Looking after your heart

If your doctor suspects a heart problem, he or she is likely to refer you to a cardiologist — a specialist in diagnosing and treating heart conditions. With some conditions that require surgery, you may also be referred to a cardiothoracic surgeon but you are likely to remain under the supervision of a cardiologist.

There has been very fast progress in cardiology in recent years. Increasingly, it has become difficult for cardiologists to keep fully up to date with all areas. So there is an increasing tendency for them to specialise in particular areas. That means that if your doctor refers you to a heart specialist, you should ensure that the person is an expert in your condition, or the test or treatment being recommended.

Do I need an angiogram?

People with chest pain are often referred to a specialist for coronary angiography — a diagnostic technique which identifies whether there are any blockages in the heart’s blood vessels (see below for more details). It is not always necessary and the procedure carries some risks but, if there is a possibility that the cause of chest pain is angina, it is generally best to have an angiogram. The risk of serious complications following an angiogram is about one in 1,000. The risks of undiagnosed and untreated heart disease are many times higher.

What medication will I need?

Large clinical trials have demonstrated that patients who are proven to have coronary artery disease have a better prognosis if they take each of these four drugs: aspirin, a statin, an ACE (angiotensin-converting enzyme) inhibitor and a beta-blocker. But you should always seek medical advice first.

What is my cholesterol level?

High cholesterol levels are an important contributor to development of coronary artery disease. The most effective way to lower them is by taking a statin drug. There are other drugs that can also be used to lower cholesterol levels, as well as dietary measures.

What is my blood pressure and how often should I have it checked?

High blood pressure is another important risk factor for coronary artery disease that can be modified with the right treatment. As a rule of thumb, only half of people with high blood pressure have it checked, only half of those people receive treatment and only half of those people receive effective treatment, which amounts to only an eighth of those with the problem.

What is my blood glucose level? Was it checked while fasting?

Diabetes is a very important cause of coronary artery disease. It is best detected by a fasting blood glucose test in which you fast from midnight and have a blood test in the morning.

For more information

• See our physical health and wellbeing section
  
• www.bhf.org.uk/