Cardiology

Cardiologists investigate and treat a number of cardiac conditions including breathlessness, chest pain, hypertension, heart failure, coronary disease, palpitations and syncope. The majority of diagnostic tests are performed on site and can be arranged either on the same day or within 48 hours of your appointment. Please click on the relevant tabs below for more information with regards to common cardiac symptoms and conditions.

Please find below information with regards to Consultants working at The Berkshire Clinic that provide these services.

Dr Nicos Spyrou
Consultant Cardiologist

Dr Nicos Spyrou is a Consultant Cardiologist.

He qualified in Medicine at St George's Hospital in London, where he also obtained a BSc in Clinical Pharmacology. He recieved most of this cardiology training at St Mary's and the Hammersmith Hospitals, as well as having worked for Prof Sir Magdi Yacoub at Harefield. Dr Spyrou set up angioplasty in Reading and performed the first procedure in Reading at Battle Hospital in 2003!

Dr Spyrou is involved in all aspects of cardiology, including acute coronary syndromes/primary angioplasty, valvular heart disease, arrhythmias, heart failure etc, with particular interests in: interventional cardiology, which includes permanent pacing, angioplasty, complex angioplasty which could involve, rotablation, intravascular lithotripsy (shockwave treatment of coronaries), OCT (optical coherence tomography) and IVUS (intracoronary ultrasound) as well as treatment of CTOs (chronic total occlusions).

Dr Spyrou is married with one son and one daughter. His wife is a GP in Sonning Common, and a Professor of Primary Care at St George's University. He is a keen tennis player, a great fan of football, and is also an Advanced Open water PADI diver.

Dr Shahed Islam
Consultant Cardiologist

Dr Islam offers private consultations at The Berkshire Clinic in person and through remote video technology at the convenience of patients.

His NHS appointment is at the Royal Berkshire Hospital NHS Foundation Trust.

He consults patients with wide range of adult cardiac conditions. These include patients with chest pain, shortness of breath, palpitations, hypertension, hyperlipidaemia, valvular heart disease, heart muscle disease and pre-operative assessment prior to non-cardiac surgery.

Dr Islam obtained his primary medical qualification (MBBS) with Merit from Guy’s, King’s and St Thomas’s School of Medicine in 2008, followed by an award of the membership of the Royal College of Physicians (MRCP), London in 2012.

He has over 10yrs experience in cardiology training across some of best centres in the UK including the Barts Heart Centre in London and the Essex Cardiothoracic Centre in Essex. He had dedicated fellowship in all aspects of coronary intervention and heart function impairment. In addition, he also performs non-invasive imaging using echocardiography and implantation permanent pacemaker systems.

Dr Islam has academic interest in cardiovascular medicine having pursued 2 years of full-time clinical research, for which he was awarded MD (Res) in 2015. He published in several peer reviewed journals.

He is particularly interested in post-resuscitation care for cardiac arrest survivors and cardiac rehabilitation following a heart attack.

He is the current Clinical Lead for Cardiac Rehabilitation at the Royal Berkshire Hospital.

Dr Zarin Shaikh
Consultant Cardiologist

Dr Islam offers private consultations at The Berkshire Clinic in person and through remote video technology at the convenience of patients.

His NHS appointment is at the Royal Berkshire Hospital NHS Foundation Trust.

He consults patients with wide range of adult cardiac conditions. These include patients with chest pain, shortness of breath, palpitations, hypertension, hyperlipidaemia, valvular heart disease, heart muscle disease and pre-operative assessment prior to non-cardiac surgery.

Dr Islam obtained his primary medical qualification (MBBS) with Merit from Guy’s, King’s and St Thomas’s School of Medicine in 2008, followed by an award of the membership of the Royal College of Physicians (MRCP), London in 2012.

He has over 10yrs experience in cardiology training across some of best centres in the UK including the Barts Heart Centre in London and the Essex Cardiothoracic Centre in Essex. He had dedicated fellowship in all aspects of coronary intervention and heart function impairment. In addition, he also performs non-invasive imaging using echocardiography and implantation permanent pacemaker systems.

Dr Islam has academic interest in cardiovascular medicine having pursued 2 years of full-time clinical research, for which he was awarded MD (Res) in 2015. He published in several peer reviewed journals.

He is particularly interested in post-resuscitation care for cardiac arrest survivors and cardiac rehabilitation following a heart attack.

He is the current Clinical Lead for Cardiac Rehabilitation at the Royal Berkshire Hospital.


Angina is a type of chest discomfort that occurs when the heart muscle does not receive sufficient blood and oxygen. Angina is typically a pressure, squeezing, fullness, or burning sensation in the chest. The discomfort may also be felt in the arms, neck, jaw, shoulders or back. Other symptoms which may occur with angina include shortness of breath, sweating, nausea, or fatigue.

The most common cause for angina is narrowings in the arteries supplying the heart (coronary artery disease). Other causes include narrowing of the aortic valve (aortic stenosis), cardiomyopathy or dysfunction of the small blood vessels within the heart (microvascular angina).

Angina can be triggered by physical exertion, stress or exposure to the cold. Angina that occurs at rest, or does not pass within five minutes, requires immediate medical attention with the calling of an ambulance as it may be the symptoms of a heart attack.

If you experience symptoms of angina, it is important to speak with your doctor. Your doctor may perform tests such as an electrocardiogram (ECG) or potentially refer you to a cardiologist. The cardiologist may arrange an echocardiogram or CT coronary angiogram to determine the underlying cause of your symptoms.

Treatment for angina includes lifestyle changes such as quitting smoking, exercising regularly and eating a healthy diet. Medications that may be prescribed include GTN spray, aspirin, statins, beta-blockers and calcium channel blockers to manage symptoms and reduce the risk of a heart attack.

In some cases, angioplasty (stents) or bypass surgery may be recommended to treat symptoms and potentially improve prognosis.

Blackouts are a sudden, temporary loss of consciousness. They have a number of potential causes, including vasovagal syncope (‘faint’), cardiac or neurological conditions.

With a blackout the loss of consciousness may last for a few seconds or several minutes. Other symptoms may include light-headedness or nausea. After regaining consciousness, some people feel confused, disoriented, or have a headache.

If you experience a blackout, it is important to seek urgent medical attention, especially if it occurs without warning or is accompanied by chest pain or other symptoms.

Your doctor will want to take a detailed history of the events surrounding the blackout, perform a physical examination and potentially arrange investigations, for example blood tests or an electrocardiogram (ECG).

Your doctor may wish to arrange for you to have a specialist cardiac or neurological review to further investigate the cause of the blackout. Cardiac investigations that may be arranged include echocardiogram and heart rhythm monitoring. Neurological investigations that might be arranged include CT or MRI scan of the head.

Treatment for blackouts depends on the underlying cause. For example, if the blackout is due to vasovagal syncope lifestyle changes such as increasing fluid and salt intake may be recommended and avoiding triggers such as dehydration or standing for long periods. If the blackout is due to slow or fast heart rates, treatments for these include pacemakers and medication.

Palpitations is the sensation of your heartbeat feeling abnormal. Your heart may feel like it is racing, pounding, fluttering, or skipping a beat. Palpitations are very common. They are usually harmless and settle on their own accord, but can be a sign of an underlying heart condition.

There are many causes of palpitations, including stress, caffeine, alcohol, and certain medications. Palpitations can also be caused by medical conditions including anaemia, over active thyroid or heart disease.

If you experience palpitations, it would be sensible to speak with your doctor. They may recommend you have an electrocardiogram (ECG) or a heart rhythm monitor, or potentially specialist cardiology review.

Treatment for palpitations depends upon identifying the underlying cause. If the cause is stress or anxiety, your doctor may recommend relaxation techniques. If the cause is a medical condition, such as hyperthyroidism or heart disease, treatment will focus on managing that condition.

Shortness of breath is the sensation of difficulty or discomfort when breathing. There are a number of causes for shortness of breath, including lung and heart conditions.

Respiratory causes of shortness of breath include asthma, chronic obstructive pulmonary disease (COPD), and chest infection. Cardiac causes include heart failure, heart attack, abnormal heart rhythm and heart valve disease. Anaemia and anxiety can also cause a feeling of shortness of breath.

If you experience shortness of breath, you should speak with your doctor. If you experience sudden onset of shortness of breath, you should seek immediate medical attention.

Your doctor may perform tests such as a chest X-ray, blood tests, or a pulmonary function tests to investigate the underlying cause.

Treatment for shortness of breath depends on the underlying cause. Your doctor may refer you to a respiratory physician or cardiologist for specialist review. Specialist investigations that may be requested include echocardiogram, CT scan of the lungs and heart. For respiratory conditions such as asthma or COPD, inhalers or other medications may be prescribed. For heart conditions, medications including diuretics or beta-blockers may be prescribed to reduce fluid build-up or improve heart function.

Ectopic heartbeats, also known as premature heartbeats or extrasystoles, occur when the heart's electrical system sends signals to the heart muscle in an abnormal way. These extra beats can disrupt the regular rhythm of the heart and may be felt as a "skipped" or "extra" beat.

Ectopic heartbeats are quite common and are usually harmless, although they can be concerning and uncomfortable. They can be triggered by various factors, such as stress, anxiety, caffeine, alcohol, nicotine, certain medications and underlying heart conditions. In most cases, ectopic heartbeats occur spontaneously and do not require treatment.

Typically, people with ectopic heartbeats may experience occasional extra beats or a fluttering sensation in the chest. While these sensations can be alarming, they are often harmless and go away on their own. However, if you are experiencing frequent or prolonged episodes, or if you have additional symptoms like chest pain, lightheadedness, or shortness of breath, it is important to consult with a healthcare professional to rule out any underlying heart conditions. In many cases, managing ectopic heartbeats involves making lifestyle adjustments to reduce triggers and improve overall heart health. Strategies may include reducing stress levels, avoiding excessive caffeine or alcohol consumption, quitting smoking, and maintaining a healthy lifestyle with regular exercise and a balanced diet.

If ectopic heartbeats are causing significant discomfort or anxiety, your healthcare provider may recommend further evaluation or treatment options. These can include medication to regulate heart rhythm or, in rare cases, catheter ablation to eliminate the source of abnormal electrical signals. It is important to remember that while ectopic heartbeats can be bothersome, they are usually benign and not indicative of a serious underlying condition. However, if you have concerns or persistent symptoms, it is always best to seek medical advice for appropriate evaluation and guidance.

Coronary artery disease (CAD) is a common heart condition that affects millions of people worldwide. It occurs when the blood vessels (arteries) supplying the heart become narrowed or blocked by a build-up of fatty deposits in the walls of the arteries called plaques.

CAD often develops gradually over time, and its symptoms may vary. Some individuals may experience chest pain or discomfort, known as angina, when the heart muscle does not receive sufficient blood. Others may have no symptoms before a heart attack occurs.

Several factors contribute to the development of CAD. The most significant risk factors include high blood pressure, high cholesterol levels, smoking, diabetes, obesity, a sedentary lifestyle, and a family history of heart disease. While some of these factors are out of our control, adopting a healthy lifestyle can significantly reduce the risk of developing CAD.

The prevention and management of CAD involves making positive lifestyle changes. Regular physical activity, such as brisk walking or cycling, can strengthen the heart and improve blood flow. Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting saturated and trans fats, is crucial for maintaining a healthy heart. Quitting smoking and managing stress levels are also important steps to reduce the risk of CAD.

If diagnosed with CAD, medications may be recommended. These can include medications to control blood pressure, lower cholesterol levels, and prevent blood clots. In certain cases, angioplasty (stents) or bypass surgery may be recommended to improve blood flow to the heart.

Awareness and early detection play a vital role in combating coronary artery disease. Check-ups with a healthcare professional, maintaining a healthy lifestyle, and recognizing the warning signs can help ensure a healthier heart, a better quality of life and potentially avoid some of the complications of the disease.

Heart failure is a medical condition in which the heart does not pump blood effectively to meet the body's needs.

There are various causes of heart failure, including coronary artery disease, high blood pressure and heart valve problems. Over time, these conditions can weaken the heart muscle, making it less efficient at pumping blood.

The symptoms of heart failure can vary from person to person, but commonly include shortness of breath, fatigue, swelling of the ankles and rapid or irregular heartbeat.

It is important to seek medical attention if you experience any of these symptoms, as early detection and treatment can significantly improve outcomes. Your doctor will conduct a thorough assessment, which may include tests such as an electrocardiogram (ECG), echocardiogram or blood tests, to diagnose heart failure.

Treatment for heart failure aims to manage symptoms, improve quality of life, and improve prognosis. Lifestyle changes, such as adopting a heart-healthy diet, engaging in regular physical activity, quitting smoking, and limiting alcohol intake, are crucial in managing heart failure. Medications may also be prescribed to help control symptoms, reduce fluid build-up, and strengthen the heart muscle.

In some cases, medical procedures or devices may be necessary. These can include coronary artery bypass surgery, heart valve repair or replacement and implantation of specialist pacemaker or defibrillator.

Living with heart failure requires ongoing management and care. This includes following the treatment plan agreed with your healthcare provider, monitoring your symptoms, and attending regular check-ups. The treatment and prognosis of heart failure has improved hugely in recent years, with people able to live active, fulfilling lives with the condition.

Hypertension, or high blood pressure, is a common medical condition that affects millions of people worldwide. It occurs when the force of blood against the walls of the arteries is consistently too high. Hypertension is often referred to as the "silent killer" because it usually does not cause noticeable symptoms, but it can have serious health consequences if left untreated.

Several factors contribute to the development of hypertension, including genetics, age, lifestyle choices, and underlying health conditions. Uncontrolled high blood pressure can increase the risk of heart disease, stroke, kidney problems, and other complications.

While hypertension may not have obvious symptoms, it can be detected through regular blood pressure measurements. A healthcare professional can measure your blood pressure using a cuff placed around your upper arm. A reading of 120/80 mmHg or below is considered optimal, while consistent readings of 140/90 mmHg or higher indicate hypertension. Managing hypertension involves a multi-faceted approach.

Lifestyle modifications play a crucial role in controlling blood pressure levels. These include adopting a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while limiting salt, saturated fats, and processed foods. Regular physical activity, such as brisk walking or cycling, can also help lower blood pressure. Other lifestyle factors, such as maintaining a healthy weight, limiting alcohol consumption, quitting smoking, and managing stress levels, are also essential.

In addition to lifestyle changes, medication may be prescribed by a healthcare professional to control blood pressure. Different types of medications can be used, depending on the individual's specific needs and medical history.

Regular monitoring and management of hypertension are important for overall health and well-being. It is essential to work closely with a healthcare provider, adhere to prescribed treatments, and attend regular check-ups to ensure blood pressure levels are under control.

By adopting a healthy lifestyle, taking prescribed medications, and closely monitoring blood pressure, individuals with hypertension can effectively manage their condition, reduce the risk of complications, and maintain optimal heart health.

Atrial fibrillation (or AF) is a common abnormal heart rhythm. In normal sinus rhythm, the upper chambers (atria) and lower chambers (ventricles) of the heart work together in a coordinated way to pump blood throughout the body. In AF, the atria contract rapidly and irregularly, with consequently less efficient filling of the ventricles and a reduction in cardiac output.

Common symptoms experienced with AF include palpitations, fatigue, shortness of breath, and dizziness. However, some people with AF may not experience any symptoms at all. If left untreated, AF can increase the risk of stroke and heart failure.

There are many causes of AF, including high blood pressure, coronary artery disease, valvular heart disease, cardiomyopathy, overactive thyroid and sleep apnoea. In some cases, the cause may not be apparent.

The treatment for AF typically involves medications to control the heart rate and rhythm, and may include blood thinners to reduce the risk of stroke. In certain cases, electrical cardioversion or ablation therapy may be recommended.

If you are concerned that you may have AF it is important to speak with your doctor. They can perform tests such as an electrocardiogram (ECG) to help diagnose the condition and recommend the best course of treatment. It some cases, patients with AF are referred for specialist assessment with a cardiologist.

Supraventricular tachycardia (SVT) is a heart condition characterized by a rapid heart rate that originates above the ventricles, the lower chambers of the heart. During an episode of SVT, the heart beats abnormally fast.

SVTs occur due to abnormal electrical impulses in the heart that disrupt the normal rhythm. The precipitant of SVT is not always clear, but certain factors can trigger or contribute to its occurrence, such as stress, caffeine, alcohol, smoking, certain medications, and underlying heart conditions.

Symptoms of SVT can vary from person to person, but they commonly include a rapid or pounding heartbeat, palpitations, chest discomfort, shortness of breath, dizziness, and occasionally fainting. Some individuals may experience symptoms only very occasionally, while others may have frequent and prolonged episodes.

If you suspect you may have SVT or experience concerning symptoms, it is important to seek medical attention. A healthcare professional will conduct a thorough evaluation, which may involve having an electrocardiogram (ECG) and potentially wearing a heart monitor for a number of days.

The treatment for SVT aims to maintain normal heart rhythm and manage symptoms. In some cases, SVT may spontaneously resolve without intervention. However, if episodes are frequent, last for an extended period or cause significant discomfort, medical interventions may be necessary.

Treatment options for SVT include vagal manoeuvres, which involve specific actions to stimulate the vagus nerve and slow down the heart rate. Medications may also be prescribed to control and prevent episodes. In more severe cases, procedures such as catheter ablation or cardioversion may be recommended.

Living with SVT may be helped with certain lifestyle modifications to help manage the condition. These can include avoiding triggers like caffeine and alcohol, managing stress levels, and getting sufficient rest. It is also important to follow your healthcare provider's recommendations, and take prescribed medications as directed.

While SVT episodes can be disruptive and unsettling, the condition is generally manageable with proper medical care. By understanding the triggers, seeking appropriate treatment, and making lifestyle adjustments, individuals with SVT can usually effectively control their symptoms and lead a normal, active life.

Aortic stenosis is a heart condition characterized by the narrowing of the aortic valve. Blood flows the aortic valve as it leaves the heart to go round the rest of the body. Narrowing of the aortic valve restricts the blood flow through it, forcing the heart to work harder to pump blood around the body.

Aortic stenosis can be caused by age-related changes, congenital heart defects, or the build-up of calcium deposits on the valve leaflets. As the condition progresses, symptoms may start to appear. Common symptoms include chest pain or discomfort, shortness of breath, fatigue, dizziness, and blackouts.

If you experience any of these symptoms, it is very important to consult with a healthcare professional. Your doctor may perform a physical examination and order tests such as an electrocardiogram (ECG) and echocardiography.

The treatment for aortic stenosis depends on its severity and the presence of symptoms. Mild cases may only require intermittent monitoring. If the condition becomes severe, intervention on the aortic valve may be recommended. This may involve having a mechanical or tissue valve replacement, or a transcatheter aortic valve implantation (TAVI), depending on overall health, and other factors.

Living with aortic stenosis requires ongoing care and lifestyle adjustments. It is important to follow your doctor's recommendations, take prescribed medications, and attend regular check-ups. Adopting a heart-healthy lifestyle, which includes a balanced diet, regular exercise, and avoiding smoking, can also help manage the condition and reduce the risk of complications.

With careful monitoring and timely intervention if required, individuals with aortic stenosis can lead active lives and maintain good heart health.

Mitral regurgitation is a heart condition characterized by the leakage of blood backward through the mitral valve when the main pumping chamber of the heart, the left ventricle, contracts. The mitral valve is located between the left atrium and left ventricle of the heart.

When mitral regurgitation occurs, some of the blood that should flow from the left ventricle to the rest of the body leaks back into the left atrium. This can happen due to a number of reasons, including prolapse of the mitral valve leaflets, or conditions that enlarge the heart, such as a previous heart attack.

The severity of mitral regurgitation can vary, ranging from mild cases through to severe cases that can result in heart failure. Symptoms may include fatigue, shortness of breath, a racing or irregular heartbeat, and swelling in the ankles.

If you experience any of these symptoms or suspect you may have mitral regurgitation, it is important to consult with a healthcare professional. A thorough evaluation, including a physical examination and possibly an echocardiogram may be requested

Treatment for mitral regurgitation depends on its severity and symptoms. Mild cases may only require intermittent monitoring. For more severe cases, medications may be prescribed to help symptoms. In certain instances, surgical repair or replacement of the mitral valve may be recommended. This can involve repairing the damaged valve or replacing it with a mechanical or, less commonly, a tissue valve. The choice of procedure depends on factors such as the cause of the valve dysfunction and any associated health problems.




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