Professor Sanjay Sharma

Professor Sanjay Sharma
Cardiology
South London


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Professor Sanjay Sharma

Cardiologist in
London

BSc(Hons) MD FRCP(UK) FESC


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Professor Sanjay Sharma areas of expertise:

Professional statement

Professor Sanjay Sharma is a highly-reputable cardiologist based in London. He specialises in inherited cardiac diseases and cardiomyopathy and has a special interest in echocardiography and sudden arrhythmic death syndrome (SADS). He also specialises in sports cardiology and serves as Chair of the Expert Cardiac Committee for the Football Association (FA) and as a cardiologist for the British Lawn Tennis Association and British Rugby League. He practises at St Georges Healthcare NHS Trust and other prominent clinics in the capital and is committed to research and training acting as Head of Research and as Professor of Inherited Cardiac Diseases and Sports Cardiology for St George's University.

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 Credentials

GMC: ‍3558795

 Professional experience

• More than 30 years of experience
• Professor of Inherited Cardiac Diseases & Sports Cardiology, St George’s University, London (2010 - present)
• Head of Research for Cardiac Clinical and Academic Group, St Georges Healthcare NHS Trust, London (2015 - present)
• Consultant Cardiologist, Cardiac Risk in the Young (2001-present)
• Consultant Cardiologist, St George’s Healthcare NHS Trust, London (2010 - present)
• Medical Director for Virgin London Marathon (2004 - present)
• Medical Director for BUPA 10k London (present)
• Medical Director for Prudential Ride London (present)
• Medical Director for the International Triathlon World Championships, London (present)
• Cardiac Advisor for the English Institute of Sport, Guinness Premier Rugby Union, British Lawn Tennis Association, British Rugby League, Sky Cycling Squad and British Cricket (present)
• Cardiologist for Olympic Medical Institute (2001-present)
• Lead Cardiologist for London 2012 Olympics (2012)
• Consultant Cardiologist, King's College Hospital (2007-2010)
• Consultant Cardiologist, University Hospital Lewisham (2001-2007)

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 Sub-specialties

• Cardiology
• Sports cardiology
• Cardiomyopathy
• Ion channel diseases
• Inherited heart diseases

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 Positions in public associations

• Chair of Expert Cardiac Committee, the Football Association (FA) (present)
• Chair of the ESC Sports Cardiology Nucleus (present)
• Sub-Editor for Scandinavian Journal of Sports and Exercise Medicine (2012-present)
• Editor of British Cardiac Journal (2014)
• Canadian Journal of Cardiology (2016)
• International Journal of Cardiology (2016)

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 Teaching posts

• Honorary Senior Lecturer at King's College Hospital (2007-2010)
• Senior Tutor for RCP International Teaching Faculty for MRCP (II) Exam (2006-present)
• Senior Lecturer for RCP National Teaching MRCP (II) Written Course (2009-present)
• Lecturer for P year, T year and F year (2010-present)
• Internal Examiner for St George's Medical Schools Finals (2014-present)
• External Examiner for the Brighton and Sussex Medical School (2014-present)

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 Education

• MB ChB Leeds University (1983 - 1989)
• BSc (Hons) Biochemistry in Relation to Medicine (1986)
• MRCP (UK) (1991)
• MD with Distinction (2001)

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 Publications and conferences

• His current research programmes include the assessment of the impact of long-term ultra-endurance sport on the heart, ethnic differences in phenotypic manifestations in cardiomyopathy and ion channel diseases, right ventricular adaptation to exercise and sudden arrhythmic death syndrome.
• Self-Assessment Colour Review of Cardiology in colour. Rosen S, Sharma S, and Oakley C. M. (1997) Manson Publishing Limited, London
• Rapid Review of Clinical Medicine for MRCP Part 2 First Edition. Sharma S, and Kaushal R. (2000) Manson Publishing Limited, London
• MRCP Part II Examination Handbook Sharma S. (2000) Sandpiper Publishing, London
• Questions for the MRCP (II) in adult medicine (CD Rom). Rai GS, Sharma S. (2000) Harwood Publishing
• Patient Atlas in Cardiology. Sharma S, and Camm AJ. (2002) Mardeno Publishing
• Case Histories for the MRCP (II). Rai GS, Sharma S. (2003) Harwood Publishing
• Data Interpretation for the MRCP (II). Rai GS, Sharma S. (2003) Harwood Publishing
• Questions for the MRCP (I). Kaushal R, Trivedi R, Sharma S. (2004) Manson Publishing
• Rapid review of clinical Medicine for MRCP Part 2 Second Edition. Sharma S, Kaushal R (2006) Manson Publishing
• ECG interpretation for Sports Sciences. Whyte G, Sharma S. (2010) Human Kinetics Publishing
• Rapid Review of Clinical Medicine for MRCP Part 2 Fourth Edition. (2010) Sharma S, Kaushal R. Manson Publishing
• Clinical and Genetic Aspects of Sudden Cardiac Death in Sports Medicine (Colloquium Series on Genomic and Molecular Medicine). Millar L, Sheikh N, Sharma S. (2012) Morgan & Claypool Life Sciences
• IOC Manual of Sports Cardiology. Wilson M, Drezner J, Sharma S. (2016) Wiley Publication
• He has written over 20 medical education book chapters
• He has written over 50 peer-reviewed articles for medical journals
• He has written over 50 leading articles, commentaries, letters and case reports

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 Prizes and awards

• Frank Happold Prize in Biochemistry (1985)
• McGill Prize in Surgery (1989)
• BHF Junior Research Fellowship Award (1996)
• ESC Sports Sciences Young Investigator of the Year Finalist (1998)
• Wellcome People's Award for 'Silent Heart' project (2007)
• BCN National Awards (First Prize) 'Innovations in Arrhythmia Care' (2008)
• National Clinical Excellence Bronze Award (2010)
• Selection for the Royal Society Summer Science Exhibition (2012)
• Asian Professional of the Year (Medical Category)
• National Clinical Excellence Silver Award (2014)
• ESC Vivianne Conraads Prize for Outstanding Academic Achievement (2015)
• Excellence in Education Award (Most Inspiring Lecturer) St George's (2015)

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 Professional membership

• Member of the British Cardiac Society
• Member of the Royal Society of Medicine
• Fellow of the Royal College of Physicians
• Fellow of the European Society of Cardiology
• Member of the British Society of Echocardiography
• Member of the British Medical Association
• Member of European Society of Cardiac Rehabilitation and Prevention

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Languages spoken

  • English
  • Gujarati
  • Hindi
  • Punjabi

Diseases, Medical Tests and Treatments

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 ...

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 ...

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 ...

Hereditary diseases

Hereditary diseases are the set of genetic diseases that are caused by changes in the genetic material (DNA) and transmitted from generation to genera ...

Sports cardiology

What is sports cardiology? Sports cardiology is a sub-specialty of cardiology that diagnoses and treats heart conditions in athletes and assesses if the patients are fit to participate in sports. It encompasses a series of tests aimed at identifying heart muscle diseases that may pose a risk when playing sport. These tests allow doctors to analyse the health of the heart and how well it copes with intense physical exercise.   What does sports cardiology involve? The patient may require a number of tests depending on their needs, medical history and the sport they practice. Common tests used in sports cardiology include: Electrocardiogram – this is a basic test to monitor heart rate using electrodes placed on the chest. It enables the detection of arrhythmias. Echocardiogram – this imaging test allows observation of the heart's activity by means of ultrasound and can pick up abnormalities that would otherwise have gone undetected on the electrocardiogram. Holter monitor test – this test measures your heart rate for several hours (up to 24 hours) while you go about your usual daily activity, and it shows the activities and times of the day in which your heart rate is particularly high or low. Stress test (ergospirometry) – the patient is asked to run on a treadmill or to pedal a stationary bicycle while their heart rate, blood pressure, and breathing are monitored. This data can be compared to data obtained while the patient is at rest to assess if there is a heart problem.   Why is sports cardiology necessary? This series of tests is aimed at both professional and amateur athletes and people who are starting a new sporting activity. Sport can push our body and heart to the limit, so it is essential to know how far we can go without damaging our health. These tests are therefore aimed at preventing serious heart problems such as heart attacks, Brugada Syndrome or sudden death syndrome, and for monitoring people who have had heart surgery, or who suffer from heart failure, arrhythmias or congenital heart disease. Thus, the aim of sports cardiology is to provide athletes with the necessary tests and advice to avoid health risks when practicing sport, as well as to assure people with illnesses such as heart disease that it is safe to continue to practice sport. An annual sports cardiology check-up is recommended for all athletes, especially those with heart problems. People with a heart condition who are planning to start a new sporting activity should also have a check up to find out in advance if it could harm their health. Anybody who has symptoms such as arrhythmias, chest pain, dizziness, or shortness of breath during sports should see a sports cardiologist find out the cause.   Preparing for sports cardiology tests These tests are minimally invasive and require no special preparation. The cardiologist may advise you on what clothes to wear or what food and drink you can have before the tests, as drinks such as coffee and tea, which contain stimulants are often discouraged so as not to affect the results.   What do you feel during the tests? Sports cardiology tests are minimally invasive procedures and are not painful. In the case of stress tests, however, you will have to exert yourself physically, so you may feel tired or even dizzy and have difficulty breathing.   Meaning of abnormal results Abnormal results from sports cardiology tests may mean that you have a heart condition and can no longer play certain sports, or at least not at high intensity. The cardiologist will evaluate the results and may ask that you repeat a test or have further tests to confirm the diagnosis. ...

Sudden death

Sudden death is a sudden but natural death. The main cause of sudden death is cardiac arrest.  It is estimated that 12% of natural deaths are sudden deaths. In patients with ischemic heart disease, sudden death is the most common form of death.  Popularly it is believed that there is a relationship between physical activity and sudden death. But the overall impact is small.  Some drugs, such as diuretics or antiarrhythmics, can cause arrhythmia and therefore sudden death. Drugs, especially cocaine, also can cause this unexpected death. ...

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. ...

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 over the age of 65. The atria, the upper chambers of the heart that control the rhythm, don’t function as they should and cause the heart rate to speed up, often much higher than the usual regular heart rate of between 60 and 100 beats per minute. Atrial fibrillation can be divided into three categories: Paroxysmal atrial fibrillation: a very high frequency fibrillation, which can be transient and not related to any other conditions. It normally doesn't last more than 48 hours, although in some cases it can last up to one week. It does not usually require extensive medical treatment; Persistent atrial fibrillation: a lower frequency fibrillation which requires medical treatment; Permanent atrial fibrillation: it is often caused by an underlying condition. The treatment will consist in addressing that condition first. What are the symptoms? Atrial fibrillation can affect people occasionally, experiencing symptoms for a few minutes, before they cease, or they can be persistent where the symptoms don’t stop until there is medical intervention. The most common symptoms experienced are: Heart racing or beating irregularly, known as palpitations Feeling weak or lightheaded Dizziness Fatigue Shortness of breath Pain in the chest Atrial fibrillation carries some risks for the sufferer. Due to the irregularity of the heartbeat, blood can pool and clot within the heart. If the clot breaks away, it can travel around the blood system and cause blockages within the smaller blood vessels. This can lead to stroke in some cases, with atrial fibrillation being one of the main causes of strokes. Atrial fibrillation can also lead to heart failure, as the heart’s muscles may become weakened, especially if the condition is long-standing. How is it diagnosed? Atrial fibrillation can be diagnosed with a heart exam. The main tests to diagnose atrial fibrillation are: Pulse rate measurement ECG Chest X-ray scan Echocardiogram What causes it? Atrial fibrillation is mainly caused by cardiac disorders, such as: rheumatic heart disease cardiac valve disorders myiocardial infarction coronary heart disease hypertension Moreover, the following conditions can also lead to atrial fibrillation: hyperthyroidism type 2 diabetes respiratory diseases gastroesophageal reflux disease hiatal hernia obesity smoking, alcohol and illegal drugs excessive caffeine intake How can it be prevented? You can help to prevent atrial fibrillation by leading a healthy lifestyle: maintaining a healthy weight, exercising regularly and quitting smoking.   How is it treated? The condition is not life-threatening in the short term, but should be treated where possible to overcome the risks mentioned above. Treatment usually involves one or more of the following: Medication to control the irregular heart rhythm Blood-thinning medication (anticoagulants) to reduce the cha nce of stroke. This acts to prevent the blood pooling and clotting in the heart’s chambers. Catheter ablation surgery which involves the placement of a catheter along the veins of the leg to the heart. The catheter is then heated to burn the section of the heart that is causing the irregular rhythms, effectively killing the source of the electrical signals that are causing the heartbeat. To make an appointment with a doctor specialising in the treatment of atrial fibrillation, click here. ...

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  ...

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 constitutes one of the most important tools to find out and evaluate most of the cardiac conditions. Also, electrocardiography provides an invaluable tool for the diagnosis of the growth of the heart chambers (atria and ventricles). In many cases, the diagnosis of congenital heart diseases comes from the characteristic ECG graphic. In fact, the ECG provides important data for the evaluation of more than 80% of heart diseases. ...

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 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. ...

Hypertension

What is hypertension? Hypertension, or high blood pressure, is a chronic condition where your resting blood pressure is persistently higher than what is considered a normal reading (120/80mmHg). If your diastolic pressure is persistently higher than 90 mmHg and your systolic pressure is persistently higher than 140mmHg, then you have high blood pressure. Based on different readings, hypertension can be classified as: Mild or prehypertension: between 130/85 and 139/89mmHg; Stage 1 hypertension: between 140/90 and 159/99mmHg; Stage 2 hypertension: between 160/100 and 179/109mmHg; Stage 3 hypertension: 180/110mmHg or higher. Prognosis: Hypertension is a complex condition which may lead to severe complications, such as heart attack or stroke. Hence, being aware of your blood pressure and controlling a healthy level is very important for your overall health. What are the symptoms of hypertension? The symptoms of hypertension are not specifically linked to this condition and they may be overlooked as being related to other, less severe conditions. The most common symptoms are: Headache; Dizziness and/or vertigo; Buzzing or hissing in the ears; Eyesight problems. How is hypertension diagnosed? Hypertension can be diagnosed with several different tests, including: Blood test; Urine test; Stress or exercise ECG; 24-hour ambulatory blood pressure monitoring. What causes hypertension? Hypertension can be caused by ageing, family predisposition, a high salt diet, smoking, obesity, having a sedentary lifestyle, drinking a lot of alcohol, stress and other concurrent conditions. How is hypertension treated? Hypertension can be treated with antihypertensive agents, diuretics, alpha-blockers, beta-blockers and sympatholytic drugs. However, it is important to keep in mind that medication therapy should always be accompanied by lifestyle changes. A low-salt diet, constant and moderate intensity exercise, weight control, stopping smoking and cutting down on alcohol can help you reduce your blood pressure. Which doctor should I talk to? If you are suffering from hypertension, you should see a cardiologist. In case you also have other conditions, you may have to see an internal medicine doctor, a nephrologist or a neurologist. ...

Myocarditis

Myocarditis is the inflammation of the heart muscle. It is a rare disease and can be caused by several factors: infections, allergic reactions, diseases with an immunological cause, etc. In some patients there are no symptoms, but in the majority of cases this disease manifests through chest pain, fatigue, fever, joint pain, or respiratory distress, among other symptoms. A series of tests (a general analysis, a heart ultrasound and an electrocardiogram) are required for diagnosis. Treatment aims to eradicate the cause of the inflammation of the heart muscle through the prescription of antibiotics or anti-inflammatories, and the recommendation of a low-salt diet, or a decrease in physical activity. In many cases, recovery with appropriate treatment can lead to the patient’s complete cure, avoiding major complications such as heart failure. ...

Palpitations

What are palpitations? Palpitations are heartbeats that feel either too fast or too heard, 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. ...

Pericarditis

What is pericarditis? Pericarditis is the inflammation of the pericardium which is the thin outer sac that surrounds the heart. Common symptoms include chest pain, which is acute and subsides quickly. However, sometimes pericarditis can be chronic. Often cases of pericarditis will improve on their own, but more severe cases do require treatment. What are the symptoms of pericarditis? Symptoms will vary depending on what type of pericarditis you are experiencing. Your pericarditis may be acute, chronic or recurrent. Common symptoms include: Sharp, throbbing pain over the middle or left side of the chest. Often this intensifies when inhaling. Palpitations Fatigue A dry cough Swelling in the ankles, legs and feet Mild fever There is the possibility of complications arising from untreated pericarditis or pericarditis that has a late diagnosis. This includes constrictive pericarditis which is the permanent thickening and contraction of the pericardium, preventing the heart from working properly. Another complication is cardiac tamponade which is when too much fluid collects in the pericardium, preventing the heart from filling properly with blood. What causes pericarditis? The cause of pericarditis can be difficult to determine. Often though it is due to an infection (viral, bacterial or fungal). Additionally, pericarditis can be caused by: Following a heart attack or heart surgery Trauma Other health problems (e.g. AIDS, tuberculosis or cancer) Some medications Lupus and rheumatoid arthritis Can pericarditis be prevented? Many cases cannot be prevented. How is pericarditis diagnosed? A diagnosis will begin with a thorough assessment of your medical history and your symptoms, as well as a physical examination. It is likely you will have an electrocardiogram (ECG), echocardiogram, X-ray and a CT scan to exclude other possible causes of your chest pain. What is the treatment for pericarditis? Treatment depends on the severity of the symptoms and whether it is acute or chronic. Mild cases will usually improve on their own without treatment. If medication is given, you will likely have painkillers, a drug called colchicine (this reduced inflammation) or corticosteroids. If the cause is a bacterial infection, antibiotics will be given. If you are suspected of having a complication (e.g. cardiac tamponade), you may need a surgical procedure to reduce the build-up of fluid in the pericardium. ...

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

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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