Palpitations are the sensations of pounding or fluttering in the chest due to an abnormal heart rhythm. 

Palpitations are very common and can be due to many different heart rhythm problems which may be completely safe and benign or much more rarely can be more dangerous. 

The key to treatment for palpitations is the clinical assessment of the patient and the nature of the symptoms. 

Tests such as Holtor monitoring can be helpful to clarify the nature of heart rhythm disturbance.

Hypertension means high blood pressure. 

Although often not associated with symptoms, high blood pressure increases the risk of heart attack and stroke as well as kidney failure. 

Management of high blood pressure is via lifestyle modification such as diet and exercise, as well as tablet therapy.

This term applies to a wide range of conditions that effect the heart muscle. 

These can range in severity from very mild and benign to severe and life threatening. Often symptoms do not exist. 

The condition may cause blackouts, shortage of breath or even cardiac arrest. 

Some forms of cardiomyopathy run in the family and screening for family members of patients with some forms of cardiomyopathy may be recomended.

Heart Failure is a condition in which the heart no longer works effectively as a pump. 

This can be because either the heart muscle is impaired and doesn't squeeze blood out of the heart efficiently or if the heart muscle is stiff and therefore doesn't fill with blood effectively. 

Symptoms of heart failure include breathlessness, ankle swelling, shortage of breath especially on lying flat or waking up in the night with breathlessness. 

One of the more common but often unrecognised symptoms of heart failure is general tiredness or lethargy.

Heart failure can be a very serious condition but fortunately modern treatment has vastly improved outcomes for patients with heart failure. 

Treatments range from tablet therapy, specialised pacemakers, stenting of coronary arteries and even cardiac transplantation. 

This is the condition that gives rise to Angina and Heart Attacks. 

It is the most common heart disease in the UK and occurs due to blockages within the heart arteries by fatty deposits called, "Plaques".

Risk factors for IHD include smoking, diabetes, obesity, high blood pressure, high levels of fat (cholesterol) within the blood. 

IHD can however also occur without any risk factors. Important symptoms include chest pain or breathlessness, particularly on exertion such as exercise.

Treatments for IHD vary from medications to prevent progression, to stents to open up blocked arteries through to procedures such as coronary bypass operations. 

The treatments required depend on the severity and extent of coronary disease.

An Electrocardiogram (ECG) is a test to assess the electrics of the heart. 

It is simple and non invasive to perform and requires you to lie on a couch with stickers placed on the chest and arms. 

A print out of your heart's electrics is then obtained which requires interpretation by your cardioloogist.

This is an ultrasound scan of the heart. 

It is safe and non-invasive. 

It is very similar to the type of scan that is done to assess the baby during pregnancy. 

The scan will tell us whether the heart is structurally normal although more subtle changes may need other types of scan to assess.

This is sometimes called a treadmill test and is a screening test to look for evidence of angina. 

The test involves being attached to an ECG as above and then walking on a treadmill to increase the heart rate. 

The electrical signals on the ECG show changes if there is evidence of angina type problems.

This is a non invasive test usually used to look for evidence of angina or blockage in the coronary arteries. 

The test involves an initial echocardiogram.

The heart rate is then increased either by exercise on a treadmill or bike or by giving a drug. 

The ultrasound is then repeated when the heart rate has increased and the baseline and "stress", pictures compared to look for changes suggestive of problems.

Holter monitors are wearable ECG monitors that can assess the heart rhythm over a longer time period. 

They are used in patients with symptoms such as palpitations or abnormal sensations in the heart. 

They can also be used to investigate the cause of blackouts. 

These are supplied by HeartTec Solutions and can be sent direct to the patient to be worn at home and returned by mail order. 

The information collected can then be interpreted through a computer by your cardiologist.

This is test to look for blockages within the coronary arteries that may be causing angina symptoms or putting you at risk of a heart attack. 

The test is usually performed under local anaesthetic and involves putting a small tube into the artery of the groin (femoral artery) or wrist (radial artery). 

Small tubes known as catheters are then passed through the blood vessels to the heart where dye is put into the cornary arteries and xray pictures taken. 

The test takes around 30 mins to an hour and most patients go home a few hours later.

A cardiac MRI is a magnetic resonance scan of the heart. 

It gives very clear pictures of the structure and function of the heart and can also provide information on signs of angina or coronary blockages. 

The test involves lying flat on a bed and being passed through a tunnel which takes pictures of the heart. 

Some people can find this a little claustrophobic but most people find it quite manageable.

A cardiac CT is another type of scan that can give information on th estructure of the heart and the state of the coronary arteries. 

It involves lying on a bed and passing through a "doughnut" to take pictures of the heart and coronaries.

This is similar to a coronary angiogram.

But involves using specialised wires and balloons to open a severely narrowed arteries and then keeping these arteries open by implanting the latest generation of drug eluting stents or drug coated balloons. 

Often, your cardiologist will use specialised imaging techniques as part of the procedure to maximise the chance that you have long lasting benefits from this procedure.

Chronic total occlusions are the most difficult blockages to treat and require the highest degree of technical ability to successfully treat. 

Many of these arteries will have been blocked for many years, and so these procedures can take a few hours to successfully treat.

This is electric shock treatment to the heart if you have atrial flutter/fibrillation with the aim of restoring it back to a normal rhythm.  

You will often need to have had your blood thinned for at least 4 weeks, and are also likely to require some rhythm control medications.    

The treatment is performed with deep sedation, similar to a general anaesthetic and so you will not feel/remember the treatment, but unlike a general anaesthetic, you are less likely to feel groggy afterwards.

A pacemaker implant is a device that is implanted into patients who have a slow pulse (also called bradycardia). 

The pacemaker operation can take up to an hour. 

The pacemaker consists of a battery (generator) and leads. 

The leads are special wires that are inserted into the heart from a vein under the collar bone using an x-ray to guide the wire into the heart. 

The leads are then tested to make sure they are in the correct position. 

The leads are then connected to the generator which is buried under the skin. 

If you have a pacemaker implant you will need to have regular checks to make sure it is working properly (every 6 to 12 months).

Cardiac resynchronisation therapy (CRT) is a specialised pacemaker implanted into patients with heart failure where the left and right ventricles of the heart stop working together. 

Only patients with a certain type of heart failure benefit from CRT. 

The procedure is very similar to that of a pacemaker with wires placed into the heart via a vein under the collar bone. 

However CRT pacemakers have a third wire that is placed around the back of the heart to allow the left and right ventricles to work together again. 

CRT pacemakers can help improve heart failure symptoms as well as heart function.

An ICD is a device that is implanted into patients who are at risk of having a cardiac arrest due to a serious disturbance of the heart rhythm. 

Usually this occurs in patients with heart failure, but it can also happen in a number of hereditary conditions that predispose to cardiac arrest. 

The operation is performed under a local anaesthetic with wires inserted into the heart using x-ray to guide placement. 

These wires are then connected to a generator and buried under the skin on the left side of the chest. 

The procedure is very similar to that of a pacemaker but the generator is usually larger than a pacemaker. 

Patients with ICD implants usually need to have them checked every 6 months to ensure they are working properly.

If a patient has lots of narrowing affecting a lot of the heart arteries it may be necessary to have coronary bypass surgery. 

This is a routine but major operation that involves opening the chest through the breast bone, stopping the heart and using the veins in your leg and the artery in your wrist or breast bone to graft onto the blocked arteries to restore the blood supply to the heart. 

Although it is a big operation done with a general anaesthetic it is a routine procedure involving approximately a one week stay in hospital.