What to expect.
Consult.
At your consultation with Dr. Kepreotis, you can expect a thorough and personalised approach to understanding your heart health. Your visit typically includes:
Detailed Consultation: A comprehensive discussion of your symptoms, risk factors, family history, medical conditions, and any medications you’re currently taking.
Physical Examination: A focused assessment to gather critical insights about your cardiovascular health.
Review and Interpretation of Investigations: Dr. Kepreotis will analyse any previous tests or results and may recommend further investigations if necessary.
Depending on your individual needs, your consultation may also include:
Cardiac Function Assessment: Using advanced echocardiography to evaluate the structure and function of your heart.
Exercise Stress Testing: If indicated, to assess how your heart performs during physical exertion and identify any areas of concern.
Dr. Kepreotis is committed to ensuring you receive expert, tailored care to address your heart health needs.
Conditions.
Coronary Artery Disease
Coronary Artery Disease (CAD) is one of the most common heart conditions and occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, become narrowed or blocked due to the buildup of fatty deposits known as plaque. This process, called atherosclerosis, can restrict blood flow and lead to various complications.
Symptoms of CAD:
Chest pain or discomfort (angina), often triggered by physical activity or stress.
Shortness of breath, fatigue, or dizziness.
In some cases, a heart attack may be the first sign of CAD.
Risk Factors for CAD:
Several factors increase the risk of developing CAD, including:
Family history of heart disease.
High cholesterol levels, especially LDL ("bad" cholesterol).
High blood pressure or diabetes.
Smoking, obesity, or a sedentary lifestyle.
Poor dietary habits and unmanaged stress.
Why CAD is Serious:
If left untreated, CAD can lead to significant complications, such as:
Heart attacks due to a complete blockage of blood flow.
Heart failure from prolonged strain on the heart muscle.
Arrhythmias or irregular heartbeats.
Managing and Treating CAD:
Dr. Kepreotis specializes in diagnosing and managing CAD, offering tailored care plans to help you reduce your risk and improve your quality of life. Treatment may include:
Lifestyle changes, including dietary modifications, exercise, and stress management.
Medications to control cholesterol, blood pressure, or other risk factors.
Advanced procedures, such as coronary angiography and percutaneous coronary intervention (PCI), to restore blood flow and relieve symptoms.
Coronary Calcium Score.
A coronary calcium score is a diagnostic test that helps assess the risk of developing coronary artery disease (CAD) by measuring the amount of calcium deposits (hardened plaque) in the coronary arteries. Plaque buildup is an early sign of atherosclerosis, which can lead to blockages and increase the risk of heart attack.
How the Test Works:
The test uses a specialised imaging technique called a CT (computed tomography) scan of the heart. This scan is non-invasive, painless, and typically takes a short time to complete.
What it Measures: The amount of calcium present in the walls of your coronary arteries. The result is given as a Calcium Score (or Agatston score) – a numeric value that indicates your level of risk.
Calcium Score Interpretation:
Score of 0: No calcium detected, indicating a low risk of CAD.
Score 1–100: Small amount of calcium, suggesting mild atherosclerosis and low-to-moderate risk.
Score 101–400: Moderate amount of calcium, indicating a higher risk of CAD and possible narrowing of arteries.
Score >400: Significant calcium buildup, associated with a high risk of serious heart complications, such as heart attack.
Benefits of a Coronary Calcium Score:
Provides early detection of coronary artery disease, even before symptoms appear.
Helps guide personalised treatment plans, including lifestyle changes, medications, or further diagnostic tests.
Supports decisions about the need for preventative therapies, such as statins or other cholesterol-lowering medications.
Limitations:
It may not accurately measure the severity of blockages or soft plaque stenoses, particularly if there is a very high amount of coronary calcium, or if the scan could not be optimally performed.
A high calcium score may indicate risk but may not always correlated with the presence of symptoms.
The test requires the administration of intravenous contrast which may be contraindicated in certain clinical scenarios.
Example of a CT Coronary Angiogram:
Coronary Angiogram.
Heart failure is a chronic medical condition where the heart is unable to pump blood effectively to meet the body’s needs. This does not mean the heart has stopped working but that it is functioning less efficiently.
What Causes Heart Failure?
Heart failure often develops as a result of other conditions that strain or damage the heart. Common causes include:
Coronary Artery Disease (CAD): Narrowed arteries reduce blood flow to the heart muscle.
High Blood Pressure: The heart works harder to pump blood, eventually weakening over time.
Heart Attack: Damage to the heart muscle from a previous heart attack can impair its function.
Valve Disease: Faulty heart valves affect blood flow through the heart.
Cardiomyopathy: Diseases of the heart muscle caused by infections, toxins, or genetic factors.
Symptoms of Heart Failure:
Shortness of breath during activity or while lying down.
Persistent fatigue or weakness.
Swelling (oedema) in the legs, ankles, feet, or abdomen.
Rapid or irregular heartbeat.
Persistent cough or wheezing, often with pink-tinged mucus.
Managing and Treating Heart Failure:
While heart failure is a chronic condition, it can often be managed effectively with a combination of treatments:
Lifestyle Changes: Reducing salt intake, maintaining a healthy weight, exercising, and avoiding alcohol or smoking.
Medications: To improve symptoms, enhance heart function, and reduce strain on the heart (e.g., diuretics, ACE inhibitors, beta-blockers).
Advanced Therapies: For severe cases, treatments such as pacemakers, defibrillators, or, in rare cases, heart transplantation may be recommended.
Coronary angiography is a specialised imaging procedure that provides detailed views of the coronary arteries to identify blockages or narrowing caused by plaque buildup.
How it Works: A thin, flexible tube (catheter) is inserted into an artery, usually in the wrist or groin, and guided to the heart. A contrast dye is injected, allowing X-ray images to reveal the condition of your coronary arteries.
What is Percutaneous Coronary Intervention (PCI)?
PCI, also known as angioplasty, is a minimally invasive procedure used to open blocked or narrowed coronary arteries, restoring blood flow to the heart.
How it Works:
A catheter with a small balloon at its tip is guided to the site of the blockage.
The balloon is inflated to compress the plaque against the artery walls, widening the artery.
In most cases, a stent (a tiny, expandable mesh tube) is placed to keep the artery open long-term.
Benefits of PCI: PCI provides immediate relief from symptoms like chest pain (angina), improves blood flow to the heart, and reduces the risk of heart tissue damage.
What to Expect:
This procedure is typically performed in a hospital's cardiac catheterisation lab under local anaesthesia and light sedation. Patients can usually return to normal activities within a few days. Dr. Kepreotis ensures a personalised approach, using the latest technology to provide safe and effective care.