Common Heart Conditions Treated by Cardiologists
Heart disease remains one of the leading causes of illness and death in the UK, yet many conditions can be treated effectively when caught early and managed by the right specialist. This article explains the most common heart conditions that cardiologists treat, what those conditions mean for your health, and what modern treatment options are available to you.
Dr Charis Costopoulos is a Consultant Interventional Cardiologist and Clinical Lead for Structural Heart Intervention at Royal Papworth Hospital in Cambridge. With a PhD from Cambridge University, over 50 peer-reviewed publications, and specialist expertise in procedures including TAVI, MitraClip, and PFO closure, he brings a depth of clinical knowledge that spans both structural heart disease and complex coronary intervention. He also sees patients privately as a private cardiology consultant in London at One Welbeck.
Whether you are an older adult concerned about a heart valve problem or a younger person who has been told you may have a structural heart abnormality, understanding your condition is the first step. Then, understanding cardiologist subspecialties can help you make sense of who does what within cardiology and why the right subspecialist matters.
Coronary Artery Disease
Coronary artery disease (CAD) is the most common form of heart disease in the UK. It develops when the arteries supplying blood to the heart muscle become narrowed or hardened due to a build-up of fatty deposits called atherosclerotic plaques. Over time, this restricts blood flow to the heart, causing symptoms such as chest pain (angina), breathlessness, and fatigue. If a plaque ruptures suddenly, it can trigger a heart attack.
The condition affects people across all age groups, though the risk rises considerably with age, smoking, high blood pressure, raised cholesterol, diabetes, and a family history of heart disease. For younger patients, premature coronary artery disease can be particularly alarming, often prompting questions about genetics and lifestyle that their older counterparts may not face in the same way.
How coronary artery disease is treated
Treatment depends on the severity of the disease. Many patients are managed with medication including statins, aspirin, beta-blockers, and drugs to control blood pressure. When medication is insufficient, or when the disease is more advanced, an interventional procedure may be needed.
Coronary angioplasty (PCI): A thin wire and balloon are used to open a narrowed or blocked artery. A small mesh tube called a stent is usually placed to keep the artery open. This is a minimally invasive procedure performed under local anaesthetic through a small incision in the wrist or groin.
Coronary artery bypass grafting (CABG): For more complex or widespread disease, a cardiac surgeon may recommend bypass surgery, using a healthy blood vessel from elsewhere in the body to reroute blood around the blockage.
Interventional cardiologists like Dr Costopoulos specialise in the catheter-based techniques used in angioplasty, and in complex cases can offer sophisticated options such as rotational atherectomy or intravascular imaging to guide treatment with precision.
Heart Valve Disease
The heart has four valves that keep blood moving in the right direction. When one or more of these valves becomes diseased, either narrowing to restrict blood flow (stenosis) or failing to close properly and allowing blood to leak backwards (regurgitation), the heart has to work much harder. Over time this places enormous strain on the heart muscle and, left untreated, can lead to heart failure.
Valve disease is particularly common in older adults. Aortic stenosis, for example, affects around one in eight people over the age of 75 in the UK. Mitral regurgitation is also extremely prevalent, and for many years the only treatment option was open-heart surgery, which carries significant risks in frail or elderly patients.
Aortic stenosis and TAVI
Aortic stenosis occurs when the aortic valve, which sits between the heart and the main artery carrying blood to the body, becomes calcified and stiff. Symptoms often develop gradually and include chest tightness, breathlessness, and dizziness or fainting on exertion. Without treatment, severe aortic stenosis carries a poor prognosis.
Transcatheter Aortic Valve Implantation, known as TAVI, has transformed the treatment of this condition over the past two decades. Rather than opening the chest, a new valve is delivered via a catheter, most commonly through a small puncture in the femoral artery in the groin. The procedure takes place under sedation or light general anaesthetic, and most patients are mobile and eating within hours. Hospital stays are typically short, and recovery is far faster than with conventional surgery.
TAVI was originally reserved for patients considered too high-risk for surgery. Evidence now supports its use in intermediate-risk and, increasingly, lower-risk patients. Dr Costopoulos is one of the UK's leading TAVI specialists, performing this procedure as Clinical Lead for Structural Heart Intervention at Royal Papworth Hospital, one of the country's foremost centres for cardiac care.
Mitral regurgitation and MitraClip
Mitral regurgitation occurs when the mitral valve, which separates the left atrium and left ventricle of the heart, fails to close fully during each heartbeat. Blood leaks backwards, reducing the heart's efficiency. Symptoms include breathlessness, reduced exercise tolerance, palpitations, and, in severe cases, signs of heart failure.
The MitraClip procedure offers a catheter-based alternative to open surgery for patients with significant mitral regurgitation who are not suitable for conventional repair or replacement. A small clip is guided through a blood vessel to grasp the leaflets of the mitral valve and hold them together, reducing the degree of leakage. The procedure is performed under general anaesthetic with guidance from echocardiography, and is particularly well suited to older or frail patients for whom surgery would carry too great a risk.
Heart Failure
Heart failure does not mean the heart has stopped working. It means the heart is no longer pumping as well as it should, causing fluid to build up in the body and leaving organs without the blood supply they need. It is a common final pathway for many forms of heart disease, including coronary artery disease, valve disease, and hypertension.
Symptoms of heart failure include breathlessness (particularly when lying flat or during physical activity), ankle and leg swelling, persistent fatigue, and reduced ability to exercise. The condition can develop acutely following a heart attack, or gradually over years of uncontrolled blood pressure or progressive valve disease.
Treatment typically involves a combination of medications to reduce fluid overload and support heart function, alongside management of any underlying cause. Where valve disease is driving heart failure, treating the valve problem with TAVI or MitraClip can produce substantial improvements in symptoms and quality of life, even in very elderly or high-risk patients.
Atrial Fibrillation
Atrial fibrillation (AF) is the most common abnormal heart rhythm, affecting around 1.4 million people in the UK. In AF, the upper chambers of the heart (the atria) beat chaotically and out of step with the lower chambers (the ventricles). This causes an irregular and often rapid pulse, and can lead to symptoms including palpitations, breathlessness, dizziness, and fatigue.
AF significantly increases the risk of stroke, because the irregular beating can allow blood to pool and clot within the heart. For this reason, many patients with AF are prescribed anticoagulant medication to reduce that risk.
Treatment options for AF include rate control medication (which slow the heart rate without restoring a normal rhythm), rhythm control medication, and procedures such as cardioversion or catheter ablation. The right approach depends on the patient's symptoms, the type of AF, and their overall health.
Structural Heart Disease
Structural heart disease refers to a group of conditions involving abnormalities in the heart's physical structure, including its valves, walls, chambers, and the connections between them. Some are congenital, meaning present from birth, while others develop over time.
Patent foramen ovale (PFO)
A patent foramen ovale is a small hole between the two upper chambers of the heart that fails to close after birth, as it normally should. It is surprisingly common, present in around one in four adults, and in the vast majority of cases causes no problems at all. However, in some individuals, a PFO can allow a small blood clot to pass from the right side of the heart to the left and travel to the brain, potentially causing a stroke.
PFO closure is a minimally invasive catheter-based procedure in which a small device is used to seal the hole. It is typically recommended in younger patients who have suffered a stroke with no other obvious cause. Dr Costopoulos has considerable experience in PFO closure and the careful assessment process used to determine which patients are most likely to benefit.
Hypertension and Its Cardiac Consequences
High blood pressure, or hypertension, is often called a silent condition because it frequently causes no symptoms until significant damage has occurred. Sustained high blood pressure places the heart under chronic strain, leading to thickening of the heart muscle, accelerated atherosclerosis, and an increased risk of heart attack, stroke, heart failure, and kidney disease.
A cardiologist may be involved in the management of hypertension when it is difficult to control, when it has already caused measurable damage to the heart, or when an underlying cause such as renal artery stenosis is suspected. Lifestyle changes remain a cornerstone of treatment, but most patients will also require medication, and some may need specialised interventional treatment to address the underlying cause.
A Quick Guide: Which Conditions a Cardiologist Can Help With
Condition | Common Symptoms | Typical Treatment Options |
Coronary artery disease | Chest pain, breathlessness, fatigue | Medication, angioplasty (PCI), bypass surgery |
Aortic stenosis | Chest tightness, breathlessness, dizziness | TAVI, surgical valve replacement |
Mitral regurgitation | Breathlessness, palpitations, reduced exercise tolerance | MitraClip, surgical repair or replacement |
Heart failure | Swelling, breathlessness, fatigue | Medication, treatment of underlying cause |
Atrial fibrillation | Palpitations, dizziness, breathlessness | Rate or rhythm control, ablation, anticoagulation |
Patent foramen ovale | Often none; may be linked to stroke | PFO closure device |
Hypertension | Often none; headaches in severe cases | Lifestyle changes, medication, specialist intervention |
When to See a Cardiologist
Some people are referred to a cardiologist by their GP following an abnormal ECG or echocardiogram. Others are referred urgently after a heart attack or stroke. A cardiologist may also be appropriate if you have a family history of early heart disease, if you experience unexplained breathlessness or chest discomfort, or if you have been told you have a heart murmur that needs further investigation.
Waiting for symptoms to become severe is never advisable. Many of the conditions described in this article progress silently for years before a person feels unwell, and early specialist assessment can make a meaningful difference to outcomes. This is especially true for valve disease in older adults, where timely intervention with procedures like TAVI or MitraClip can restore quality of life significantly.
Younger patients should also take symptoms seriously. Conditions such as PFO, early coronary artery disease, and inherited cardiac conditions are manageable with the right specialist care, and early treatment can prevent more serious complications later in life.
Conclusion
Heart disease is not a single entity. It covers a wide range of conditions, each with its own causes, natural history, and treatment options. What unites them is the fact that skilled, experienced specialist care can make an enormous difference, whether that means reducing symptoms, preventing deterioration, or offering a minimally invasive procedure that spares a patient the risks of open surgery.
Dr Charis Costopoulos combines the precision of an interventional specialist with a genuinely patient-centred approach, taking time to ensure that every person he sees understands their diagnosis and feels supported in their choices. If you or someone you love has been told they have a heart condition, or if you are experiencing symptoms that concern you, please do not wait. Reaching out to a specialist is a straightforward step that could prove invaluable to your long-term health and wellbeing.
About Dr Charis Costopoulos
Dr Charis Costopoulos is a highly regarded Consultant Interventional Cardiologist based in the UK, currently serving as the Clinical Lead for Structural Heart Intervention at the world-renowned Royal Papworth Hospital in Cambridge.
Clinical Expertise & Services
Dr Costopoulos specialises in both general and interventional cardiology, focusing on the diagnosis and treatment of complex heart conditions.
Conditions Treated: Coronary artery disease, chest pain (angina), heart failure, valvular heart disease, palpitations, breathlessness, and hypertension.
Procedures Performed:
Coronary Interventions: Angioplasty and stent insertion to treat blocked arteries.
Structural Heart Procedures: Transcatheter Aortic Valve Implantation (TAVI), MitraClip (for leaky mitral valves), and Patent Foramen Ovale (PFO) closure.
Diagnostic Tests: Echocardiography, coronary angiography, and 24-hour blood pressure monitoring.
Professional Background & Education
Education: He graduated with distinction from the University of Cambridge (MB BChir) in 2006 and later completed a PhD there (2017) focusing on biomechanical forces in coronary atherosclerosis.
Specialist Training: He underwent extensive training in North West London, including Hammersmith Hospital, and completed a prestigious fellowship in coronary and structural intervention at the San Raffaele Scientific Institute in Milan, Italy.
Research: An active researcher, he has published over 50 peer-reviewed papers in leading journals like the European Heart Journal and was awarded the Young Investigator of the Year award in 2017 for his work on vascular biology.
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