Heart conditions
Heart problems can develop with a wide range of symptoms. These may include chest pain, feeling breathless, tiredness, feeling your heart racing or skipping a beat or swelling of the legs. Once a heart problem is suspected, it is crucial that a diagnosis is made quickly so that an effective treatment plan put in place. Many conditions can be diagnosed by carefully exploring the symptoms and a thorough examination, but should be confirmed with appropriate testing. For many, this can be achieved with simple tests such as an ECG (electrical heart tracing) or echocardiogram (ultrasound scan of the heart), but for others a CT or MRI scan may be required to make a definitive diagnosis.
Once a diagnosis is made, a detailed treatment plan is needed. This should be personalised to the individual’s condition, any other medical conditions and preferences. Depending on the severity of the condition, treatment may be with simple lifestyle advice, medication taken either for a short course or over the long term, or procedures to correct major abnormalities. Recent medical advances mean that many of these treatments can be delivered in a minimally invasive manner, reducing pain and allowing people to get back to their lives sooner.
Finally, the prevention of cardiac conditions is crucial both in people who have never had heart problems and in those who have had prior treatment. Cardiovascular disease prevention may include exercise, dietary advice, support with making healthier lifestyle choices as well as medication where necessary. Prevention is most effective when supported by a thorough assessment of an individual person’s risk of heart disease, through both taking a detailed medical history as well as testing.
Conditions
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Coronary artery disease (CAD) occurs when the blood vessels supplying your heart muscle, known as the coronary arteries, become narrowed or blocked due to a build-up of fatty deposits called plaque. This can reduce blood flow to the heart, leading to chest pain (angina), breathlessness, or in more severe cases, a heart attack. It is one of the most common heart conditions and can develop gradually over time, often linked to risk factors such as high blood pressure, high cholesterol, smoking, diabetes, and a family history of heart disease.
Dr Matthew Ryan is a Consultant Cardiologist with extensive experience in diagnosing and managing coronary artery disease. Through a personalised approach, Dr Ryan will carefully assess your symptoms, perform any necessary investigations such as heart scans or stress tests, and develop a tailored treatment plan. This may include lifestyle changes, medications to manage symptoms and reduce further risk, and in some cases, referring you for specialised procedures if needed. With Dr Ryan’s expert guidance, you can take control of your heart health and work towards preventing complications, improving your quality of life.
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Angina is a condition characterised by chest pain or discomfort that occurs when the heart muscle does not receive enough blood. It is commonly caused by narrowing of the coronary arteries due to deposits of cholesterol. Symptoms often include a squeezing, pressure-like sensation in the chest, which may also radiate to the shoulders, arms, neck, or jaw. Angina can be triggered by physical exertion, emotional stress, or even at rest in more severe cases.
If you are considering private healthcare for the evaluation and management of angina, consulting a specialist cardiologist like Dr Ryan offers personalised and comprehensive care tailored to your individual needs. Dr Ryan conducts a thorough assessment, including detailed history taking, clinical examination, and appropriate investigations such as ECG, stress testing, and coronary imaging where needed.
Treatment for angina involves a combination of medication, lifestyle changes and procedures to relieve the narrowed arteries. Many narrowings can now be treated by stenting, a procedure in which Dr Ryan is a recognised expert. Stenting involves placing a small tube via the wrist, stretching the narrowing with a small balloon and then implanting a stent to hold the artery open. Stenting is highly effective in relieving angina and is usually a day case procedure, where you can be discharged the same day.
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A heart attack, medically known as a myocardial infarction, occurs when the blood flow to a part of the heart muscle is blocked, usually due to a blood clot forming on a ruptured plaque within a coronary artery. This blockage prevents blood from reaching that part of the heart, causing damage or death to the heart muscle tissue.
Once a heart attack is diagnosed, it is important that the coronary arteries are assessed with an angiogram, and any narrowings or blockages are treated to prevent further heart attacks from occurring. Depending on the severity, blockages can be treated with either stents or surgery. In the past, around half of people would die in the first year after having a heart attack, but with careful treatment this can be reduced to only 1 in 20.
For patients who have recently experienced a heart attack, the recovery period is a critical phase that requires careful management. It is crucial to initiate lifestyle changes early, and to ensure you are receiving the correct combination of medications to help the heart to heal. Some patients require further stenting to treat additional blockages. Finally, a detailed rehabilitation programme should be put in place, including dietary advice, exercise prescription and psychological support. Each of these interventions has important effects in reducing the chance of further heart attacks or developing heart failure, and the earlier they are started the greater the effect.
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Microvascular angina is a condition where people experience typical symptoms of angina without obvious blockages of the main coronary arteries. In this case, the restriction of blood flow comes from the smaller blood vessels which supply the heart muscle. Testing for microvascular angina is not widely available, and many patients wait a long time before receiving a diagnosis.
Trained by Professor Divaka Perera at St Thomas’ Hospital, Dr Ryan has particular expertise in the diagnosis and management of coronary microvascular dysfunction, as well as the associated condition of vasospastic angina. Using a combination of both non-invasive testing and advanced coronary physiology, he can effectively diagnose the condition, before providing a detailed management plan and further support to people suffering with this under recognised and under treated condition.
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Hypertension, commonly known as high blood pressure, is a condition where the force of the blood against the walls of your arteries is consistently too high. It is the most common factor contributing to heart attacks and strokes, but this risk can be fully mitigated with appropriate treatment.
Blood pressure readings can be taken at home, in clinic or with an ambulatory blood pressure monitor worn for 24 hours. A diagnosis of high blood pressure typically requires readings above 140/90 mmHg on several occasions.
The treatment of high blood pressure usually requires a combination of medication and lifestyle changes. If someone is overweight, weight loss can help to bring blood pressure down, as can exercise. There are a huge range of blood pressure medications available, and choosing the right medication should be a personalised process involving ongoing discussions between physician and patient.
Once high blood pressure is diagnosed, it is important to ensure that you receive a personal blood pressure target and support with achieving it. Research shows that high blood pressure is under-treated in the majority of patients, leaving them at an unnecessarily high risk of future heart problems.
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High cholesterol is a critical factor in cardiovascular health because it directly contributes to the development of atherosclerosis—the build-up of fatty deposits in the walls of arteries. These deposits can narrow and harden the arteries, reducing blood flow and increasing the risk of heart attacks, strokes, and other vascular diseases.
Modern diets mean that the majority of people will have high cholesterol, raising their risk of heart disease. Deciding whether to give treatment of high cholesterol is a personalised process, where a wide variety of factors should be considered including a person’s age, ethnicity, other medical problems and personal preferences.
Eating a healthy diet is an important part of controlling cholesterol levels, but dietary changes along often only reduce cholesterol by 10-15%. Statins remain an important part of managing cholesterol, but recently several new medical treatments have been developed. These new medications have particular benefits for people for whom statins have not been effective or who prefer to explore other options. Dr Ryan is an expert in the evidence-based management of high cholesterol and provide a personalised treatment plan.
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Pericardial disorders refer to conditions affecting the pericardium, the thin sac surrounding the heart. These disorders can include inflammation (pericarditis), fluid accumulation (pericardial effusion), or thickening and scarring, all of which can impact heart function and may require specialist assessment and treatment.
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Heart failure is a condition where the heart muscle becomes either weak or stiff, and can no longer pump well enough to keep up with the demands of the body. Heart failure can present in many ways, though shortness of breath, leg swelling and profound fatigue are often common symptoms. The most common cause of heart failure is coronary artery disease.
Heart failure is a serious condition which can reduce life expectancy, but with modern treatment symptoms can often be controlled and life expectancy restored to normal. Treatment may include medications, lifestyle changes and procedures such as stenting or implantation of a pacemaker.
Dr Ryan has particular expertise in the diagnosis and treatment of heart failure caused by coronary artery disease. He can provide a diagnosis, treatment plan and a detailed explanation of the prognosis and likely effectiveness of treatment.
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Arrhythmias are a condition where the heart beats in an abnormal rhythm. Common symptoms include feelings of the heart racing, fluttering, or skipping beats. Arrhythmias range from very benign conditions to serious problems needing advanced treatment.
Dr Ryan is able to provide a detailed initial assessment for people with suspected arrhythmias, including testing for underlying causes and confirming the precise nature of the problem. He provides a comprehensive initial treatment plan, and can subsequently provide an onward referral for patients needing advanced treatment such as pacemakers or ablation treatment.
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The heart valves are crucial to maintaining the proper flow of blood around the body. Heart valve disorders occur when the valves stop working correctly, either because they leak or become narrowed. Depending on the valve affected and the severity of the disorder, the condition may be asymptomatic, cause breathlessness, chest pain or even loss of consciousness.
Dr Ryan provides a detailed initial assessment to diagnose heart valve disorders and institute a treatment plan. For patients with severe heart valve disease requiring surgery or other interventions, he can provide an onward referral to ensure patients receive the most effective care.