What are the common symptoms that your patients tend to present with?

Chest pain, shortness of breath, palpitations, dizziness and collapse are the main symptoms. People also come and see me because they are concerned that they've been found to have high blood pressure. Or they’ve been found to have high cholesterol. Or they've got a very strong family history of heart disease and they want to be checked out. Or their GP has given them lots of information about things that they don’t quite understand. So, these are the kind of main areas that people come to see me.

What are the treatments that you're able to offer your patients?

First of all, we need to investigate patients very thoroughly, and that involves history-taking, it involves a clinical examination, it involves ECG. We often use cardiac ultrasound or echocardiography to look at the structure and function of the heart chambers and the valves. We can then use other investigative tools such as ambulatory blood pressure monitoring or heart rhythm monitoring to see if people have any heart arrhythmias or palpitations.

We can also image the heart noninvasively using CT and also MRI if you want more detailed information about the heart muscle or about any blockages within the heart arteries.

If all of those tests come back suggesting further problems, then we've got options for invasive management, and that includes coronary angiography that is carried out under local anaesthetic and involves putting a tube into the heart arteries and establishing if there are any blockages. If there are blockages that are causing problems, you can actually use a small balloon and a stent in a procedure called coronary angioplasty and stenting or PCI (percutaneous coronary intervention). We can do that both in patients with acute problems with chest pain such as those having a heart attack or in those with more stable, chronic symptoms such as angina or chest pain.

If people have got issues with heart failure or impaired pumping function or poorly controlled blood pressure or high cholesterol, then there are lots of medical treatments that can be undertaken for those patients as well.

There is not one size that fits all when it comes to managing these conditions. It’s about tailoring the treatment to an individual patient’s requirement based on their particular need.

What are your areas of sub-specialist interest?

My subspecialist interest is in ischaemic heart disease and I am the clinical lead for coronary revascularization at the Royal Free heart attack centre. I undertake a high level of complex coronary interventions in both emergency patients, as well as elective stable patients.

We have an international profile. We attract patients from around the world. We have fellows and students coming to train with us from around the world. We are the third-biggest heart attack centre in London by volume. We do live cases around the world as well.

We are a very institutionally prolific, well-regarded unit. We do a lot of research. All of us have honorary titles at the University College London in the cardiovascular research unit. I’m an honorary senior lecturer there. We have roles in conferences around the world, presenting on panels and presenting on research. The Royal Free is where I’m based and that’s where I do a lot of my work, but we also do a lot of procedures at other centres as well.