There are a number of symptoms that are suggestive of underlying heart disease. These can include palpitations, dizziness & blackouts, chest pain, shortness of breath & fatigue. Symptoms of heart disease vary from person to person. Important symptoms suggesting underlying heart disease should not be ignored and are outlined below:
Palpitations
are an awareness of your heart beating. They are common and can be normal in certain situations (e.g. after exercise or in stressful situations). Palpitations may be of concern if they are sudden, prolonged or associated with other symptoms such as sweating, dizziness, chest pain or breathlessness. Palpitations can be a sign of a heart rhythm abnormality called arrhythmia and examples include:
- Atrial fibrillation
- Atrial flutter
- Supraventricular tachycardia (SVT)
- Ventricular tachycardia (VT)
Palpitations are investigated with a 12-lead ECG and prolonged heart rhythm monitoring if needed (24-hour Holter monitoring, 7-day event recording, REVEAL device implantation). Evaluation of the heart from a structural and functional perspective is important to understand why an arrhythmia is present and this may involve echocardiography, cardiac MRI or CT coronary angiography.
Treatment options vary depending on the precise nature of the arrhythmia. For some, simple measures and reassurance can be all that is required. In other cases medications and tablets are sufficient. In a few cases invasive treatment is preferable and this can include electrophysiological studies and ablation or cardiac device therapy. (e.g. permanent pacemaker, implantable cardioverter defibrillator, cardiac resynchronisation therapy).
Treatment options vary depending on the precise nature of the arrhythmia. For some, simple measures and reassurance can be all that is required. In other cases medications and tablets are sufficient. In a few cases invasive treatment is preferable and this can include electrophysiological studies and ablation or cardiac device therapy. (e.g. permanent pacemaker, implantable cardioverter defibrillator, cardiac resynchronisation therapy).
Dizziness & blackouts
– are an unpleasant sensation of light headedness or feeling ‘giddy’ that can lead to temporary loss of consciousness. It can be ‘normal’ in certain circumstances like after prolonged standing in a hot environment, being dehydrated or after giving blood. However, they can be more serious if such episodes are sudden, prolonged or associated with other symptoms (e.g. chest pain, palpitations, breathlessness). It can also be very serious depending on the circumstances (e.g. whilst driving) or if a blackout leads to head or facial injuries.
Episodes are investigated with a 12-lead ECG and prolonged heart rhythm monitoring if needed (24-hour Holter monitoring, 7-day event recording, REVEAL device implantation). If symptoms are worse with exertion an exercise stress test is performed. Evaluation of the heart from a structural and functional perspective is important to understand why dizziness and blackouts occur and this may involve echocardiography, cardiac MRI and/or CT coronary angiography. In some cases we will try to reproduce these episodes with a ‘tilt-table test’.
Treatment options vary and for some, simple measures and reassurance can be all that is required. In other cases medications and tablets are sufficient. In a few cases invasive treatment is necessary and this can include coronary angiography, electrophysiological studies and ablation, cardiac device therapy. (e.g. permanent pacemaker, implantable cardioverter defibrillator, cardiac resynchronisation therapy) or heart valve procedures.
Episodes are investigated with a 12-lead ECG and prolonged heart rhythm monitoring if needed (24-hour Holter monitoring, 7-day event recording, REVEAL device implantation). If symptoms are worse with exertion an exercise stress test is performed. Evaluation of the heart from a structural and functional perspective is important to understand why dizziness and blackouts occur and this may involve echocardiography, cardiac MRI and/or CT coronary angiography. In some cases we will try to reproduce these episodes with a ‘tilt-table test’.
Treatment options vary and for some, simple measures and reassurance can be all that is required. In other cases medications and tablets are sufficient. In a few cases invasive treatment is necessary and this can include coronary angiography, electrophysiological studies and ablation, cardiac device therapy. (e.g. permanent pacemaker, implantable cardioverter defibrillator, cardiac resynchronisation therapy) or heart valve procedures.
Chest pain
– pain or discomfort in the chest can be a worrying symptom and should never be ignored. There are many structures in the chest including the heart, lungs, oesophagus, major blood vessels and the sternum/ribs, all of which can lead to discomfort. Pain due to the heart is called angina and occurs due to poor blood supply to the heart muscle. Typically, this is described as a heaviness or tightness in the centre of the chest that is worse with exertion and relieved with rest. It may radiate to other areas such as the left arm, neck or jaw. There can be associated features like shortness of breath, sweating or sickness. Interestingly, women often do not always experience this classical description of angina.
Angina is investigated with a 12-lead ECG and echocardiogram initially. An exercise stress test can also be performed. CT imaging of the coronary arteries is incredibly useful for visualisation of the blood supply to the heart muscle. If a problem is identified from these tests you require a coronary angiogram which is the gold standard to not only evaluate the coronary arteries but also to treat the arteries with stents if needed. This is called percutaneous coronary intervention (PCI).
Treatment of coronary artery disease requires important focus on risk factor modification in the first instance. Changes to diet, exercise and lifestyle will often be required. Medications can help support this process and help to improve blood flow to the heart muscle. Dr Chandra specialises in Interventional Cardiology, so if coronary angiography or PCI is necessary you will be in safe hands.
Treatment of coronary artery disease requires important focus on risk factor modification in the first instance. Changes to diet, exercise and lifestyle will often be required. Medications can help support this process and help to improve blood flow to the heart muscle. Dr Chandra specialises in Interventional Cardiology, so if coronary angiography or PCI is necessary you will be in safe hands.
Shortness of breath & fatigue
– can be caused by problems with your heart health. Problems with the blood supply to the heart muscle, narrowed or leaking heart valves, electrical rhythm abnormalities and heart muscle weakness can all lead to shortness of breath, fatigue or reduced exercise capacity. Moreover, shortness of breath and fatigue can also be caused by other medical problems not related to the heart including lung disease, kidney problems, hormone imbalances and low blood counts.
Investigating for heart abnormalities giving rise to shortness of breath and fatigue will require blood tests, 12-lead ECG and echocardiography. Further testing will depend on the possible cause and may involve heart rhythm monitoring, exercise stress testing, detailed heart imaging (cardiac MRI or CT scanning) or coronary angiography.
Treatment also hinges on the exact cause of the breathlessness and fatigue but will start with improvements to diet, exercise and lifestyle. Medications may also be required to ease symptoms and improve heart function. Some procedures can be performed on the heart that will be beneficial including PCI, device therapy (pacemakers), electrophysiological studies or heart valve intervention. Dr Chandra will guide you through the best options for you and provide a tailored management plan.
Treatment also hinges on the exact cause of the breathlessness and fatigue but will start with improvements to diet, exercise and lifestyle. Medications may also be required to ease symptoms and improve heart function. Some procedures can be performed on the heart that will be beneficial including PCI, device therapy (pacemakers), electrophysiological studies or heart valve intervention. Dr Chandra will guide you through the best options for you and provide a tailored management plan.
