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.


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 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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24/06/2017

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Diseases, Medical Tests and Treatments

Arrhythmia

Arrhythmia is an abnormal heart rhythm. The heartbeat in a resting adult is between 60 and 100 beats per minute. When it increases significantly it is ...

Atrial Fibrillation

Atrial fibrillation is a heart rhythm irregularity that causes the heart to beat fast or irregularly. It affects around 4% of people over the age of 6 ...

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

Electrophysiological study is used to detect cardiac abnormalities by observing the electrical activity of the heart. It is performed by inserting catheters in the area (usually the neck or groin) through which electrodes are passed to the body, directed towards the heart by radioscopy. This way it is possible to permanently analyse the activity of the cardiac muscle and to recognise the causes of the cardiac abnormality of each patient. This therapeutic electrophysiological study can cause discomfort in the area of puncture and there is the risk of causing palpitations. In the event this occurs, an electric shock should be performed in the area to address the problem and continue the process. ...

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

Factors that lead to an increased likelihood of cardiovascular disease (CVD) include cholesterol, diabetes, hypertension, smoking, genetics, stress, obesity, and heart rate. The most common consequences are myocardial infarction or cardiovascular pathologies such as thrombosis, stroke, or cerebral haemorrhage. Variables such as age, sex, race, and family history all play a part. Maintaining a balanced diet also helps to control the blood pressure, cholesterol, and blood glucose. ...

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

An echocardiogram is a diagnostic test based on the use of ultrasonic techniques in the chest area. The ultrasound reaches several structures of the heart and when it bounces back the data is collected, analysed and represented through graphics. The echocardiographic analysis or ultrasound of the heart represents a histogram of the mobility of the heart muscle and is especially useful for the study of the functioning of heart valves and their pathology. Also, this diagnostic test is useful for the metal prosthesis post-op follow-up. The 2D scan allows viewing images in real time, which lets the specialists, make the calculation of volumes and areas of the valves orifices, which serves to complete medical diagnostics. ...

Fatty liver

Fatty liver disease, also known as hepatic steatosis, is a disease characterised by the accumulation of fatty acids and triglycerides in liver cells. ...

Heart attack

A heart attack or myocardial infarction occurs when a coronary artery is blocked, causing damage to a portion of the heart muscle. The blood supply to the heart is reduced when the arteries are blocked. If it happens for a prolonged period of time the tissue dies and does not regenerate. ...

Heart failure

Heart failure occurs when there is a blockage in the blood circulation. This blockage may be located within the heart muscle or outside, causing an increase in blood pressure. There are two types of heart failure: systolic when the heart muscle cannot pump blood out of the heart and diastolic, which is when the heart muscles are stiff and do not fill with blood. Both are treatable. Firstly, the patient should avoid any effort that overloads the heart, and then, he/she should take the medications that provide vitality to the exhausted heart muscle. If the blockage is within the coronary arteries it is known as coronary insufficiency. ...

Heart murmur

Heart murmurs are sounds similar to the sound of the air of a torch. Heart murmurs are usually pathological, although in young children may be normal. You can listen to the heart using a stethoscope, which is placed at chest level. Heart murmurs are always indicative that there is increased blood flow to heart level, either by an alteration of a heart valve or a non-cardiac cause. It is important to take note of all the characteristics of the heart murmur, such as the intensity, timing, location, shape, radiation, quality and pitch, as they offer a lot of information regarding the pathology that causes it. ...

Hypercholesterolemia

Hypercholesterolemia is the presence of cholesterol above the normal levels in the blood. This increase is often associated with coronary problems, diet, sex, lifestyle and endogenous synthesis. Therefore, the concentration of cholesterol in the blood involves hereditary and dietary factors, along with other factors related to physical activity. There are two types of hypercholesterolemia. Primary hypercholesterolemia, derived from problems in the cholesterol transfer systems and genetic factors, and secondary hypercholesterolemia, in which the increase in cholesterol is associated with certain liver, endocrine and renal diseases. ...

Palpitations

Palpitations are heartbeats of sudden onset, usually rapid and uncomfortable. Normally the cardiac variations are only perceived in a situation of stress, strong emotion or after performing a major physical exercise. But heart palpitations can occur in certain pathological states in which the heart rate increases in intensity and frequency, as in the case of tachycardia, which may be a symptom of cardiac or non-cardiac disease, such as serious anaemia, increased thyroid function, liver disease, or other conditions. Palpitations may also appear after the ingestion of alcohol, tea, coffee and other stimulants. ...

Preventive cardiology

Preventive cardiology is the set of measures that tend to protect the person from the possibility of suffering a particular medical condition. The high incidence and high mortality due to ischaemic heart disease have made society aware of prevention, the importance to raise awareness and awareness campaigns, with the aim of trying to avoid and combat the so-called risk factors: obesity, tobacco, hypertension, sedentary life and hypercholesterolaemia. This type of action prior to the onset of the disease is called primary prevention, while the secondary prevention uses certain medical or even surgical guidelines, such as bypass surgery, to improve quality and survival rates. ...

Syncope

Syncope, lipothymy or fainting are practically synonymous and are defined as loss of consciousness. In lipothymy, patients are aware that they are becoming weaker and that at any moment their body can collapse and lose consciousness. In the case of syncope, the patient suddenly loses consciousness without previous symptoms. The causes of syncope can be very diverse, from cardiovascular such as arrhythmias or cardiac conditions, to neurovascular, such as migraines and pharmacological or metabolic causes. Its treatment consists of keeping the patient with the legs elevated and the head lowered in a well-ventilated place and without too many people around. Secondly, if this is not enough, the primary cause of the patient's lymphocyte must be treated. As for treatment, there is no drug that prevents fainting. ...

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

The tilt table test is used to find the cause for spells of fainting. To perform the test, the patient must be attached by the arms and feet on a special reclining table, and an intravenous catheter will be inserted into one arm while blood pressure is monitored through the other. In addition, to analyse the heart rate, a set of electrodes connected to an electrocardiograph obtains constant electrocardiograms during the test. The individual will see their heart rate altered to such an extent that they will eventually lose consciousness, just as in a fainting fit. This way, the detailed results of the test let the professional set pharmacological treatment to prevent the patient from suffering any more fainting. ...

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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