PATIENT RESOURCES
HEART CONDITIONS: YOUR SYMPTOMS & YOUR TREATMENT
Many heart conditions can be investigated and are successfully treated. We offer a number of highly specialised and patient-specific diagnostic tests to investigate a wide range of heart symptoms. We will guide you on what is the most appropriate test for you and what information we get from it to make an accurate diagnosis and offer the best possible treatment. We will talk you through the results of each investigation and what it means in terms of your heart function and its health. Some of the tests will give complimentary information on the state of your heart. We will use this information to give you further advice on how to maintain a healthy heart. Once you have your consultation you will be informed of the test(s) required to investigate your symptoms. We will arrange many of the tests quickly in the shortest possible time so that you can carry on with your life as normal.
Chest pain
Angina is often described as a heaviness or tightness in the chest, and this may spread to the arms, neck, jaw, back or stomach as well. You may experience severe tightness, while others say it’s more of a dull ache. This can be associated with shortness of breath too. Angina is often caused by narrowing of the coronary arteries and is treatable condition. However If not treated it can lead to a heart attack.
What tests do I need?
We will talk to you about your condition and perform a clinical examination. We then may recommend the following initial tests:
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Blood tests-including cholesterol level
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
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Functional test (e.g excercise test or stress echo)
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Cardiac CT scan
Further tests may be necessary depending on the initial test results. These may include:
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Coronary angiogram
What treatment do I need?
We will start you on tablets to reduce your risk of developing a heart attack. Futher treatment may include:
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coronary stent(s) (angioplasty)
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Bypass surgery
Shortness of breath (Breathlessness)
Breathlessness can be a symptom of heart disease. Common, treatable heart conditions such as coronary heart disease (the cause of heart attacks), heart valve disease, heart failure and abnormal heart rhythms like atrial fibrillation can all cause breathlessness. It's also one of the most common reasons people call 999 for an ambulance.
What tests do I need?
We will talk to you about your condition and perform a clinical examination. We then may recommend the following initial tests:
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Blood tests
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
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Chest X-ray
Further tests may be necessary depending on the initial test results. These may include:
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24/48 hour ECG monitoring
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Coronary angiogram
What treatment do I need?
The treatment you may need depends very much on the cause of your breathlessness and this could include:
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Tablets
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Life style changes
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Coronary angioplasty
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Surgery
High Blood Pressure (Hypertension)
High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes. Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body. The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They're both measured in millimetres of mercury (mmHg).
Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:
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It's not always clear what causes high blood pressure, but certain things can increase your risk.
What tests do I need?
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Blood and urine tests
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
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24 hour blood pressure monitor
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Ultrasound scan of the kidneys
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Further tests may be necessary depending on the initial test results. These may include:
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MRI scan of the adrenal glands, kidneys and heart
What treatment do I need?
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You may not need treatment initially, but we will try life style changes if your blood pressure is not too high
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Tablets
The following lifestyle changes can help prevent and lower high blood pressure:
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reduce the amount of salt you eat and have a generally healthy diet
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cut back on alcohol if you drink too much
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lose weight if you're overweight
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exercise regularly
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cut down on caffeine
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try to get at least six hours of sleep a night
If you're diagnosed with high blood pressure, we may recommend taking one or more medicines to keep it under control. These usually need to be taken once a day.
Common blood pressure medications include:
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ACE inhibitors – such as ramipril
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angiotensin-2 receptor blockers (ARBs) – such as valsartan
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calcium channel blockers – such as amlodipine, felodipine
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diuretics – such as indapamide and bendroflumethiazide
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beta-blockers – such as bisoprolol
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alpha-blockers – such as doxazosin
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renin inhibitors – such as aliskiren
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other diuretics – such as amiloride and spironolactone
The medication recommended for you will depend on things like how high your blood pressure is and your age.
Palpitations (Arrhythmia)
An abnormal heart rhythm – sometimes called an arrhythmia – means your heart is beating too fast, too slow, or with an irregular pattern. There are lots of reasons why you may have a different heart rhythm. This may present as a sensation of 'palpitation'
What investigations do I need?
We will talk to you about your condition and perform a clinical examination. We then may recommend the following initial tests:
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Blood tests
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
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24/48 hr ECG monitor
Further tests may be necessary depending on the initial test results. These may include:
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72hr/7day event recorder
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Implantable loop recorder
What Treatment do I need?
This may include:
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Tablets
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Electrical shock (Cardioversion)
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Permanent Pacemaker
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Ablation treatments
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Implantable Defibrillator
Heart Attack
A heart attack is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle. A heart attack is known medically as a myocardial infarction or MI.
Symptoms can include:
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chest pain – the chest can feel like it is being pressed or squeezed by a heavy object, and pain can radiate from the chest to the jaw, neck, arms and back
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shortness of breath
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feeling weak and/or lightheaded
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overwhelming feeling of anxiety
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It is important to stress that not everyone experiences severe chest pain; the pain can often be mild and mistaken for indigestion. It is the combination of symptoms that is important in determining whether a person is having a heart attack, and not the severity of chest pain.
A heart attack is a medical emergency. Dial 999 and ask for an ambulance if you think you or someone you know is having a heart attack. Coronary heart disease (CHD) is the leading cause of heart attacks. CHD is a condition in which coronary arteries (the major blood vessels that supply blood to the heart) get clogged up with deposits of cholesterol. These deposits are called plaques.
Your risk of developing CHD is increased by:
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smoking
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a high-fat diet
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being overweight or obese
What tests do I need?
A heart attack is a medical emergency and life-threatening condition. Seek help immediately by dialling 999 and asking for an ambulance. The ambulance crew will perform a 12 lead ECG and take you to the nearest Heart Attack Centre.
What treatment do I need?
You will receive a life-saving treatment called Primary Coronary Angioplasty to open up your blocked artery that caused the heart attack. The sooner this is done the better the outcome.
Raised cholesterol
Cholesterol is a fatty substance known as a lipid and is vital for the normal functioning of the body. It's mainly made by the liver, but can also be found in some foods. Having an excessively high level of lipids in your blood (hyperlipidemia) can have an effect on your health. High cholesterol itself doesn't usually cause any symptoms, but it increases your risk of serious heart conditions.
Evidence strongly indicates that high cholesterol can increase the risk of:
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narrowing of the arteries (atherosclerosis)
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heart attack
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stroke
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transient ischaemic attack (TIA) – often known as a "mini stroke
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peripheral arterial disease (PAD)
What tests do I need?
We will talk to you about your condition and perform a clinical examination. We then may recommend the following initial test:
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Blood test to assess your lipid profile
Further tests may be necessary depending on the initial assessment and whether you have already developed complications form the raised cholesterol.
What treatment do I need?
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We will advise you about life style changes that you can make to lower your cholesterol
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We will consider tablets if your cholesterol is very high and your risk of developing complications is also high
Irregular heart rhythm (Atrial Fibrillation)
An irregular pulse could be a sign that you have an abnormal heart rhythm. Atrial Fibrillation (AF) is one of the most common forms of abnormal heart rhythm. You may experience palpitation, tiredness, shortness of breath, dizziness or feeling faint with it. AF can increase the risk of a blood clot forming inside the chambers of the heart, which can lead to a stroke. AF increases stroke risk by around four to five times. AF can be caused by high blood pressure, heart valve disease, thyrotoxicosis (overactive thyroid gland) and excess alcohol consumption. It’s also associated with coronary heart disease. But in many patients no underlying cause can be found. Sometimes the AF can be resolved once the underlying condition has been dealt with.
What tests do I need?
We will talk to you about your condition and perform a clinical examination. We then may recommend the following initial tests:
-
Blood tests
-
Electrocardiogram (ECG)
-
Echocardiogram (Echo)
-
24/48 hr ECG monitor
Further tests may be necessary depending on the initial test results. These may include:
-
72hr/7day event recorder
-
Implantable loop recorder
What treatment do I need?
This may include:
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Tablets
-
Electrical shock (Cardioversion)
-
Permanent Pacemaker
-
Ablation treatments
Arterial narrowing (Atherosclerosis)
This is the process that leads to narrowing of the coronary arteries. It is caused by a combination of factors such as high cholesterol, high blood pressue and diabetes resulting in coronary build up of fatty plaques that end up blocking the arteries. This can lead to angina (chest pain), heart attack, stroke and peripheral arterial disease.
What investigations do I need?
We can screen for coronary artery disease using one of the following tests based on your symptoms and clinical examination:
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Functional test (e.g excercise test or stress echo)
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Cardiac CT
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Diagnostic coronary angiogram (Dye test)
What Treatment do I need?
Atherosclerosis can’t be stopped and current treatments can’t reverse it. But there are medicines that can slow down its progress and lower your chances of having a heart attack or stroke. We will discuss these medicines with you and choose the most appropriate.
Heart failure
Heart failure is a condition caused by the heart failing to pump enough blood around the body at the right pressure. The most common reason is that your heart muscle has been damaged, for example after a heart attack. Breathlessness, feeling very tired and ankle swelling are the main symptoms of heart failure. If you have heart failure, it does not mean your heart is about to stop working. It means your heart needs some support to do its job, usually in the form of medicines.
There are lots of reasons why you might be diagnosed with heart failure. It can be sudden or it can happen slowly over months or even years. The most common causes are:
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heart attack
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high blood pressure
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cardiomyopathy (diseases of the heart muscle. Sometimes these are inherited from your family and sometimes they are caused by other things, such as viral infections).
Heart failure can also be caused by:
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heart valve problems
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alcohol or recreational drugs
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an uncontrolled irregular heart rhythm (arrhythmia)
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congenital heart conditions (ones you’re born with)
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a viral infection affecting the heart muscle
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some cancer treatments.
What tests do I need?
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Blood tests including a special blood marker called BNP
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
Further tests may be necessary depending on the initial test results. These may include:
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Coronary angiogram
What treatment do I need?
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Tablets
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Life style changes
Other treatment options including special pacemaker devices (CRT) to help synchronise the heart function, surgery or heart transplant will be considered depending on the cause of your heart failure.
Heart valve disease
If one or more of your heart valves becomes damaged or diseased, it can affect the flow of blood through your heart. There are four chambers in your heart and the valves make sure that the blood flows through them in one direction. You may not experience any symptoms but some of the common symptoms are: being out of breath swelling of the ankles and feet being unusually tired.
If your valve is diseased or damaged this can affect the flow of blood to your heart in 2 ways:
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If the valve does not open fully, it will obstruct the flow of blood. This is called valve stenosis.
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If the valve does not close properly, it will allow blood to leak backwards, in the wrong direction. This is called valve incompetence or regurgitation.
The main causes of heart valve disease are:
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being born with an abnormal valve or valves (congenital heart disease)
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having had rheumatic fever
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cardiomyopathy - a disease of the heart muscle
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damage to the heart muscle from a heart attack
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getting older
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a previous infection with endocarditis.
What tests do I need?
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Electrocardiogram (ECG)
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Echocardiogram (Echo)
Further tests may be necessary depending on the initial test results. These may include:
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Transoesophageal echo (TOE)
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Stress echocardiogram
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Coronary angiogram
What treatment do I need?
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You may not need any treatment at all but we may ask you to come back regularly for review, or if your symptoms get worse.
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Most valve problems can be treated using medicines or by valve heart surgery
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Non-surgical treatment such as Transcatheter Valve Intervention will be considered during your consultation
Inherited heart conditions
If one or more of your heart valves becomes damaged or diseased, it can affect the flow of blood through your heart. There are four chambers in your heart and the valves make sure that the blood flows through them in one direction. You may not experience any symptoms but some of the common symptoms are: being out of breath swelling of the ankles and feet being unusually tired.
The most common inherited heart conditions are:
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Inherited heart rhythm disturbances
We can screen you for cardiomyopathies and Familial hypercholesterolaemia if you have a family history of either condition.