One of the common health questions people ask themselves in later life is ‘Do I need to see a heart specialist?’
Dr Aftab Gill talks about common symptoms that could be linked to a heart problem, typical risk factors for developing heart issues, and when it may be time to seek specialist advice.
Is it my heart?
Dr Aftab Gill is the Lead Consultant Cardiologist at Queens Hospital, Burton on Trent, as well as being an Honorary Consultant at Derby Royal Hospital and Glenfield Hospital, Leicester. He also holds private clinics in the West Midlands
at the Spire hospitals in Solihull and Little Aston.
Chest pain can be a frequent occurrence, from a slight twinge that comes out of the blue, to sharp stabbings pains, to something that feels like indigestion or even just doesn’t feel right. Severe pain can also be accompanied by nausea, shortness of breath and sweating. Chest pain that arises due to heart problems can often be a sign of either angina or a heart attack.
Heart attacks occur if one of the fuel pipes to the heart becomes blocked, resulting in a certain area of the heart not receiving any blood and the heart muscle starting to die. It depends on the amount of muscle that dies as to whether the heart can continue working and whether the person survives.
One of the first questions that may be asked if somebody has any chest pain is ‘are they having a heart attack?’. The symptoms of a heart attack normally include chest pain which presents as a heaviness and feeling of pressure in the centre of the chest (sometimes similar to that of bad indigestion). People can also feel unwell, short of breath, sweaty and like they want to vomit (some do). The pain/heaviness can travel into the shoulder, down one or both arms and up into the neck and jaw. These can all occur with no previous history of heart problems and you should seek urgent advice (normally call 999) if you have these symptoms.
It is important to remember that chest pain can be due to heart problems, but there are also a number of non-heart issues that can cause discomfort, such as muscular pain, indigestion, infections, anxiety and blood clots in the lungs. Chest pain is always a reasonable concern and should be discussed with your GP or a cardiologist.
This is chest pain or shortness of breath which occurs because the fuel pipes to the heart itself (coronary arteries), are narrower than they should be due to cholesterol building up inside the artery. Therefore, when the heart is beating harder/faster than normal (for example, walking quickly or uphill), it needs more fuel. If the fuel pipes supplying it are narrower than they should be this will cause problems in the form of chest tightness or shortness of breath. If you experience any of these symptoms it is also advisable to meet with your GP or a cardiologist.
‘Palpitations’ is a word used by different people to describe different things. In some it is simply being aware of their heartbeat, whilst others use it to describe a forceful heartbeat, ‘a huge thump’ or the sensation of their heart pounding. The word can also be used to portray an irregular heartbeat, the feeling of the heart skipping a beat, missed beats or just a constant feeling of irregularity.
The majority of people who see cardiologists or heart specialists that are worried about palpitations are suffering with ‘ectopic beats’. These most commonly occur when relaxing and not doing anything (for example lying in bed at night before falling asleep, watching TV or reading a book/magazine). They may feel their heart give out a very abnormal forceful thump, then a bit of a pause followed by a run of heartbeats. The heart can then carry on as normal or there can be another thump and the whole cycle repeats itself. When people feel this, they are obviously worried that their heart may stop or even worry that they are having a heart attack. ‘Ectopic beats’ are not generally dangerous, and do not need treating (although there are options available to treat them if they are making life difficult). However, if they are associated with dizzy episodes, blackouts, chest pain or shortness of breath, this could be cause for concern and will require further investigation.
Ectopic beats can be made worse by high caffeine intake (too much tea or coffee), drinking high energy drinks, and excessive chocolate and alcohol consumption. They can also occasionally be due to hormone problems.
The standard medical interpretation of ‘palpitations’ is a fast regular or irregular heartbeat lasting at least 5-10 seconds (that could also go on for hours). If accompanied with feeling dizzy, light headedness, chest pains or even passing out these episodes could be more worrying and should be investigated more thoroughly – usually with a heart monitor (Holter monitor) and an ultrasound scan of the heart (Echocardiogram). This could potentially uncover problems with the ‘wiring in the heart’ causing it to beat much faster than it should.
It is important to remember that most episodes of palpitations are not worrying or dangerous, and will not need treating. However, if you are concerned, it always better to seek medical advice.
There is nothing anyone can do to guarantee they won’t have a heart attack, but there are tests that can be done to gain an idea of the risk to your heart and its state of play. There are also a number of risk factors that could indicate a need to be vigilant and conscientious about the health of your heart. These include the following:
Family history of heart disease
You might want to book a heart check if your family have a history of cardiovascular disease as you will be at greater risk. It is considered a family risk factor if your father or brother was diagnosed with a heart problem before 55, or if your mother or sister was diagnosed before the age of 65.
High blood pressure
Your heart could be at risk if you suffer from high blood pressure, which can cause tears that scar the arteries and make them more susceptible to plaque that blocks the heart.
Cholesterol is a fatty substance found in your blood that increases your risk of heart disease and cardiovascular disease. There are a number of causes for high cholesterol, including poor diet, smoking, alcohol and a lack of physical activity. Finding our your ‘bad’(LDL) cholesterol levels can help indicate your risk factor. It is recommended you have your cholesterol checked every 5 years if you are between the ages of 40 and 75 and every 12 months if you are
on cholesterol lowering medication.
Other significant risk factors that make having a heart check up worthwhile include smoking, diabetes, poor diet, lack of exercise and/or previous heart problems/concerns. Addressing risk factors, and identifying any worrying signs before they become a serious problem can significantly improve things for most people. If you are concerned about any of these factors you may want to consider undergoing a potentially life saving heart health check.
There are a wide range of heart tests and scans that are able to assess heart health and identify any worrying signs before they become a serious problem. Dr Gill is able to perform these tests at his clinic, where he also sees patients with a full range of cardiology problems such as chest pains, palpitations, high blood pressure, high cholesterol, heart failure, being short of breath, dizzy episodes and blackouts. He is able to perform various procedures such as coronary angiograms, angioplasties (stents), pacemaker implants, CRT and ICD implants.
He sees private patients at the Spire Hospitals in Solihull and Little Aston, as well as The Burton Clinic and Nuffield Hospital Derby, where appointments can usually be made within 2 working days (Skype or telephone consultations may be available at shorter notice).
Telephone and skype consultations
Skype or telephone consultations allow you to have a provisional discussion with Dr Gill about your symptoms, problems and concerns. They can be offered at short notice and present an opportunity to seek advice leading to further consultation or investigation, or can even offer a second opinion.
A 30 minute telephone or Skype consultation usually costs £80. This can then be deducted from the full ‘face to face’ consultation fee if you wish to proceed with an appointment.
It should be noted that having an initial consultation in this manner does not replace a full face to face consultation, examination and assessment, but allows you to seek advice on whether further action would be suitable.
Funding and insurance
Self-funding patients can arrange an appointment directly with Dr Gill for a private heart check/consultation and do not need to be referred by their GP. Payments can be accepted via cash, cheque, credit card or debit card. A new consultation with a private ECG is usually only £220, whilst a follow-up consultation is only £180.
Insured patients wishing to claim for their consultation and/or treatment fees require pre-authorisation from their insurance provider and a GP referral prior to seeing Dr Gill.