Sanjay's Blog

Implantable cardioverter defibrillators

  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 [...]

By |December 3rd, 2019|0 Comments

Hypertrophic Cardiomyopathy

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 [...]

By |December 3rd, 2019|1 Comment

The effects of Ecstasy on the heart

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 [...]

By |November 11th, 2019|0 Comments

Ventricular Septal Defect (VSD)

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 [...]

By |November 11th, 2019|0 Comments

Caffeine and the heart: The low-down

There is a perception within the public and many healthcare professionals that ingestion of caffeine may contribute to the development of heart rhythm disturbances and this leads to an almost universal recommendation in patients with heart palpitations to abstain from caffeine. In this blog, I wanted to explore the evidence or lack of to support this proposition. Caffeine is a stimulant and is fou [...]

By |November 4th, 2019|Tags: |3 Comments

AFib and its silent but deadly parent

AFib and its silent but deadly parent Afib is one of the commonest heart rhythm disturbances which is associated with an increased risk of stroke. Whilst we know of many risk factors which increase the likelihood of Afib such as high blood pressure, diabetes or precasting heart disease. However, there is one risk factor which is extremely common yet rarely ever diagnosed. This risk factor is a con [...]

By |October 29th, 2019|0 Comments

12 Lifestyle Modifications which work in POTS

POTS (postural orthostatic tachycardia syndrome) is commoner than we think. 1 in 3 people with a diagnosis of Chronic Fatigue Syndrome(CFS) or ME also have POTS. Similarly a large number of patients with Fibromyalgia probably also have POTS. In my practice, I have the privilege of managing the treatment of about 150 patients with POTS . I have found that lifestyle and behaviour change recommendati [...]

SINUS ARRHYTHMIA and the drummer par excellence

SINUS ARRHYTHMIA   Sinus rhythm means that the electrical impulses which regulate the heart rhythm are being produced in the pacemaker that god gives us all when we are born. This ‘pacemaker’ is otherwise called the Sino-atrial node and this is why this rhythm that is generated from the sinus node is called sinus rhythm. A nice analogy is to think of the sinus node as a drummer who beats th [...]

I have atrial fibrillation (Afib) but I don’t want to take blood thinners

Patients with a diagnosis of atrial fibrillation (Afib) who are above the age of 65 or who have co-morbidities such as heart failure, diabetes, high blood pressure, vascular disease or previous strokes are believed to be at a higher risk of future strokes. There is overwhelming evidence that such patients should be started on lifelong stroke prevention medications. All currently prescribed stroke- [...]

Cocaine and the Heart

Cocaine is purported to be the most potent stimulant of natural origin and is extracted from the leaves of the coca plant which is indigineous to the andean highlands of south america. It is a highly addictive and once someone uses it, it causes an irresistable craving in the user to use it again. Despite the ecstacy and euphoria, it never gives a feeling of satisfaction. Pure cocaine was first is [...]

By |September 28th, 2019|1 Comment

The More Muscular Looking Heart

The heart is a muscle and as with any muscle, when it has to work against a higher pressure over a prolonged period of time, it becomes more muscular. This increased muscle mass is seen as an increased thickness in the walls of the heart and is known as hypertrophy. Doctors sometimes erroneously refer to this as an enlarged heart. This is not true - the heart is not bigger but it is heavier; the w [...]

By |September 28th, 2019|1 Comment

E-cigarettes, Vaping and the Heart: What we know so far

Vaping and the heart - e-cigarettes Very recently, there have been a large number of news reports alerting the public about possible dangers of vaping after 5 deaths and 450 possible causes of vape-related lung illnesses were reported across 33 states in the USA. Whilst it is unclear what the exact cause is, it is believed that chemicals like Vitamin-E acetate which are used to emulsify THC (tet [...]

By |September 12th, 2019|1 Comment

BNP: The blood test that detects heart failure

Today I am going to talk about a really interesting blood test that detects weakness of the heart muscle (heart failure). This test is called BNP.  BNP stands for brain natriuretic peptide and this test is already being used commonly in medical practice. Before I talk about this BNP, I wanted to start off by talking about heart failure.  In heart failure, the fundamental problem is that the heart [...]

The 3 important questions to ask if you have been diagnosed with high blood pressure

If there is one thing that causes a tonne of anxiety, it is the mention of high blood pressure. A common scenario, for example is that the patient goes to see his doctor for a routine visit or a completely unrelated complaint and the first thing the doctor or the practice nurse will do is measure the patient’s blood pressure.  Then the doctor will shake his head, and say the words “your blood pres [...]

The 2 most important (and rational) questions to ask and answer if you have ectopic heart beats

A lot of my work involves talking to and reassuring people who suffer from ectopic heart beats which seem to cause a great deal of anxiety and really seem to have a negative impact on quality of life. Most patients I have spoken to have already seen a doctor for their symptoms of ectopic beats and the doctor has told them that they are not dangerous but for many this reassurance is seldom enough. [...]

Afib, strokes and bleeding: Enter the Watchman

Introduction Patients with AF who are above the age of 65, or have co-morbidities such as diabetes, high blood pressure, vascular disease or heart failure are at an increased risk of stroke. It is understood that these patients are at a higher risk of stagnation of blood within the heart; the stagnant blood can form clots within the heart and these clots can get dislodged, travel to the brain, and [...]

Why everyone with Afib should have an echocardiogram

An echocardiogram is an ultrasound-based assessment of the heart.  It is painless, harmless, readily available in most hospitals and can give a large amount of very useful information about the structure and function of the heart.  As atrial fibrillation can be caused by a structural problem with the heart such as heart valve disease or heart muscle weakness, the echo can help to elucidate the und [...]

Patent Foramen Ovale: The door within out hearts

A patent foramen ovale (PFO) is best thought of as a communication at the level of the atrial septum between the left heart and the right heart.  It is found in 25-30% of a normal healthy population and usually does not cause any symptoms, impact on quality of life or lifespan. Many people refer to it as a ‘hole in the heart’ although strictly speaking, a PFO is more like a flap or a partially ope [...]

Mestinon: A glimmer of hope for POTs patients

Introduction: Medical care for patients who have a diagnosis of POTS remains hugely unsatisfactory. POTS or rather dysautonomia is a very heterogenous condition. No two people are exactly the same. There is no one single aetiology that can even sometimes be identified. Often the patient who is really suffering looks alright from the outside. Many doctors, largely out of ignorance or perhaps arroga [...]

Pulmonary Hypertension

Today I wanted to discuss an interesting but also potentially very dangerous condition called pulmonary hypertension. I refer to it as interesting for 3 reasons: Most heart disease tends to affect older people but pulmonary hypertension can affect young people as well. The symptoms in the early stages can be non-specific and not dramatic and therefore may not get taken as seriously by the patient [...]

Spontaneous Coronary Artery Dissection (SCAD): An important cause of heart attacks in young women

What is it? SCAD is an uncommon but potentially dangerous cause for heart attacks in young patients and especially young women (less than 50 years of age). Most heart attacks occur because of a blockage in the lumen of a coronary artery. This is usually because of build-up of atherosclerotic plaque over a number of years and this is why heart attacks are more common in the elderly. In SCAD however [...]

Wolff-Parkinson-White Syndrome

Wolff Parkinson White syndrome is an unusual heart rhythm condition in which patients can develop sudden onset of fast heart palpitations. These can be associated with light-headedness/dizziness, blackouts, chest pain and in very rare cases, sudden death. However the good news is that this is a completely curable condition. Wolff –Parkinson-White syndrome was first described by 3 physicians – Loui [...]

Peripartum Cardiomyopathy (PPCM)

What is peripartum cardiomyopathy? This is also known as pregnancy associated cardiomyopathy and is a relatively uncommon condition which affects women either late during pregnancy or within 5 months of giving birth and is characterised by the development of heart muscle weakness (also called heart failure) To be diagnosed with peripartum cardiomyopathy, 3 criteria need to be met 1) Development of [...]

Atrial Flutter?

What is atrial flutter? Atrial flutter is an abnormal heart rhythm. In atrial flutter, the atria contract at 300 beats per minute and every other impulse goes down into the ventricles and therefore the ventricles beat at 150 beats per minute. In patients who are taking medications such as beta blockers or calcium blockers the impulses reaching the ventricles may be reduced even more so the heart r [...]