Your initial consultation at The Princess Margaret will begin with your consultant asking for a detailed medical history, as well as an outline of the symptoms you’ve been experiencing. They may ask you questions such as:
- What symptoms have you noticed?
- How long have you had these symptoms?
- Have you had any previous heart concerns?
- Do you have a family history of heart problems?
- Are your symptoms provoked by exertion/exercise?
- Have your symptoms been getting increasingly frequent?
- Have you received any other treatment yet?
Your consultant will also assess your risk factors, which include high blood pressure, diabetes, whether you drink heavily or smoke, as well as your genetic history (specifically looking at your ‘first degree’ family, i.e. parents and siblings). A clinical examination will follow this, with your consultant listening to your heart and lungs, and they will likely check your blood pressure.
A large majority of patients need no further investigations, and your consultant can reassure you that nothing concerning has been found. Occasionally, other investigations can be used just to be sure. For patients with high cholesterol or high blood pressure, your consultant can advise you on whether or not you should take preventative medication to help combat any future concerns.
Diagnostic scans will be required if you have reported any of the notable symptoms of a heart condition, such as chest pain, shortness of breath or palpitations.
The typical test in the first instance is an ECG (Electrocardiogram), where electrodes are fitted to the front of the chest, measuring the electrical signals of the heart.
An echocardiogram is an ultrasound scan of the heart to highlight the valves and muscles, and is particularly useful when investigating heart failure.
Patients with palpitations may need a heart rhythm monitor, which is a useful test used to record your heart rhythm over a period of 24-48 hours (although variations are available to record up to 7 days, depending on your needs). These tend to be sent out to your home address, allowing you to carry on with your normal day-to-day activities while the equipment records your heartbeat, which can then be assessed by your consultant.
Those with chest pain/coronary artery concerns will either undergo a Stress Echocardiogram (where your heart rhythm is monitored while you exercise on a treadmill) or a CT Coronary Angiogram. Having placed your heart under stress with the guidance of your consultant, this can often provide confidence and reassurance that you can continue your normal routine without fear. These specialist scans will take place at another site, but will be overseen by your chosen consultant.
Once all investigations are complete, you will meet with your consultant again for a follow-up, where you will be presented with options for your personalised treatment plan, which is always evidence-based, taking into account your goals for recovery.