About Cardiac Care

The Wellington offers extensive cardiac facilities including outpatient diagnostic testing, daycase cardiology and cardiothoracic surgery.

Our cardiac services are led by some of the UK’s top heart consultants, and supported by a highly skilled team of cardiac physiologists, radiographers and specialist nurses, giving the hospital the reputation for providing one of the largest private cardiology and cardiothoracic surgical programmes in Europe.

The Heart

The  cardiovascular system includes all the blood vessels within the body, the heart and the lungs.

Heart diagram

The engine, pump or driving force behind all of this is the heart. It measures about 300g, and is about the size of a fist. The heart is an incredibly powerful pump that not only has to move blood around the body at high pressure, but also has to pump blood to the lungs under low pressure. It is this “double pressure” system that makes the cardiovascular system so effective.

It is a four-chamber pump, with the right side receiving deoxygenated blood from the body at low pressure and pumping it to the lungs (the pulmonary circulation) and the left side receiving oxygenated blood from the lungs and pumping it at high pressure around the body (the systemic circulation).

The atria make up the upper portion of the heart whilst the ventricles make up the lower portion. Oxygen poor blood returning to the heart collects in the right atria before moving forward into the right ventricle. As this ventricle contracts, blood is forced up under low pressure into the lungs via the pulmonary artery where waste products of metabolism such as carbon dioxide are released. Fresh oxygen is taken up by haemoglobin in the blood and transported back down to the left atria via the pulmonary veins. This oxygen rich blood is then moved into the left ventricle ready for ejection into the aorta for transportation around the entire body.

The heart is therefore the pump responsible for maintaining adequate circulation of oxygenated blood around the vascular network of the body.

 The Conducting System & ECG

Although the heart is an amazing piece of biological engineering, it needs a constant source of stimulation for it to work in a synchronous manner. Within the heart, there are groups of specialized cells which are responsible for conducting tiny electrical impulses to various areas of the heart in order to stimulate the pumping mechanism. The heart’s natural pacemaker is called the Sinoatrial node, and is located in the right atria. This node sends out an impulse which travels to another group of cells called the Atrioventricular (AV) node.

The AV node lies at the bottom of the right atria. The impulse then leaves the AV node, travels down the nerve fibres into the right and left ventricle where they spread rapidly across the ventricles causing the muscle fibres to contract. This contraction is responsible for ejection of blood into the aorta and around the body. These impulses can be monitored on an ECG. Depending on the waveforms produced, cardiologists can diagnose different abnormalities and arthymmias of the heart. 

Blood Pressure

Within the cardiovascular system, there are many different levels of pressure exerted by the blood. The most commonly measured blood pressure is that of Systolic (ejection of blood into the aorta) and Diastole (when the heart is resting and receiving blood). For most people who do not have heart disease, this is generally around 100-140/60-80mmHg, with males having a slightly higher pressure. Blood pressure reduces as blood flows to the different areas of the body. When blood leaves the heart, it is under its highest pressure (systole approx 120mmHg). As it flows out of the arteries and into arterioles and capillaries, its pressure is very much lower (approx 25mmHg). This pressure reduces further when measured at the veins.

Systolic pressure is determined by the amount if blood being forced into the aorta and arteries with each ventricular contraction (heartbeat). If the volume of blood is increased, the systolic pressure is increased. Systolic pressure can also be affected buy the elasticity of the arteries. If the walls of the artery become stiff, a condition called arteriosclerosis, they are unable to compensate for the sudden increase in blood flow which occurs on ventricular contraction. Thus, systolic pressure increases, leading to hypertension.

Diastolic pressure provides valuable information regarding peripheral resistance. This is the resistance to blood flow through the vascular network of arteries and veins. If the body need to increase blood pressure e.g. during fainting, one of the ways it achieves this is by constricting the arterioles; a process known as arteriolar vasoconstriction. This constriction of the vessel impedes blood flow from the arterial network, thus increasing blood pressure. The diastolic pressure is also dependent on a number of other factors, such as systolic blood pressure, the thickness or viscosity of the blood, and presence or absence of arteriosclerosis.

 

Conditions of the heart

There are a number of different types of conditions that can affect the heart from chest pain to heart attacks, and palpitations to breathlessness.

Here we identify the main heart problems that may be diagnosed.

Problems of the heart

Outpatient Cardiac Investigations

If you are suffering from a suspected cardiac problem, your GP may refer you for further investigations to help diagnose a condition or rule out a cardiac issue.

If you are referred to us for investigations we have a bright, spacious, purpose-built echocardiography and non-invasive suite located on the first floor of our North building.

The cardiac team will talk you through what will happen in the test, and give you the opportunity to ask any questions.  

 

Discover more about outpatient investigations

Interventional Cardiology

This involves cardiologists treating heart disease without using open surgery. Interventional procedures are minimally invasive and often involve catheters. Your cardiologist will make small cuts to gain access to the inside of the body and use thin, hollow, flexible tubes (catheters) to assist with opening up any veins that are restricting or blocking your blood from flowing.

Interventional procedures include:

  • Coronary angiography
  • Coronary angioplasty
  • Mitral valvuloplasty
  • Intravascular ultrasound
  • Pressure wire studies 
  • Ablations
  • Trans-catheter Aortic Valve Implantation (TAVI)

More about interventional procedures

Arrhythmias And Rhythm Management

Cardiac arrhythmias are abnormal heart rhythms that can be develop throughout life. Rhythm disturbances can occur from childhood to old age causing a range of symptoms that include palpitation (an awareness of abnormal or irregular heartbeats), breathlessness, lethargy, dizziness and blackouts, or feelings of chest discomfort and anxiety. The heart rhythm can be abnormal either because it may be beating too slowly, too rapidly or becomes irregular.

Arrhythmias are in the top 10 causes for hospital attendances. There are 700,000 people in the UK that suffer from these symptoms. Some arrhythmias such as ectopic beats are benign but others such as ventricular arrhythmias arising from the lower ventricular pumping chamber can be life threatening.

Intensive research over the last 2 decades has significantly improved our knowledge and understanding of the basic mechanisms of how arrhythmias occur and new treatments developed to cure these conditions. The UK government has recently published guidelines for the treatment of cardiac arrhythmias in chapter 8 of the National Service Framework, a document setting out best practise and minimum standards in the treatment of arrhythmias in the UK. In this official document it is advised that patients with arrhythmias should be referred to a cardiac rhythm specialist to receive the most appropriate advice and treatment.

Normal cardiac conduction

The basic function of the heart is to pump blood around the body for all the essential of the vital organs to keep us alive. In fact, we can only survive for a few minutes if the heart stopped pumping before irreversible damage and subsequent death would occur. The heart consists basically of four chambers, two upper atrial collection chambers which collects blood coming back to the heart, each is connected to a lower “high pressure” pumping chamber that are able to generate the forward driving pressure to pump blood around the body. The entire mechanical pump is driven by an electrical system. The sinus node is the area of the heart that initiates electrical signals (pacemaker) to start a heartbeat. Activation results in contraction of the upper atrial chamber passing this onto the lower ventricular pumps. The pacemaker signals then continues onto a relay station (AV node), which is connected to the lower pump by specialised bundles of electrical wiring (His Purkinje system).

There are a total of four one-way valves in the heart that open and close in sequence during periods of filling and active pumping that keep blood flowing in one direction (Figure 1). Standardly the His Bundle leading from the AV node, is the only connection between the top atrial chamber and the lower ventricle. Normally the whole process repeats itself always starting from the pacemaker area progressing from a top to bottom direction (Figure 2). Abnormities occur when the normal sequence is disrupted leading to cardiac arrhythmias.

Figure_1_Cardiac_ArrhythmiasFigure_2_Cardiac_Arrhythmias

 

More information rhythm management procedures

Surgical options for patients 

Cardiothoracic surgery is the surgical treatment of organs inside the the chest and includes the treatment of conditions of the heart and lungs. 

Your doctor will have explained the operation you are having, what it involves and what you can expect to happen after surgery. If you have any questions, or if anything is worrying you, talk to your doctors or the cardiac nurse.

Heart surgery has developed tremendously in recent years and although a heart operation is a major surgery, techniques have moved on so much that, for most people, it is now a routine operation. Here we look at some of the main types of surgery available at the hospital, if you would like further information on your condition or the treatments available please visit the British Heart Foundation

Types of Cardiothroacic Surgery

Cardiac Imaging

Diagnostic imaging is a non-invasive way to check your heart internally. For example a cardiac MRI scan creates a view of your heart’s structure including the muscle, chambers and valves of your heart and can help assess how well your heart is pumping.

Individual cardiac scans

Doctors

Browse doctors for this speciality, and find out more about their skills

Dr Syed Ahsan Consultant Cardiologist
Cardiology
Dr Syed Ahsan
Dr Raj Amersey Consultant Cardiologist
Cardiology
Dr Raj Amersey
Dr George Amin-Youssef Consultant Cardiologist
Cardiology
Dr George Amin-Youssef
Dr Richard Andrew Archbold Consultant Cardiologist
Cardiology
Dr Richard Andrew Archbold
Mr Wael Awad Consultant Cardiothoracic Surgeon
Cardiac Surgery
Mr Wael Awad
Mr Toufan Bahrami Consultant Cardiac and Transplant Surgeon
Cardiothoracic Surgery
Mr Toufan Bahrami
Mr Inderpaul Birdi Consultant Cardiothoracic Surgeon
Cardiothoracic Surgery
Mr Inderpaul Birdi
Dr Richard Carroll Consultant Interventional Cardiologist
Cardiology
Dr Richard Carroll
Mr Roberto Casula Consultant Cardiothoracic Surgeon
Cardiothoracic Surgery
Mr Roberto Casula
Dr Anthony Wai-Cheong Chow Consultant Cardiologist
Cardiology
Dr Anthony Wai-Cheong Chow
Mr Andrew Chukwuemeka Consultant Cardiothoracic Surgeon
Cardiothoracic Surgery
Mr Andrew Chukwuemeka
Dr John Gerard Coghlan Consultant Cardiologist
Cardiology
Dr John Gerard Coghlan
Dr Joseph Davar Consultant Cardiologist
Cardiology
Dr Joseph Davar
Dr (John) Rex Dawson Consultant Cardiologist
Cardiology
Dr (John) Rex Dawson
Dr Duncan Dymond Consultant Cardiologist
Cardiology
Dr Duncan Dymond
Mr Stephen J Edmondson Consultant Cardiothoracic Surgeon
Cardiothoracic Surgery
Mr Stephen J Edmondson
Dr Sabine Ernst Consultant Electrophysiologist
Cardiology
Dr Sabine Ernst
Dr Thomas Evans Consultant Cardiologist
Cardiology
Dr Thomas Evans
Dr Azad Valentine Ghuran Consultant Cardiologist
Cardiology
Dr Azad Valentine Ghuran
Dr Robert Greenbaum Consultant Cardiologist
Cardiology
Dr Robert Greenbaum
Dr Clive Handler Consultant Cardiologist
Cardiology
Dr Clive Handler
Dr Stuart Harris Consultant Cardiologist
Cardiology
Dr Stuart Harris
Dr Roger Philip Hayward Consultant Cardiologist
Cardiology
Dr Roger Philip Hayward
Dr Julian Jarman Consultant Cardiologist
Cardiology
Dr Julian Jarman
Dr Honer Kadr Consultant Cardiologist
Cardiology
Dr Honer Kadr
Dr Prapa Kanagaratnam Consultant Cardiologist
Cardiology
Dr Prapa Kanagaratnam
Dr Simon Kennon Consultant Cardiologist
Cardiology
Dr Simon Kennon
Dr Fakhar Khan Consultant Cardiologist
Cardiology
Dr Fakhar Khan
Dr Masood Khan Consultant Cardiologist
Cardiology
Dr Masood Khan
Dr Michael Koa-Wing Consultant Cardiologist
Cardiology
Dr Michael Koa-Wing
Mr Shyamsunder Kolvekar Consultant Cardiothoracic Surgeon
Cardiac Surgery
Mr Shyamsunder Kolvekar
Dr Avijit Lahiri Consultant Cardiologist
Cardiology
Dr Avijit Lahiri
Mr David Lawrence Consultant Cardiac Surgeon
Cardiothoracic Surgery
Mr David Lawrence
Dr David Lefroy Consultant Cardiologist
Cardiology
Dr David Lefroy
Dr David Lipkin Consultant Cardiologist
Cardiology
Dr David Lipkin
Dr Timothy Lockie Consultant Cardiologist
Cardiology
Dr Timothy Lockie
Dr Iqbal Malik Consultant Cardiologist
Cardiology
Dr Iqbal Malik
Professor Jamil Mayet Consultant Cardiologist
Cardiology
Professor Jamil Mayet
Dr Anthony Wayne Nathan Consultant Cardiologist
Cardiology
Dr Anthony Wayne Nathan
Dr Niket Patel Consultant Cardiologist and Interventionalist
Cardiology
Dr Niket Patel
Dr Deven Patel Consultant Cardiologist
Cardiology
Dr Deven Patel
Professor Nicholas Peters Consultant Cardiologist
Cardiology
Professor Nicholas Peters
Dr Roby Rakhit Consultant Cardiologist
Cardiology
Dr Roby Rakhit
Dr Dominic Piers Scott Rogers Consultant Cardiologist
Cardiology
Dr Dominic Piers Scott Rogers
Dr Stuart Rosen Consultant Cardiologist
Cardiology
Dr Stuart Rosen
Dr Alexander Sirker Consultant Cardiologist
Cardiology
Dr Alexander Sirker
Dr Elliot Smith Consultant Cardiologist
Cardiology
Dr Elliot Smith
Dr Nigel Stephens Consultant Cardiologist
Cardiology
Dr Nigel Stephens
Mr Rakesh Uppal Consultant Cardiothoracic Surgeon
Cardiac Surgery
Mr Rakesh Uppal
Dr Michael Van Der Watt Consultant Cardiologist
Cardiology
Dr Michael Van Der Watt
Dr Amanda Varnava Consultant Cardiologist
Cardiology
Dr Amanda Varnava
Dr Romeo Vecht Consultant Cardiologist
Cardiology
Dr Romeo Vecht
Dr Mark Westwood Consultant Cardiologist
Cardiology
Dr Mark Westwood

Your route to diagnosis and treatment

During investigation and treatment for cardiac problems, there are a number of different areas you may come across

In most circumstances you will visit your GP who will refer you for further investigation or to a cardiologist.

In most circumstances you will visit your GP who will refer you for further investigation or to a cardiologist.

Cardiac tests such as an ECG, Echo, or 24 hour tape can help monitor your heart to diagnose any problems

Cardiac tests such as an ECG, Echo, or 24 hour tape can help monitor your heart to diagnose any problems

Our cardiac catheter laboratories are where angiogram, angioplasty and minimally invasive treatment for rhythm disorders are undertaken

Our cardiac catheter laboratories are where angiogram, angioplasty and minimally invasive treatment for rhythm disorders are undertaken

Cardiothoracic surgical intervention including a Heart Bypass or Mitral Valve Replacement are undertaken in the North building

Cardiothoracic surgical intervention including a Heart Bypass or Mitral Valve Replacement are undertaken in the North building

The Wellington Enquiry Helpline can assist you with making an appointment to see a Cardiologist or Cardiac Surgeon, or for Outpatient cardiac tests after referral from your GP.

The Wellington Enquiry Helpline can assist you with making an appointment to see a Cardiologist or Cardiac Surgeon, or for Outpatient cardiac tests after referral from your GP.

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