed sinus tachycardia, nothing dangerous. “I can’t find the off switch,” she said. Her father had passed away recently, and she’d been holding herself together for everyone else. When she finally started talking about him, her pulse slowed on the monitor in real time.

Sometimes, the heart doesn’t need more effort. It needs permission to rest.

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🧠 Science:
Chronic stress keeps the sympathetic nervous system switched on. Elevated adrenaline shortens the heart’s refractory period, increases premature beats, and lowers heart rate variability. Studies show that emotional suppression — the inability to “let go” — keeps cortisol high and HRV low. Allowing emotion, through expression or tears, reactivates the parasympathetic system and restores balance.

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📜 Wisdom:
In Buddhism, clinging is the root of suffering. The Stoics taught amor fati — love your fate, release what you can’t control. The Bhagavad Gita reminds us to act without attachment to results. Each tradition points to the same truth: peace is a rhythm restored, not forced.

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🧘‍♀️ Tool:
Try this tonight:
1. Place two fingers on your wrist and feel your pulse.
2. Inhale through your nose for four counts.
3. Exhale for six.
4. With each breath out, silently say: Let it be.

Notice how the pulse softens. The body hears what the mind is finally willing to say.

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💭 Reflection:
The next time you feel your heart race trying to hold everything together, pause. Sometimes the first beat of healing is not control — it’s release.

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🫶 Want more?
If this resonated, you can read more Pulse essays at draseemdesai.substack.com.
Each week I share real stories, science, and strategies from both sides of the stethoscope — helping you harness your heartbeat to find calm, clarity, and connection.

10/30/2025

🫀 The Hidden Link Between Your Heart, Brain, and Gut

🎙️ Reboot with Dr. Arasi Maran

It was a joy to join my colleague and friend, Dr. Arasi Maran, interventional cardiologist and host of Reboot, to explore how the heart, brain, and gut communicate through the autonomic nervous system—and what that means for stress, focus, and connection.

💡 Key takeaways:
• Your heartbeat reflects your inner state long before your mind catches up. Palpitations, gut tension, or brain fog are often early signals from your nervous system, not random symptoms.
• The vagus nerve connects the three “brains”—heart, brain, and gut—regulating heart rate variability (HRV), a key measure of resilience and emotional balance.
• Energy drinks, caffeine, dehydration, and poor sleep all push this system toward overload. Awareness is the first antidote.
• Wearables are tools, not judges. Look for patterns, not perfection, and always correlate the data with what you feel.
• When stress hits, take your own pulse first. That pause steadies the breath, clears the mind, and helps shift your body out of fight-or-flight.

❤️‍🔥 My upcoming book, Pulse: Harness Your Heartbeat to Relieve Stress, Improve Focus, and Strengthen Relationships, expands on this idea—showing how subtle changes in your heart’s rhythm, rate, and variability can help regulate your nervous system, calm stress responses, sharpen focus, and strengthen emotional connection.

🎥 Watch the full episode here: https://youtu.be/p-FFyER06nM?si=fk-WY_HpAI57APVY

🎧 Listen to the podcast here: https://podcasts.apple.com/us/podcast/reboot-with-dr-arasi-maran/id1736143730?i=1000731653552

👉 Follow and for more evidence-based tools to live a healthy and heart centered life.

Podcast Episode · Reboot with Dr. Arasi Maran · 10/13/2025 · 51m

10/28/2025

🫀 The Pulse of Interdependence

What medicine—and life—teach us about shared rhythm.

The call came from one of my partners.
“Aseem, Laura’s in the ER. Her heart rate’s over two hundred. We’ve tried everything.”

By the time I arrived, she was conscious but slipping. Her EKG showed ventricular tachycardia—the same rhythm that took my father’s life years ago.

Within minutes, a team formed around her. The nurse, anesthesiologist, pharmacist, respiratory therapist—each person anticipating the next move. When her heartbeat finally steadied, the room exhaled together.

That’s what interdependence looks like in medicine.
Every role distinct, yet completely connected.

We talk often about leadership, expertise, and independence. But in the most critical moments, survival depends on something else: our ability to synchronize.

Interdependence isn’t just a value. It’s biology.

Every beat of the heart depends on timing between electrical, neural, and muscular systems. The nervous system balances acceleration with rest. When communication breaks down—inside the body or within a team—rhythm falters.

The same principle holds in every field: aviation, education, business, even family life. Systems thrive when connection replaces control.

Ancient traditions knew this long before medicine could measure it.
Marcus Aurelius wrote, “What harms the hive harms the bee.”
Buddhism calls it pratītyasamutpāda—dependent origination.
Vedanta teaches that awareness flows through all beings as one pulse.

No one heals alone.
Every pulse depends on another.

Take a moment today to notice yours.
Slow your breath.
Feel the rhythm that connects you to everyone and everything around you.

Read the full essay here:
👉 The Pulse of Interdependence

How the body, mind, and society depend on the rhythm we share

08/26/2025

The Pulse of Uncertainty
How to reset your body when your brain is stuck in limbo

“I’ll be sitting at my desk and feel a pause.
Like my heart forgets what to do.”

Brian’s heart was structurally fine.
But his nervous system wasn’t.

Two months of job uncertainty had taken a toll.
He was stuck in a loop of what-ifs, and his body was looping too.

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🧠 Science

Uncertainty activates the brain’s threat centers (amygdala, insula), while exhausting the prefrontal cortex, the part that helps us stay calm and focused.
The result?
• Racing heart
• Skipped beats
• Shallow breath
• Sleeplessness
The body braces, even if nothing’s “happened.”

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📿 Wisdom

“We suffer more often in imagination than in reality.” — Seneca
Ancient traditions knew this pain.
The Stoics called it training.
The Buddhists called it impermanence.
Vedanta called it a fog.
They all pointed to the same thing:
When you can’t control the future, return to the present.

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🛠 Strategy: The Open Loop Reset
1. Name what’s unresolved.
2. Notice how your body is reacting.
3. Take one small action.
4. Close a different loop: give your body something it can complete.

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Uncertainty doesn’t always scream.
Sometimes, it skips a beat.

▶️ Read the full post: “The Pulse of Uncertainty”
(link in bio)

08/26/2025

08/21/2025

🫀 New on Pulse

Loneliness doesn’t just hurt. It shows up in the body. Rising heart rate. Restless sleep. Stress that won’t let go.

This week’s essay, The Pulse of Relationships, looks at how connection heals and why disconnection takes such a toll.

💡 A reminder: the relationships that steady us are as vital as the heartbeat itself.

👉 Read the full piece at the link in bio

08/21/2025

🫀 New on Pulse

Loneliness doesn’t just hurt. It shows up in the body. Rising heart rate. Restless sleep. Stress that won’t let go.

This week’s essay, The Pulse of Relationships, looks at how connection heals and why disconnection takes such a toll.

💡 A reminder: the relationships that steady us are as vital as the heartbeat itself.

👉 Read the full piece here:

Loneliness, the Heart, and the Cost of Silence

07/31/2025

How do you consume social media: for connection, curiosity, or clicks?

In neuroscience, unexpected rewards cause the biggest dopamine spikes.
In the ICU, dopamine is delivered as a drip—to support the heart 🫀and kindeys without overwhelming them.

Maybe our brains 🧠 need the same.
A steady rhythm, not a chaotic rush.

Read 📚: The Pulse of Dopamine

Subscribe to the Pulse newsletter on Substack. Stories, science, and strategies to help you live in rhythm—one beat at a time.

Rewiring Reward for a Steady Life Rhythm

07/29/2025

Twenty years ago, I moved from Chicago to Orange County to join the medical staff at Mission Hospital and Mission Internal Medical Group— now Providence health system Mission Hospital and Mission Heritage Medical Group.

While titles, systems, and technologies have changed, one thing has remained constant: the people.

From the nurses and advanced practice providers to the hospital and office staff, and my physician colleagues across departments—this is a place where clinical excellence is matched by compassion and teamwork. It’s a powerhouse of talent within a small-town atmosphere, and it’s been a privilege to be part of it.

In heart care, and in all of health care, there’s no such thing as “just another day.” Every interaction has the potential to change a life. The people here show up every day with that awareness—and with heart.

Thank you to all who make this mission real.

Leading innovation, delivering with compassion.

07/24/2025

Heart disease remains a top cause of not only mortality but morbidity related to hospitalizations and reduced quality of life. Thank you to Providence health system for supporting top-notch cardiovascular care.