Dr Fakhar Khan

Dr Fakhar Khan
Cardiology
Central London


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Dr Fakhar Khan

Cardiologist in
London &
St Albans

MRCP MA MD

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Dr Fakhar Khan areas of expertise:

Professional statement

Dr Fakhar Khan is a prominent London cardiologist, specialised in the field of heart rhythm disorders. He divides his time between various top London hospitals and sees patients to fit pacemakers, defibrillators, and other devices. A Cambridge graduate, he completed his studies in Oxford and London. He has written numerous peer-reviewed articles, is a member of many prominent associations and is an accomplished, patient orientated consultant.

 Credentials

GMC: ‍4635235

 Professional experience

• More than 20 years of experience
• Consultant Cardiologist, The London Cardiac Centre
• Barts Heart Centre, St Bartholomew’s Hospital
• The Royal Free Hospital in Hampstead
• Consultant Cardiologist The Heart Hospital, University College London Hospitals
• Clinical Electrophysiology Fellow University Health Network, Toronto, Canada
• Specialist Registrar in Cardiology (Interest in Electrophysiology, Devices and Heart Failure) Papworth Hospital NHS Foundation Trust

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 Sub-specialties

• Cardiology
• Electrophysiology

 Education

• Medical Doctorate, University of Cambridge
• Training in General Medicine and Cardiology in Oxford, London, and Cambridge
• Medical degree from the University of Cambridge (1999)

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 Publications and conferences

• Led a major clinical trial on improving outcomes for patients needing cardiac resynchronization therapy

 Prizes and awards

• The Mirium L Burnett Fellowship in Electrophysiology and Devices in Toronto
• Young Investigator Award in 2010 by the Heart Rhythm Society UK
• Ralph Noble Prize from the University of Cambridge

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 Professional membership

• Royal College of Physicians
• International Board of Heart Rhythm Examiners

Languages spoken

  • English
  • Hindi
  • Punjabi
  • Urdu

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27/06/2017

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24/06/2017

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Diseases, Medical Tests and Treatments

Arrhythmia

What is arrhythmia? An arrhythmia is also known as a heart rhythm problem, causing the heart to either beat too fast (tachycardia), too slow (brady ...

Atrial Fibrillation

What is it? Atrial fibrillation is a heart rhythm irregularity that causes the heart to beat fast or irregularly. It affects around 4% of people ov ...

Dilated cardiomyopathy

What is dilated cardiomyopathy? Dilated cardiomyopathy is a disease of the heart muscle that results in the heart not being able to pump blood arou ...

Electrocardiogram

The electrocardiogram (ECG) is a diagnostic test that records the electrical activity of the heart to test for any kind of pathology. It also constitu ...

Electrophysiology study

What is it? An intracardiac electrogram is an exam that tests the heart’s electrical system function, in order to see whether there is any arrhythmia. What does it involve? This test is considered an invasive one and is carried out under local anaesthetic. During the procedure, the doctor will insert electric cables into the chest, which will start sending periodical electric stimuli to the heart. These stimuli will cause small, induced arrhythmias and the leads will record the effects of the arrhythmias. After the procedure, you will be kept under clinical observation and your heart’s activity will be monitored through an ECG. What is it for? An intracardiac electrogram evaluates the functioning of the heart’s electrical system. However, it may also be used to investigate the origins of tachycardia or any other cardiac disorders, such as syncope (or temporary loss of consciousness), collapse (fainting) and palpitations (perceived heartbeat irregularity). How can you prepare for it? You may be advised not to eat anything before the procedure and you might need to stay in hospital overnight afterwards. After that, you will be able to go back to your normal routine. What does it feel like during the procedure? Since the test is carried out under local anaesthetic, the only discomfort you may feel may be due to the induced electric stimuli. It is very rare for complications to arise after this exam, however in 1% of the cases these complications are of vascular and cardiac nature. In case of vascular complications, the valves the leads pass through may be damaged. This may cause conditions such as venous thrombosis, haematoma and arteriovenous fistulae. Cardiac complications may include haemorrhagic pericardial effusion (which can be easily treated with a chest drain) or malignant ventricular arrhythmia (which can be treated with electric cardioversion). This is why a hospital stay after the procedure is important – the medical team can monitor you closely and treat any complications that occur. What would a “bad” result mean? An abnormal result may mean that you have a heart rhythm disorder. There are many types of heart rhythm disorder, but most can be treated in a number of ways – including medication, radiofrequency ablation, or the fitting of an artificial pacemaker. ...

Pacemaker

What is a pacemaker? A pacemaker is a small electric device which generates electrical impulses to regulate your heart rhythm. It is generally fitted in the chest but can sometimes be fitted in the abdomen. About 25,000 people are fitted with a pacemaker each year in the UK. Most people will be fitted with a traditional pacemaker, of which there are three types, depending on how many wires it has: a single-chamber pacemaker has just one wire, connected to the upper or lower heart chamber on the right side a dual-chamber pacemaker has two wires connected to both heart chambers on the right side a biventricular pacemaker has three wires, two connected to the chambers on the right side, and one connected to the left ventricle Some people might be fitted with a special type of pacemaker designed to coordinate the pumping action of the different chambers of the heart. In some cases, a defibrillator is attached. The use of this type of pacemaker is known as cardiac resynchronisation therapy, and it is recommended in people who have heard failure because of their left ventricle. Who might need a pacemaker? A pacemaker is a popular device used to treat a variety of heart problems. You might need a pacemaker if: you have an irregular heartbeat (atrial fibrillation) you have a slower heartbeat than normal due to heart block or heart failure your heart is beating too fast (tachycardia) and you cannot control it with medication If you’ve had a heart attack in the past and your doctor thinks you have a high risk of having another in the future, they might recommend a similar device to a pacemaker called an implantable cardioverter defibrillator (ICD). What does fitting a pacemaker involve? Pacemaker surgery is a safe operation generally performed under local anaesthetic, taking about 45 minutes to perform. You can usually go home a few hours after the surgery is complete. The battery in the pacemaker can last for about 10 years, so you’re unlikely to have to get it replaced any time soon. After your pacemaker has been fitted, you’ll be advised on how to use it, and in particular, what to do to avoid electrical or magnetic devices interfering with the electric signals your pace produces. It’s important to let your car insurance company know that you have a pacemaker, as well as the DVLA. For more information on pacemaker surgery, click here. ...

Angina

What is angina? Angina, or angina pectoris, is chest pain that occurs when the blood supply to the muscles of the heart is restricted. This is because the arteries supplying the heart become hardened and narrowed. An angina attack has been described as a dull and tight pain in the chest, which can spread to the left arm, neck or back. It can be triggered by physical activities or stress. It is always an emergency when an angina attack occurs and medical attention is imperative. Sometimes angina pain can be difficult to distinguish from other types of chest pain, and can be misinterpreted as indigestion. What are the symptoms of angina? The symptoms that are associated with angina include: Chest pain Pain in the neck, jaw, shoulder or back Nausea Tiredness and fatigue Shortness of breath Sweating Dizziness The chest pain felt during an angina attack has been described as an extremely heavy weight on the chest or that the chest has been squeezed. The duration of the angina attack can vary. The symptoms of angina in women can be different from the classic signs. A woman can experience nausea, shortness of breath, fatigue, abdominal pain without chest pain. This can result in a delay in seeking emergency treatment. What are the different types of angina? Stable angina is the most common type. This develops when the heart works harder, such as when exercising. It lasts for a short amount of time such as less than five minutes. It can disappear if the person experiencing the attack rests. An unstable angina is a medical emergency. This can occur even when a person is at rest and it is completely unexpected. It is severe and can last as long as 30 minutes. It can signal a heart attack. Risk factors of angina The following can increase the risk factor of an angina: Tobacco – smoking and regular exposure to second-hand smoke damages the interior walls of arteries and allows deposits of cholesterol to collect and block blood flow. Diabetes Hypertension (high blood pressure) High cholesterol or triglyceride levels – The wrong cholesterol, known as low-density lipoprotein (LDL) increases the risk of angina and heart attacks. Increase in age No exercise Overweight Stress How to prevent angina An improvement to lifestyle choices can be made to prevent angina. This includes quitting smoking, monitoring other health conditions such as hypertension and high levels of cholesterol. A healthy diet, which eradicates saturated fats is also recommended, as is regular physical activity. Stress levels should be reduced and a healthy weight maintained.  ...

Atherosclerosis

What is atherosclerosis? Atherosclerosis is the most frequent disease of the arteries. It consists of the formation of plaque in the blood vessels through which oxygen and nutrients are transported. The plaque is a sticky substance formed by fat, cholesterol or calcium, which over time can harden and narrow the arteries causing a lack of blood flow to the tissues and organs. Often affecting the blood vessels near your heart, atherosclerosis can affect blood vessels anywhere in the body. What are the symptoms of atherosclerosis? In general, atherosclerosis does not show symptoms until an artery is reduced too much, or the blood flow in one part of the body slows down or gets blocked. As a result, people suffering from atherosclerosis often don’t realise until they have an emergency. Depending on which arteries are affected the following symptoms might be experienced: Arteries near your heart – chest pain Arteries near your brain – numbness in your limbs, slurred speech, drooping on one side of the face Arteries in your arms and legs – pain in the affected limb Arteries near your kidneys – high blood pressure and potentially kidney failure What causes atherosclerosis? The progression of atherosclerosis is slow and takes time to manifest. Although the exact cause is unknown, it is thought that damage to the artery can cause the build-up of plaque. Damage to arteries can be caused by: High cholesterol High blood pressure Smoking Inflammatory diseases (e.g. lupus, arthritis) High fat content in your blood If the venous wall is damaged, debris and blood cells build up at the injury site, and gradually this builds up, narrowing the diameter of the artery. Can atherosclerosis be prevented? It is possible to prevent atherosclerosis with the right lifestyle changes, including: A healthy diet (reduced consumption of fatty food) Stop smoking Reduce cholesterol Exercise regularly Maintain a healthy weight What is the treatment for atherosclerosis? The following medications can help to slow down the build-up of plaque in the arteries and potentially reverse it: Cholesterol medication which reduces the bad cholesterol levels in the blood (low-density lipoproteins, LDLs). Blood pressure medication to reduce high blood pressure (e.g. ACE inhibitors or calcium channel blockers). Blood-thinning medication such as aspirin. If medication does not prove effective and more aggressive treatment is needed, surgery might be recommended. Surgically installing a stent into an affected artery will keep the artery open and blood flowing through it. Fatty deposits can also be removed surgically (endarterectomy). Bypass surgery to bypass the damaged blood vessel might be necessary. ...

Cardiovascular disease

What is cardiovascular disease? Cardiovascular disease (CVD) is a group of disorders that affect the heart and the blood vessels. It is associated with the build-up of fatty deposits in the arteries, which is known as atherosclerosis. It often involves hypertension, which can be both a cause and result of CVD. The disorder is one of the main causes of death in the UK yet can often be prevented with a healthy lifestyle.   What are the different types of cardiovascular diseases? The four main types of cardiovascular disease are: Coronary heart disease – occurs when the flow of blood to the heart is blocked. It can lead to angina, heart attacks or heart failure. Strokes and TIAs – the blood supply of the brain is cut off during a stroke. A transient ischaemic attack is similar but the blood flow to the brain is only temporary. Peripheral arterial disease – occurs when there is a blockage in the arteries to the limbs, such as the legs. Aortic diseases – these are a group of conditions affecting the aorta, the largest blood vessel in the body that carries blood from the heart to the rest of the body. The commonest type is an aortic aneurysm.   What are the causes of cardiovascular disease? There are many things are risk factors and increase the chance of a person developing CVD. These include: Hypertension – if the blood pressure is too high it can damage the blood vessels Smoking – the harmful tobacco substances can narrow the blood vessels. High cholesterol – the fatty substance in the blood can increase the chance of developing a blood clot. Diabetes – high blood sugar levels can damage the blood vessels. Lack of regular exercise – staying active helps promote good heart health. Obesity – being overweight or obese increases the chance of developing diabetes and hypertension, which are both risk factors for CVD. Family history – having a family history of the disease means that the risk of developing CVD is increased.   Other risk factors for cardiovascular disease The other factors that can affect the development of CVD are: Age Gender Poor diet Alcohol   How to prevent cardiovascular disease Living a healthy lifestyle can prevent and lower the risk of cardiovascular disease. This means: Stop smoking Eating a balanced diet Exercising regularly Reaching and maintaining a healthy weight Reducing alcohol intake Medication ...

Cholesterol

What is cholesterol? Cholesterol is a fatty substance known as a lipid, which is mainly made by the liver and can also be found in some foods. It is vital for the human body to function properly but if the levels of cholesterol are too high in the blood, it can result in heart disease and heart stroke among other problems. Cholesterol can increase with age and is only detected through a blood test. There is also something else that may need to be monitored if someone has high cholesterol, and that is triglycerides. Having a high level of triglycerides, a type of fat (lipid) in the blood, can also increase the risk of heart disease. Why is it important to lower cholesterol? Evidence shows that high cholesterol levels can increase the risk of having a heart attack, a stroke, a mini-stroke (known as transient ischaemic attack) or a peripheral arterial disease (PAD). Cholesterol can build up in the artery wall, which restricts the blood flow to the heart, brain and the rest of the body. It can also increase the risk of a blood clot in other parts of the body. The risk of developing coronary heart disease is also higher when the blood’s cholesterol level increases. What causes high cholesterol? There are many factors that increase the chances of having high cholesterol, which include: An unhealthy diet – especially eating high levels of saturated fat. Smoking Diabetes Hypertension (high blood pressure). A family history of stroke or heart disease. Even people who eat healthily can inherit a condition called familial hypercholesterolemia, which can cause high cholesterol. What should my cholesterol levels be? The levels of blood cholesterol is measured in millimoles per litre of blood (mmol/L.) Total cholesterol levels should be 5mmol/L or less for healthy adults or 4mmol/L or less for those who are at high risk. Low-density lipoprotein (LPL) levels should at 3mmol/L or less for healthy adults or 2mmol/L or less for those at high risk. How to lower cholesterol levels? To reduce the level of cholesterol, it is recommended to maintain a healthy and balanced diet, which is low in fatty foods. Regular exercise and quitting smoking are also recommended to lower the levels of cholesterol. If following these steps does not reduce the cholesterol levels, a doctor may prescribe medication such as Statins to help. Statins block the chemicals in the liver that help to make cholesterol, which leads to a reduction the blood cholesterol level. They are only prescribed to people who are at a high risk of heart disease and will need to be taken for life. Low cholesterol diet A balanced diet, low in saturated fats can reduce LDL (bad cholesterol). The following foods should be avoided or the intake reduced: Fatty meats and meat products Butter and lard Cream, sour cream and ice cream Cheese Cake and biscuits Chocolate Coconut oil  ...

Coronary heart disease

What is coronary heart disease?  Coronary heart disease (CHD), also known as ischaemic heart disease, is when the coronary arteries narrow over time due to a build-up of fatty material within the artery walls. The coronary arteries are responsible for supplying the heart with oxygenated blood. Prognosis of coronary heart disease:  If treated, the symptoms of coronary heart disease can be lessened and the function of the heart can be improved.  Symptoms of coronary heart disease: The most common symptoms of coronary heart disease include: Angina (chest pain) Heart attacks Heart failure Breathlessness Heart palpitations Medical tests to diagnose coronary heart disease: If your doctor suspects you might be at risk for coronary heart disease, then they might recommend you have a risk assessment done. There is a national screening program in place in the UK which offers free screenings for those aged 40-74 years old in England and between 40-64 years old in Scotland.  A risk assessment can involve: Blood test Review of medical and family history CT scan MRI scan Coronary angiography Treadmill test Echocardiogram Electrocardiogram (ECG) What are the causes of coronary heart disease? The process of the coronary arteries becoming blocked by fatty deposits is called atherosclerosis, and the fatty deposits are known as atheroma.  There are certain risk factors that can cause atherosclerosis, including: Smoking Heavy drinking High cholesterol Hypertension Diabetes Sedentary lifestyle (lack of exercise) Obesity  Family history of CHD  Can coronary heart disease be prevented? Certain lifestyle changes can help reduce the risk of developing coronary heart disease, including: Exercising regularly Maintaining a healthier weight Quitting smoking Reducing alcohol consumption Eating a healthy, balanced diet low in cholesterol Controlling blood pressure Managing diabetes well Treatments for coronary heart disease: There is no cure for coronary heart disease, however, there are treatments available to both manage the symptoms and reduce the likelihood of a heart attack. The main treatments include lifestyle changes, medications, surgery, and angioplasty. Medications that treat CHD can either widen the arteries or reduce blood pressure. The following are common medications given to CHD patients: Statins – lowers cholesterol Antiplatelets – blood thinners Beta-blockers – treat hypertension and prevents angina ACE inhibitors & calcium channel blockers – reduce blood pressure Angioplasty is an emergency treatment option for those having a heart attack. A small balloon is inserted into the narrowed artery, pushing out the fatty deposits. A stent is then inserted to hold the artery open. Other surgical treatments include: Coronary artery bypass graft Heart transplant Which type of specialist treats coronary heart disease? A cardiologist would treat coronary heart disease. ...

Echocardiogram

What is an echocardiogram? An echocardiogram is a non-invasive, painless ultrasound scan carried out to create an image of the heart. The exam uses ultrasound waves to view the structure and examine the functionality of the heart, including the chambers, valves, cardiac muscle and adjoining blood vessels.   What does an echocardiogram involve? An echocardiogram is a non-invasive diagnostic tool that allows the doctor to examine the chambers of the heart and connecting blood vessels, providing useful information on your heart’s general state of health and on any potential cardiopathies. It usually lasts 10-15 minutes, during which you’ll need to be very still. You will have to take your shirt off and lie down on a flat bed. A special gel will be applied on your skin and then some electrodes will be placed on your chest. A probe or transducer will be then placed on your chest and, thanks to the ultrasound waves the probe emits, the doctor will have a clear picture of your heart and surrounding structures.   What is an echocardiogram for? An echocardiogram is done to get more information about your heart’s pumping strength, the condition of the valves and the blood flow to the heart’s cavities. It can be carried out in several different ways: Transthoracic echocardiogram – the transducer is placed on your chest, emitting ultrasound waves which will give a real time picture of your heart. Transesophageal echocardiogram – it is done by endoscopy and it can identify conditions that are otherwise hard to diagnose, such as complex valvular defects, rare congenital malformations or conditions of the thoracic aorta. Three-dimensional echocardiography – enables detailed anatomical assessment of the heart.   You may have to do an echocardiogram if: You’ve had a heart attack You suffer from heart failure Your heart valves are damaged You’ve had an artificial heart valve implanted You were the recipient of a heart transplant   What does it feel like during the procedure? You won’t feel any pain or discomfort, since the procedure is completely painless and safe. ...

Fatty liver

What is fatty liver? Fatty liver disease is the accumulation of fatty acids and triglycerides in liver cells. There are two types: Non-alcoholic fatty liver disease: it is the most common cause for obesity due to a build-up of fat in the liver cells. There are other factors that can also trigger the disease, such as oxidative stress, the production and release of toxic inflammatory proteins, or necrosis or death of liver cells. Alcohol-related liver disease, also known as alcohol hepatic steatosis: as the name suggests, this disease is caused by excess alcohol intake. The liver breaks down most of the alcohol but during the process, harmful substances to the liver are released that cause inflammation and weaken the body’s natural defences.     What are the symptoms?  Symptoms of this disease include upper right abdominal pain, general malaise, and chronic fatigue, among others. However, many patients don’t have symptoms but are diagnosed after having certain imaging tests such as an ultrasound or CT scan for other reasons.   These imaging tests are not always able to diagnose this disease, for this it’s best to undergo laboratory testing to be able to assess the degree of liver injury by assessing liver enzymes or transaminases.       Causes of fatty liver?   Specialists are still unsure as to why some people accumulate fat in the liver and others don’t.  An important factor is that some cases of fatty liver develop swelling which could turn into cirrhosis. There are however some common factors for both types of fatty liver: being overweight or obese, insulin resistance, when cells don’t process sugar in response to the hormone insulin, and high blood sugar levels (hyperglycaemia) which can indicate prediabetes or type 2 diabetes and / or high levels of blood fats, particularly triglycerides.   How can it be prevented? In most cases, fatty liver can be prevented if certain lifestyle changes are made, such as following healthy guidelines based on a varied, balanced, and low fat diet. Since alcohol is one of the things that damages the liver, it is very important to stop consuming alcohol.     Another important factor is to exercise regularly as that helps burn fat; exercises can be aerobic, such as running or walking.         What is the treatment?            There is no specific treatment for this disease, however it has been shown that weight loss, regular exercise, and following a balanced diet can help reduce fat in the liver. Controlling cholesterol levels, diabetes, and / or any other cause for a build-up of fat in the liver is also important. In cases of morbid obesity, bariatric surgery may be recommended.         ...

Heart attack

What is a heart attack? A heart attack (myocardial infarction) occurs when a coronary artery becomes obstructed, thus obstructing the flow of blood to the heart. A heart attack is a medical emergency and if it is suspected call an ambulance. If blood supply is prolonged, permanent damage could result which is life-threatening. If someone has had a heart attack, they will be conscious. Cardiac arrest, on the other hand, is when the heart stops pumping blood around the body, causing breathing to stop. If someone has had cardiac arrest, they will be unconscious and need CPR immediately. What are the warning signs and symptoms of a heart attack? Some heart attacks will be preceded by certain warning signs, whilst others will show no signs. Some warning signs include: Chest pain Difficulty breathing Sweating Nausea or dizziness Fatigue Pain that spreads to the left or right arm What causes a heart attack? A heart attack occurs when a coronary artery becomes blocked. This often results from the build-up of fatty deposits called atheroma. The main risk factors of heart attacks are the following: Arterial hypertension Atherosclerosis (coronary artery disease) Smoking Stress Sedentary lifestyle Obesity Diabetes Can a heart attack be prevented? The best way to avoid having a heart attack is to avoid developing coronary heart disease. This can be done by living a healthy lifestyle, and avoiding the following: Smoking Being overweight Poorly managed diabetes High cholesterol High blood pressure Being sedentary It is important to carry out clinical and / or cardiological checks periodically, especially if you are over the age of 40 and having a family history or heart disease. This may involve having tests, such as an echocardiogram and an electrocardiogram. These studies allow us to know if the patient is within the risk parameters. If you are within these risk parameters, it is recommended that you make certain lifestyle changes. What is the treatment for heart attacks? Following a heart attack, medications and surgery will be recommended to prevent future heart attacks. Medications include: Aspirin or other blood-thinning medications Thrombolytic medications Beta-blockers Anticoagulants Blood pressure medication Surgery may involve angioplasty or stenting to find blockages and to remove them. A stent may be inserted to keep certain arteries open. Coronary bypass surgery may also be needed, especially in an emergency, to get blood flowing back to the heart. This involves rerouting blood around the blocked artery back to the heart. Valve replacement may also be required if they are not functioning correctly. In the most severe of cases, a heart replacement will be performed. ...

Heart failure

What is heart failure? Heart failure is serious and results from various heart conditions. Heart failure is characterised by the heart’s inability to pump blood as well as it should be able to. Therefore, blood supply to the rest of the body is inadequate, ultimately resulting in the disruption of major bodily functions. Additionally, blood cannot carry enough oxygen or nutrients to the body and as a result, waste is not properly disposed of and fluid accumulates in some parts of the body. There are two types of heart failure: systolic, when myocardium cannot pump blood and expel it from the heart; and the diastolic, when the muscles of the heart are rigid and do not fill with blood. What are the symptoms of heart failure? The symptoms of heart failure vary according to each person. In the initial phase there are usually no symptoms, but if it progresses, the symptoms may worsen. The main symptoms include: Palpitations Dizziness Coughing and wheezing Weight gain Swelling in the ankles Abdominal swelling Loss of appetite What causes heart failure? The most common causes of heart failure are coronary heart disease, such as angina pectoris or myocardial infarction. High blood pressure is also another common cause of this disease, as well as excessive alcohol consumption. The following can also result in heart failure: Inherited cardiac conditions Congenital heart defects Arrhythmias Thyroid problems Drug use Diabetes Can heart failure be prevented? Heart failure can be prevented by making serious lifestyle changes that will reduce cardiovascular risk factors. These changes include: Smoking cessation Eating foods low in fat and cholesterol Maintaining a healthy weight Doing regular exercise Getting enough sleep and rest Reducing your salt intake What is the treatment? There is no certain cure for heart failure, and treatment will depend on the severity of your condition. Treatment will aim to increase your lifespan and may include taking medication to reduce clotting, reduce cholesterol levels, improve heart function or to reduce sodium levels in the blood. Surgery may also be needed, such as coronary bypass surgery. It may also be necessary to have a pacemaker or ICD fitted to control heart rhythm. The last stage for treating heart failure would be a heart transplant, but this is only done if all other treatments have failed and there is a viable heart from a donor. A large part of treatment is preventative, by adopting healthy lifestyle changes. ...

Heart murmur

What is a heart murmur? A heart murmur is a whistling, rasping sound that is heard during a heartbeat cycle. The heart murmur is an extra sound made during a heartbeat cycle. Heart murmurs can be harmless, but they may also indicate a faulty valve, for example. Heart murmurs can be heard using a stethoscope. There are two main types of heart murmur; innocent murmurs and abnormal murmurs. Innocent murmurs present when blood flows more quickly than usual through the heart. This can result from pregnancy, exercise, illness or growth spurts (e.g. puberty). Abnormal murmurs are common in cases of congenital heart defects in babies, such as valve problems or holes in the heart. What are the symptoms of a heart murmur? Often a heart murmur will not be accompanied by other symptoms, however, if they murmur is a result of an underlying heart condition, the following symptoms may also be present: Chest pain Palpitations Syncope or dizziness Sudden weight gain Shortness of breath Blue-tinged skin (especially the lips and fingers) What causes a heart murmur? Whilst people with a healthy heart can have heart murmurs, they can also result from other problems, such as: A heart valve that is thickened or not normal. An abnormal communication between two cavities, due to congenital heart disease. Atherosclerosis Hypertension, a pregnancy, anemia, fever or an overactive thyroid gland. Congenital alterations in the arteries and veins connected to the heart. What is the treatment for a heart murmur? In general, heart murmurs do not need any treatment. If the murmur is associated with an underlying heart problem, such as high blood pressure, it will be necessary to treat this. When the heart murmur is due to valvular disease, a pharmacological treatment or surgical intervention may be necessary. ...

Hypercholesterolemia

What is hypercholesterolemia? Hypercholesterolemia is an increase in the level of cholesterol in the blood above what is considered normal. The elevated level of cholesterol is related to coronary problems, lifestyle, gender, and diet. Various factors play a role in the disease; genetic and dietary factors need to be taken into account, as well as other ones related to physical activity. Symptoms of hypercholesterolemia: Patients often do not perceive that anything is wrong with them until the possible occurrence of a cardiovascular event, such as a heart attack or angina. In some cases, cholesterol deposits under the skin may appear (xanthomas or xanthelasma). What are the causes of hypercholesterolemia? The main factors contributing to hypercholesterolemia are: An unhealthy diet: excessive consumption of animal fats or alcohol makes the body consume other types of nutrients first, so it is more likely that cholesterol is not broken down and hence it accumulates in the arteries. Hepatic, renal or endocrine diseases. Familial hypercholesterolemia: a hereditary disease in which cholesterol cannot be broken down, leading to a gradual increase in its level. Can hypercholesterolemia be prevented? The main recommendations for preventing hypercholesterolemia are as follows: Follow a balanced diet (it is important to avoid saturated fats). Do physical activity of moderate intensity on a regular basis. Following these two recommendations also helps to prevent or control other risk factors for cardiovascular diseases that are sometimes associated with hypercholesterolemia, e.g. obesity or hypertension. How is hypercholesterolemia treated? Generally, all patients with hypercholesterolemia should improve their diet in order to reduce cholesterol levels, increase their physical activity and eliminate risk factors that could promote the development of associated diseases. If the dietary treatment does not achieve the desired goal, a pharmacological treatment should be added, one individualised to the patient, given that other risk factors should be taken into account, along with associated diseases. ...

Palpitations

What are palpitations? Palpitations are heartbeats that feel either too fast or too hard, and sometimes they can feel like your heart is skipping a beat. These are felt in your chest, throat or neck. Often these are not harmful and can result from stress, caffeine, nicotine or anxiety. Pregnancy can also cause heart palpitations at times. Sometimes, heart palpitations can indicate more serious heart conditions, particularly if they happen frequently. If palpitations are experienced alongside dizziness, chest pain or shortness of breath, seek medical attention. Prognosis: Heart palpitations are usually not severe, but if they occur frequently, a medical examination will be needed to rule out underlying heart problems, such as arrhythmia. Symptoms of heart palpitations Heart palpitations can feel unpleasant and feel as though the heart is beating too strong and too fast. If palpitations are experienced alongside dizziness, chest pain or shortness of breath, seek medical attention. How are palpitations diagnosed? To rule out possible underlying heart conditions, you may need an ECG, a blood pressure test or an echocardiogram. What are the causes of heart palpitations? Heart palpitations are usually a result of anxiety, stress or panic attacks; caffeine intake or nicotine; consumption of illegal drugs; exercise and fever, among others. In addition, there are conditions that can increase the probability of having an abnormal heart rhythm, such as: Previous heart disease (arrhythmias) Hyperthyroidism Abnormal heart valve Hypoglycaemia Significant risk factors for heart disease Anaemia Electrolyte blood abnormality Can hear palpitations be prevented? It is possible to prevent palpitations by doing the following: Regular moderate exercise Avoid anxiety and stress Treat underlying diseases Avoid tobacco, alcohol and coffee Treatments for heart palpitations Treatment will depend on the underlying cause of the palpitations. If it caused by anxiety or stress, then these can be managed better. If they are caused by a stimulant, then these can be avoided. If there is an underlying heart condition, then this will have to be treated accordingly. What specialist treats heart palpitations? Cardiologists would diagnose and treat heart palpitations. ...

Preventive cardiology

What is preventive cardiology? Preventive cardiology is a set of measures that aim to reduce the chances of someone experiencing the results of cardoivascular disease by recognising symptoms and risk factors early. There are two main types of preventive cardiology: Primary prevention: refers to a series of tests and tips to prevent the onset of heart disease. Secondary prevention: if there are already heart problems and even if you have already had cardiovascular surgery, preventive cardiology will help to improve health, continue rehabilitation and reduce the chances of further cardiac events. Why is preventive cardiology done? The high incidence and high mortality from diseases such as ischemic heart disease have been raising awareness in society to carry out prevention and awareness-raising campaigns. The aim of preventive cardiology is to try to avoid and fight the main cardiovascular risk factors, including: Obesity Diabetes – promoting healthy diabetes management and reducing the number of people who develop type two diabetes. Smoking High blood pressure Sedentary lifestyle – promoting a healthy diet and regular exercise. Hypercholesterolemia – reducing cholesterol levels. What does preventive cardiology involve? Preventive cardiology consists of a medical follow-up performed by a cardiologist to patients who, for whatever reason, are at risk of suffering from cardiovascular problems or who already have them. A medical follow-up is done through a sequence of medical appointments, as well as a diagnostic and preventive tests and treatments. The most common measures in preventive cardiology are: Electrocardiogram: heart activity is recorded and problems, such as arrhythmias, can be detected. Holter pressure: this test can detect sudden changes in blood pressure. Echocardiogram: through the non-invasive ultrasound system, you can observe heart function. Stress test: this test observes cardiac, pulmonary and metabolic activity when the body is in motion or exercising. Cardiac MRI: this scan allows us to observe the heart in three dimensions and assess its activity in real time. Computed tomography (CT) scan: similar to MRI scans, a CT scan obtains a number of images of the heart from different angles. Cardiac catheterisation: this test is performed to measure the pressure of the arteries and cardiac cavities, it is done by inserting a catheter through an incision in the groin until it reaches the arteries to be observed. Next, to prevent heart diseases, the following may be recommended: Healthy habits: the first step in preventive cardiology will be to give guidelines to the patient to adopt healthy habits and make significant lifestyle changes (a balanced diet, and regular exercise). Pharmacological treatment: some patients will be recommended medication designed to control heart disease, such as those that control blood pressure. Surgery: if healthy lifestyle changes and pharmacological treatment are not enough, the cardiologist can choose to do preventive surgery, such as placing a stent to strengthen the venous walls. How to prepare for preventive cardiology Before attending a medical consultation for preventive cardiology, it would be good for the patient to come prepared, and even make a list of the following; the symptoms he/she feels, the activities that he/she has carried out, keeping a list of the medicines he/she must take and other information that could be useful to the doctor. It may also be useful for the patient to write down all the questions they wants to ask to the doctor. Follow-up needed: In the process of preventive cardiology, the specialist will provide the patient with guidelines that must be followed for the best chances of preventing heart disease. Preventive cardiology is a process in which the patient's collaboration is required to make it work. ...

Syncope

What is syncope? Syncope, also known as fainting, is the sudden loss of consciousness for a brief period. This is usually caused by insufficient blood flow to the brain, and is often associated with low blood pressure (hypotension). What are the symptoms of syncope? Before fainting, you may feel weakness or nausea. The following are also warning signs experienced just before fainting: Feeling clammy and sweaty Confusion Light-headedness Blurred vision Yawning Ringing in your ears After fainting, you normally regain consciousness within 20 seconds, and you may feel weak for a short period afterwards. You may also not remember what you were doing just before you fainted. What causes syncope? Fainting (syncope) is caused by a reduction in blood flow to the brain. This can be disrupted by several factors: Triggers (e.g. heat, pain, sitting or standing up suddenly, an unpleasant sight or even swallowing) Heart problems Reflex anoxic seizures (common in children) Low blood pressure (hypotension) Low blood sugar levels Medications Dehydration Can syncope be prevented? There is no specific treatment that prevents the onset of syncope, but if a person is prone to fainting, you can either avoid known triggers, or if you feel an episode coming on, lie down and lift your legs or sit down and put your head between your knees. This keeps blood flowing to your brain. What is the treatment for syncope? Treatment depends on the cause of the syncope. If there is an underlying health condition, then tests will need to confirm this and treated accordingly. The tests that the doctor can order can include: Blood tests Heart rate monitoring Echocardiography Electrocardiography Chest x-ray Often, after fainting, no further treatment is needed, but measures to avoid future episodes can be taken, such as avoiding triggers. ...

Thoracic pain

Thoracic pain occurs in the front of the chest and can be a symptom of many conditions: heart disease, such as acute myocardial infarction, coronary insufficiency, or pericarditis; respiratory infections such as influenza, pneumonia; nervous disorders, such as anxiety attacks; or osteoarticular and muscular illnesses. However, the patient must bear in mind that, despite the sensation of severe chest pain, many times the causes are not dangerous to the health of the individual. Since the cause of chest pain can be multiple, to avoid any setbacks, it is essential to consult the specialist promptly to receive immediate treatment, if necessary. ...

Tilt table

What is a tilt test? The tilt test or tilt table test is an examination carried out to find out the causes of syncope (collapse) without any specific cause, and that is accompanied by other symptoms such as instability or vertigo. Mainly, the test is based on the evaluation of the heart rate and blood pressure while lying down, standing almost upright, and being in an erect position. What does it involve? The test involves lying on a tilt table, where you are tightly fastened with straps and with your feet lying on a foot support at the base of the table in order to help you stand in an upright position. While in this position, the first registration of your blood pressure and heart rate is done. Then you are laid flat and more registrations will be taken at the following minute intervals: 1, 5 and 10. Once 10 minutes have passed, you will be tilted to an almost upright position, between 60° and 80° for 20-30 minutes until you experience the same symptoms as when you suffer a syncope. If symptoms don´t show they will be artificially provoked using medication. The test is considered positive if it induces an episode of syncope, such as a drop in blood pressure and heart rate. These symptoms disappear when you are laid flat. Why do you need it? This test allows the doctor to find out the relation between blood pressure and the appearance of specific symptoms, which in many cases, makesdetecting the correct origin of the syncope possible, as it can sometimes be erroneously diagnosed as epilepsy. The test can also determine the origin of orthostatic hypotension and autonomic dysfunction. How to prepare for it The test lasts for around 40 minutes, and the only preparation you need is not to eat or drink for at least 3 hours before the test. It is advisable to bring someone along to your appointment as you may feel light-headed at the end of the test. For those suffering from ischaemic heart disease, diabetes mellitus, glaucoma, carotid artery stenosis, prostate enlargement and serious valvular heart disease, this test is not recommended. It is advised that you visit a specialist for advice. What do you feel during the test? The tilt test is not considered invasive, although the induced faint can feel uncomfortable. ...

Venous insufficiency

What is venous insufficiency? Veins in your legs have to carry blood back to the heart, and they can do this because the veins have one-way valves the stop the blood from flowing backwards with gravity. However, if you suffer from venous insufficiency these valves do not function properly and some of the blood remains in your legs which causes the blood to collect in the veins. This can result in pain and swelling, and sometimes leads to ulcers forming on the legs. What are the symptoms of venous insufficiency? The symptoms of venous insufficiency are: Itching and tingling Swelling Intense pain (which gets worse when stood upright or when someone is stationary) Heaviness or cramping in the legs In addition, there are also changes in the skin such as irritated or dry areas if scratched. Thickening and hardening of the skin (it can sometimes look leathery). Varicose veins What causes venous insufficiency? Venous insufficiency is due to malfunctioning vein valves in the legs. These valves can be damaged by blood clots (deep vein thrombosis, DVT). If you do not exercise much you can be at risk from venous insufficiency. Other risk factors include: People over the age of 50 Family history of venous insufficiency or DVT Being obese Being pregnant People who sit or stand for long periods of time Can venous insufficiency be prevented? The best way to prevent venous insufficiency is to make certain lifestyle changes: Losing weight Exercising regularly Consuming less salt in your diet (this reduces your blood pressure) Wearing compression stockings to help the blood in your legs flow better (these are recommended if you have suffered from DVT or had venous trauma). How can venous insufficiency be treated? As well as the above lifestyle changes, there are also medical treatments that can be recommended, particularly if these non-surgical measures have not proved successful. The following treatments might be recommended: Sclerotherapy Ligation (faulty veins are cut and tied off so that blood no longer flows through it) Vein repair Vein bypass Vein transplant Endovenous thermal ablation (high-frequency radio waves or lasers are used to close the faulty veins) ...

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