One of the most prominent and debilitating features of POTS is a very marked increase in heart rate upon adopting an upright posture. This causes the patient to experience very fast heart palpitations which are both scary and very uncomfortable. The patient therefore will try and sit down or lie down to feel better but this is at the cost of becoming increasingly deconditioned in the medium and lo [...]
Supraventricular tachycardia (SVT) is a common heart rhythm disturbance which may occur in all age groups including young and otherwise healthy patients. It is characterised by a sudden and unpredictable development of heart palpitations which to the patient feel very fast and regular. It can last between a few minutes to several hours and subside almost as quickly as it came on. Occasionally it d [...]
One of the most worrying things when we experience chest discomfort is the possibility that it can be due to heart disease and that it could be a warning for something really bad on the horizon such as a heart attack or even death. Chest pain can be due to so many different pathologies and not all forms of chest pain indicate a problem with the heart and therefore a lot of people ignore it [...]
As we find ourselves in the midst of the COVID-19 pandemic, we are realising that this particular virus is far more dangerous than we had initially thought and apart from largely supportive measures, we don’t really have any proven effective treatments. The truth is that whilst the lockdown and social distancing measures may control the spread of the illness they don’t have any impact on the dange [...]
Atrial fibrillation is a disorder both of heart rate and heart rhythm. By definition, the heart beats irregularly but also can beat excessively fast or excessively slow. When the heart beats excessively fast, there are 2 main consequences: The patient is generally more symptomatic with palpitations, breathlessness, fatigue and exercise intolerance There is a likelihood that as the heart is working [...]
As you all know we are in the midst of the COVID-19 pandemic and whilst we know the virus predominantly affects the lungs there have been several reports that it can also damage the heart and a lot of people have written to me to ask to try and clarify what i understand about the virus and its effects on the heart. The first thing to say that we only have limited data at the moment and our underst [...]
POTS is a hugely debilitating condition which is characterised by an abnormally high heart rate when the patient adopts an upright posture. A lot of medical research has focused on trying to reduce the heart rate and this does seem to make a beneficial difference in patients with POTS. However virtually every POTS patient that I have looked after will complain of lots of other symptoms which are n [...]
A lot of people have written to me asking about the safety of taking ACE inhibitors during the COVID-19 pandemic. I therefore thought I’d do a blog to clarify my understanding of this subject. It is important to note that given the very rapid and terrifying pace of growth of the pandemic, we have very limited data to make absolutely definitive conclusions and the advice may change as results from [...]
Any form of heart disease, if progressive, will lead to the heart gradually failing in its role as an effective pump. This condition is called heart failure and it is typified by an impairment in quality of life and a substantial reduction in lifespan for the sufferer. The good news Is that we now have some very good medications which can substantially improve prognosis in such patients. Th [...]
High blood pressure is a major health problem and affects about 30% of the adult population worldwide When the blood pressure is high and causing the patient damage then lowering the blood pressure can significantly reduce the risks of long term complications such as heart attacks and strokes. Currently the main strategies to control blood pressure are lifestyle management and medications. The pro [...]
Cardiac troponins are proteins that are found in heart muscle and play a role in the contraction of the heart muscle. If heart muscle is in someway damaged or injured, then cardiac troponins are leaked into the blood and can therefore be measured in the blood stream. They have therefore become exceptionally useful markers of cardiac cell injury and this is why anyone who presents to hospital with [...]
The heart is a muscle and any living muscle needs a blood supply. The blood is supplied by arteries that are known as coronary ateries. Usually these arteries sit on the surface of the heart. However sometimes a portion of the artery may run an intramuscular course for a portion of its length. This is termed a myocardial bridge. The problem with a bridge is that there is a possibility that [...]
Chest pain is both common and very scary. It can also be the first symptom of a heart attack which in itself can be a fatal event. The universal advice for anyone who experiences chest discomfort especially if it a persistent sensation of heaviness, tightness or constriction, is to call an ambulance and get to a hospital as soon as possible. Despite this heavily publicised recommendation, I am sti [...]
Hypothyrodism is a very common condition characterised by reduction in effective levels of a hormone called thyroxine. It is usually seen in women between the ages of 40-50 (but can be seen at any age) and is almost 10 x commoner in women than in men. It is estimated that about 1 in every 50 people you meet is overtly hypothyroid and it is estimated that there are many more people who are probably [...]
When the heart is significantly damaged for any reason, there is an increased risk that it can become irritable and go into a fast abnormal rhythm (ventricular tachycardia) which may make the heart so inefficient that it can no longer effectively function as a pump. This may happen out of the blue with no real warning even if the patient has been well. If left unchecked for even a few minut [...]
In simplistic terms, this is an inherited condition which is diagnosed by finding an abnormally muscular heart (ventricular hypertrophy) without an obvious cause to explain the increased muscularity. It is caused by mutations in the genes that encode components of the contractile apparatus of the heart and therefore the heart muscle itself is abnormal and this is why it looks thicker. One thing to [...]
Ecstasy or MDMA is a psychoactive stimulant which is used as an illicit recreational drug. It shares properties of both amphetamines and hallucinogens. It typically causes wakefulness, feelings of euphoria, emotional intimacy and empathic communication, sexual arousal and disinhibition. This is because it increases the amount of noradrenaline, serotonin and dopamine in the body. Its half life of a [...]
This is a common type of ‘hole in the heart’ where there is a communication between the left and the right ventricle through the ventricular septum. VSDs may be congenital (meaning that the patient is born with it) or acquired (meaning that the patient develops it later on in life due to some damage to the heart) VSDs can be of various sizes and may be present in different locations within the v [...]
