Dr Robert Greenbaum's Practice

This is the area of medicine that deals with heart disease. Cardiology includes the investigation and care of patients with chest pain, angina, heart attacks, palpitations, problems with heart valves and heart failure.

Heart disease remains a major cause of ill health in England. The factors which make the development of heart disease more likely include having a high blood pressure or high cholesterol level. Also being diabetic increases your chances of developing heart disease.

Cardiovascular disease describes a variety of conditions including angina, heart attacks and stroke. It accounts for around one in three deaths in England and Wales. Most of these deaths are due to heart attacks but around a third are due to strokes. The underlying process of cardiovascular disease is the development of fatty deposits called atheroma in the linings of the coronary arteries supplying the heart or the arteries supplying the brain.

What happens during a Heart Attack?

During a myocardial infarction the lining of an atheromatous plaque in one of the coronary arteries ruptures

In this situation the lining of an atheromatous plaque ruptures. As a result the blood in the artery comes into contact with the fatty material of the plaque. Just as when you cut yourself the blood clots on contact with the air so on contact with the fatty material it clots.

Patients may be confused by the number of terms that doctors use to describe essentially the same thing.

Atheroma is the term which describes the fatty substance that is deposited in the walls of the heart (coronary) arteries. It is made up of a complex mixture of fats including cholesterol and cell debris. The process which causes atheroma is termed atherosclerosis. The disease that results is called both Coronary and Ischaemic Heart Disease. The narrowings are sometimes described as atheromatous plaques

Angina is a common symptom of heart disease. Angina is usually not felt as a pain but rather as a feeling of tightness or pressure usually in the chest. Although angina's location varies it is often felt in the centre of the chest – behind the breast bone. Sometimes the feeling passes into one or other arm and sometimes into the neck or jaw. Occasionally it passes into the back. The actual sensation of angina is described quite differently by different patients. Often angina is brought on be exertion such as climbing stairs or rushing or lifting a heavy weight. Angina usually disappears within a few minutes of the exertion stopping.