Chest pain

If you have new or unexplained chest pain which started at rest or you believe you're having a heart attack, call 999 immediately. Don't ignore the symptoms of a heart attack. Chest pain may have many different causes and therefore may feel differently. Although we frequently associate chest pain with angina, on many occasions it has nothing to do with heart disease. There's no easy way to diagnose it without seeing a cardiologist. Chest pain is frequently associated with such symptoms as breathlessness, sweating, nausea, fullness, burning, or tightness in your chest. There are many causes of chest pains and those include angina (coronary artery disease), pericarditis, myocarditis, costochondritis, aortic dissection, pleurisy, pulmonary embolism, indigestion etc.. Many of those causes would require specific treatment.

What experience does Dr Wamil have in the assessment of chest pain?

Dr Wamil qualified as a consultant specialising in cardiology and in general medicine. Hence, she has broad experience in assessing symptoms of chest pain taking an open-minded approach supported by her knowledge of various medical specialities not just focusing on ordering cardiac investigations. In those cases where symptoms suggest cardiac origin of chest pain, Dr Wamil will request the most appropriate test prioritising a non-invasive approach. She is an expert in cardiac CT angiography, cardiac MRI perfusion and stress echocardiography. All those investigations are non-invasive and would allow full assessment of coronary artery disease and guide further management. Dr Wamil works closely with interventional cardiologists and cardiothoracic surgeons and will refer those patients who will require interventional management of their condition.

Breathlessness

Shortness of breath is often described as a tightening in the chest, which may be more apparent when you exercise, walk up hills or climb stairs. People may often describe an increasing difficulty in walking associated with breathlessness. It is frequently noted by your friend or a family member that you may become more breathless when walking outside with them or with a minimal level of exertion.

Very strenuous exercise, extreme temperatures, obesity, and higher altitude all can cause shortness of breath in a healthy person. Outside of these examples, shortness of breath is likely a sign of a medical problem.

What experience does Dr Wamil have in the assessment of shortness of breath?

Dr Wamil has broad experience in the assessment of various conditions which can present with breathlessness such as leaking or narrowed valves, heart failure and angina. After careful assessment and physical examination, she will choose the most appropriate test, which will get to the bottom of the problem very quickly.

Palpitations and blackouts

Palpitations are feelings of having a fast heartbeat, fluttering, or pounding heart. There are many possible triggers such as stress, exercise, medication, or a medical condition. In most cases, palpitations are harmless. In rare cases, they can be a symptom of a more serious heart disease that might require treatment and further assessment. Palpitations that are infrequent and last only a few seconds usually are benign in nature and may not require any treatment but only some changes to your lifestyle and diet. If you have a history of heart failure, cardiomyopathy and have palpitations that occur frequently or worsen, your symptoms may require urgent assessment because they may be life-threatening. Talk to your doctor if you experience palpitations associated with any of the following symptoms: chest discomfort, severe breathlessness, severe dizziness, or blackout.

What experience does Dr Wamil have in the assessment of palpitations?

She will carefully assess the history and might suggest heart-monitoring tests to see if palpitations are caused by a more serious heart problem. She may also choose one of the available heart scans to assess the function of the heart chambers and valves.

Ankle swelling

Ankle swelling caused by excess fluid trapped in your body's tissues may suggest a problem with heart pumping function. If your symptoms are consistent with the diagnosis of heart failure, she will offer investigations to define the cause of the heart abnormality and exclude any reversible causes. The list of investigations will likely include an echocardiogram, cardiac MRI with contrast, and possibly also cardiac CT coronary angiogram.

Appropriate treatment can improve symptoms of heart failure and may help some people live longer. Sometimes heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may need more advanced therapies or even a heart transplant. If there is a family history of cardiomyopathy one way to prevent symptoms is to prevent and control conditions that can cause it, such as coronary artery disease, high blood pressure, diabetes, and obesity.

What experience does Dr Wamil have in the assessment of ankle swelling?

Dr Wamil is a consultant specializing in heart failure and general medicine and will be able to distinguish different causes of oedema caused by congestive heart failure, kidney disease or cirrhosis of the liver and will suggest the most appropriate investigations and treatment to address the cause of oedema. Dr Wamil will decide will supervise and report those investigations and will plan the treatment based on those results.   

Dr Wamil has clinical and research interests in the diagnosis, prevention and management of heart failure in people with diabetes and hypertension.