top of page


The most common symptoms of coronary heart disease are chest pain, shortness of breath, fainting and palpitationsBut some people may not have any symptoms before they're diagnosed.

Chest Pain

Chest Pain

What are the common causes of Chest Pain?

There are many different causes of chest pain, but the most common heart problems causing chest pain include:

  • Angina or a heart attack – If you have a pressing pain in the chest, upper abdomen, neck or left arm that is worse on exercise and better at rest, please seek urgent attention as this may get more serious, come on at rest and turn into a heart attack.

  • Pericarditis – usually causing a sudden, sharp stabbing pain that gets worse when you breath-in deeply or lie down. It can affect you at any age and is less serious than angina.


Risk factors for Angina

Angina is more likely in those who:

  • Smoke

  • Are obese

  • Have high blood pressure

  • Diabetes

  • High cholesterol

  • Have a history of heart attacks or angina in family members under 60 years of age


What should I do if I have Chest Pain?

Most chest pain isn’t usually a sign of anything serious, but it is always worth seeking medical advice.


If you think you are having a heart attack, please call 999 immediately.

If you would like to seek professional advice, our consultant cardiologists can assess your risk, and either reassure you or get immediate treatment started.

You may need an ECG, Transthoracic Echocardiography (TTE) and bloods in the 1st instance.

For chest pain symptoms, and an angina diagnosis, we may need to carry out the following investigations and tests:

  • Blood tests

  • ECG

  • Echocardiogram

  • Stress echocardiogram

  • Exercise test

  • Myocardial perfusion scanning

  • CT coronary angiogram


Treatments can include:

  • Medication

  • Coronary angioplasty


Shortness of Breath

What causes Shortness of Breath (SOB)?

SOB  is an easy sign to ignore, and you may just put this down to simply age or being unfit. However, feeling out of breath while doing everyday activities on could be a sign of a potentially life-threatening heart condition.

The following conditions can cause breathlessness:

  • Coronary heart disease

  • Heart failure

  • Abnormal heart rhythms

  • Anaemia

  • Lung disease


What should I do if I feel SOB?

If you feel you are getting out of breath whilst doing your day-to-day activities, you should talk to a healthcare specialist as soon as possible.

If you would like to seek professional advice, our consultant cardiologists can perform a cardiovascular health screen to ensure there are no serious underlying conditions.

You may need an ECG, Transthoracic Echocardiogram (TTE), blood tests and lung function tests


Fainting & Blackouts

What is Fainting or a Blackout?
Fainting or a blackout is a temporary loss of consciousness.

What do you need to know?
A blackout is a temporary loss of consciousness

If someone loses consciousness for a few seconds or minutes, they are often said to have had a blackout.

Every patient presenting with an unexplained blackout should be given a 12-lead ECG (heart rhythm check)

It is important that the ECG is passed as normal.

Most unexplained blackouts are caused by syncope

Many people, including doctors, assume that blackouts are due to epileptic seizures, but much more commonly they are due to syncope (pronounced sin-co-pee) – a type of blackout which is caused by a problem in the regulation of blood pressure or sometimes with the heart. Up to 40% of the population will lose consciousness at some point in their life due to syncope. Syncope can affect all age groups, but the causes vary with age, and in older adults multiple causes often exist.

Many syncopal attacks only require reassurance from your GP

Many syncopal attacks require only explanation and reassurance from a GP or trained nurse regarding the likely absence of anything being seriously wrong. Consultation with a specialist will be necessary, though, if the cause of the syncope remains uncertain or if there are particularly concerning symptoms or there is a family history of a heart condition.

There are three major reasons for why people may experience a blackout(s):

  • Syncope: a sudden lack of blood supply to the brain. Syncope is caused by a problem in the regulation of blood pressure or by a problem with the heart.

  • Epilepsy: an electrical ‘short-circuiting’ in the brain. Epileptic attacks are usually called seizures. Diagnosis of epilepsy is made by a neurologist.

  • Psychogenic blackouts: resulting from stress or anxiety. Psychogenic blackouts occur most often in young adults. They may be very difficult to diagnose. ‘Psychogenic’ does not mean that people are ‘putting it on’. However, there is often underlying stress due to extreme pressure at school or work.

Misdiagnosis is common but avoidable:

  • Many syncopal attacks are mistaken for epilepsy.

  • However, epilepsy only affects slightly less than 1% of the population.

  • UK research has shown that approximately 30% of adults and up to 40% of children diagnosed with epilepsy in the UK do not have the condition.

  • Many elements of a syncopal attack, such as random jerking of limbs, are similar to those experienced during an epileptic seizure.

  • It can be difficult to tell the causes of the blackout apart.

Syncope causes falls:

  • Syncope causes a significant number of falls in older adults, particularly where the falls are sudden and not obviously the result of a trip or slip.

  • Many older adults will only recall a fall and will not realise they have blacked out.

  • Greater awareness of syncope as a cause of falls is key to effective treatment and prevention of recurring falls.


If you would like to seek professional advice, our consultant cardiologists can investigate your syncope to ascertain it is due to a vascular or electrical issue of your heart. If they exclude heart disease, they may need to refer you to a neurologist.



What are Palpitations?

Palpitations make you feel like your heart is beating too hard or fast, skipping a beat, or fluttering. You could feel these in your chest, throat or neck.

What causes Palpitations?

Whilst they aren’t usually serious or harmful, they can be bothersome or sometimes frightening. They also aren’t usually serious and are usually caused by stress and anxiety, or because you’ve had too much caffeine, nicotine or alcohol.

In rare cases, palpitations can be a sign of something more serious. If you do have heart palpitations it is important to see your doctor, especially if the palpitations are accompanied with the following symptoms:

Shortness of breath

  • Dizziness

  • Chest pain

  • Fainting


If you would like to seek professional advice, our consultant cardiologists can investigate your palpitations and talk to you about any of your other symptoms and your lifestyle.

For palpitations, the investigations we can carry out include:

  • ECG

  • Echocardiography

  • ECG (Holter) monitor (we can also send you a ECG remote patch recorder in the post)

  • Event recorder

  • Cardiac Electrophysiology study

bottom of page