Heart investigations, diagnosis & treatment
Chest pain
Pain or discomfort in the chest can have many causes but the most significant and potentially worrying cause of pains in the chest is angina. Angina is due to narrowing or furring of the small arteries which supply the heart with blood. Angina is typically felt as a discomfort, heaviness or tightness in the chest which usually occurs on exertion or sometimes with emotion. Rather than discomfort, angina is sometimes felt as a feeling of breathlessness.
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, furthermore advanced tests may be required:
If I have angina, what treatment may be required?
Palpitations and Atrial Fibrillation
A palpitation is a term used for an ‘awareness’ of the heartbeat. Understandably such a symptom often causes great anxiety but very often people are simply aware of normal, but fast or forceful heartbeats or maybe aware of the occasional ‘extra’ (ectopic) heartbeats which we all have at times.
The heart has its own complex electrical circuitry and any aspect of this can develop problems which can lead to palpitations. Sometimes a ‘short circuit’ of the electrics of the heart can occur which can lead to a more sustained rapid heartbeat – this can feel very unpleasant.
In investigating palpitations, it is very important to ensure that there is no abnormality in the structure of the heart as this may be the cause of the palpitations themselves and may mean the palpitations are potentially more dangerous.
A very specific type of palpitation is ‘atrial fibrillation’ (AF). This is the most common abnormal heartbeat and is a fast, completely irregular rhythm of the heart. This rhythm may come and go (called paroxysmal AF) or the rhythm may stay persistently irregular – although the rhythm in both cases is similar, the treatment may be quite different. One important complication of AF is that it is associated with the risk having a stroke – this risk may in many cases be very small but this will be discussed in detail by your cardiologist.
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, furthermore advanced tests may be required:
If I have abnormal heart rhythms what treatment may be required?
Dizziness and Fainting
Many people will faint or pass out at some point in their life, although such an event usually causes a lot of anxiety and often leads to a trip to the local hospital casualty department. There are many causes of fainting but the underlying problem causing this is likely to be a problem with the heart, brain (epilepsy) or the fine control mechanisms of the blood pressure and pulse. Your doctor will be able to find clues as to which is most likely cause before referring you to a cardiologist if necessary.
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, further more advanced tests may be required:
What treatment may be required?
Heart Murmurs and Heart Valve Problems
A heart murmur is an abnormal sound that can be heard when examining the heart. Murmurs can often be caused simply by high rates of blood flow through the heart (for example during childhood or pregnancy) and are completely innocent. However murmurs can sometimes be as a result of a significant problem, particularly with one or more of the valves of the heart.
Heart murmurs are often picked up by chance during an examination with no symptoms, but heart valve problems in particular may cause symptoms. Typical symptoms seen in patients with valve problems are breathlessness (particularly on exertion), tightness in the chest (angina) or dizziness. In addition, certain types of valve problem can lead to palpitations and atrial fibrillation (AF).
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, further more advanced tests may be required:
If I have heart valve disease, what treatment may be required?
High Blood Pressure (Hypertension)
Having a high blood pressure over many years greatly increases the risk of problems: furring in the arteries leading to angina; heart attacks and strokes. Happily, we are much better now at picking this up sooner rather than later and there are wide range of extremely effective treatments to lower blood pressure and reduce the risks of problems in the future. Much of the time you and your GP will be able to achieve good control of blood pressure but if the levels are very high or control is difficult your GP may suggest you see a cardiologist to assess things in more detail.
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, further more advanced tests may be required:
What treatment may be required for high blood pressure?
Breathlessness
There are many causes of shortness of breath but essentially this symptom is as a result of either heart or lung problems. Distinguishing between the two can prove difficult but your doctor will have assessed you and will have reason to suspect that a heart problem is the cause of your breathlessness. A number of heart problems can result in shortness of breath including angina, heart valve disease and problems with the muscle or rhythm of the heart.
Heart Failure
Heart ‘failure’ is the medical term used for symptoms and signs (clinical findings) resulting from stiffness or weakness of the heart muscle. Typical symptoms are tiredness, breathlessness and fluid retention – usually swelling around the ankles or congestion the lungs. Although heart failure is a highly significant diagnosis it certainly does not mean an inevitably poor outcome as the term may suggest. Indeed over the last few years major advances have been made in the treatment of the causes and symptoms of heart failure.
What tests can I expect?
After talking with you and an examination, it may be suggested that you undergo one or more of the following tests:
Depending on the results of these tests, further more advanced tests may be required:
What treatment may be required for heart failure?
