Clinical interests

Coronary artery disease & complex intervention

I assess and treat coronary artery disease, including patients whose symptoms remain troublesome after medication, stents or bypass surgery. I undertake coronary angiography and angioplasty, including treatment of complex coronary disease.

Coronary angioplasty uses a balloon, usually with a stent, to widen a narrowed heart artery. Decisions about treatment take account of your symptoms, test results, other health conditions and preferences. Medicines and, in some cases, bypass surgery are alternative options.

Where appropriate, I use advanced imaging such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), alongside specialist techniques for heavily calcified arteries.

Further reading: NHS: coronary angioplasty and stent insertion.

Refractory & difficult-to-treat angina

Some people continue to have angina despite conventional treatment. A review may include previous investigations and procedures, medication and other possible causes of chest pain. The aim is to understand why symptoms persist before deciding on further treatment.

Persistent angina and the coronary sinus reducer →

Microvascular angina

Chest pain can arise from abnormalities in the small blood vessels of the heart, even when the major coronary arteries do not have significant narrowing. I have a particular interest in investigating and managing coronary microvascular disease.

Microvascular assessment →

Resistant hypertension

I assess people whose blood pressure remains difficult to control despite treatment. This includes reviewing medication and investigating possible contributing causes. Renal denervation may be considered for selected patients following specialist assessment.

Renal denervation →

General cardiology assessment

I also see patients with a wider range of symptoms, including breathlessness, palpitations and collapse. The first step is a careful assessment and a discussion about which investigations, if any, would be useful.