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Harley Street Cardiology
Real Patients,
Real Outcomes
Heart disease can affect anyone — the fit, the young, the apparently healthy. These are real accounts of patients Dr Nijjer has helped, expanded to show you the journey from first symptom to full recovery.
Look After Your Heart
Heart Disease Is One of the
Biggest Killers in the World
Yet with the latest technology, screening can unearth hidden heart concerns before they become problems. Identifying symptoms early and getting the appropriate treatment can prevent serious problems from becoming life-threatening.
Cardiac symptoms vary enormously — from a slight breathlessness on the stairs to a fleeting chest tightness during exercise. The difficulty is knowing when to seek help, and from whom. A specialist opinion from an experienced cardiologist can be the difference between an anxious wait and a definitive diagnosis.
Dr Sukhjinder Nijjer is a Consultant Cardiologist working in some of London's most prestigious teaching hospitals. On this page he shares four common patterns of heart disease, and four real cases from his practice — to help you recognise whether your own symptoms warrant investigation.
"I had no idea I had such a serious heart condition. Fortunately, Dr Nijjer explained my scans and treatment to my wife and I in a thorough and professional manner. I knew I was in the best hands."
A grateful patient — Marathon runner, aged 55
Common Presentations
Four Ways Heart Disease Presents
Heart problems do not always announce themselves dramatically. These are the patterns Dr Nijjer sees most frequently — and the symptoms that should prompt you to seek a specialist opinion.
Coronary Artery Disease — Plumbing Problems
The heart is a pump that supplies the entire body with blood — but it also needs its own blood supply. Narrowing of these arteries by a disease called atherosclerosis can cause angina: a feeling of chest discomfort when exercising or walking. It may not be a pain, rather a feeling of pressure or heaviness across the chest.
The advances in CT scanning technology mean that for many patients a painless, quick scan will accurately show the arteries and any narrowings. If a blockage is found, patients can often be helped by targeted medicines or by angioplasty — a procedure in which a small tube called a stent is placed within the artery to open it.
"When choosing to use a stent, I consider the patient's lifestyle and their need to get back to the activities they love. In many cases, the procedure can be done through the wrist as a day-case." — Dr Nijjer
Heart Failure — Pump Problems
Heart failure is a frightening term that describes a condition where the heart cannot pump blood adequately, causing breathlessness, fatigue, and ankle swelling. It is life-threatening if not treated. There are many possible causes, and identifying and targeting the underlying problem is essential.
A specialist ultrasound — an echocardiogram — allows direct visualisation of the heart and its valves, quantifying function and identifying where the problem lies. Some patients benefit from a cardiac MRI scan, which provides a level of detail unsurpassed by any other imaging technique.
"MRI can really help the diagnosis in complex cases. The detail we can see is extraordinary — it has revolutionised the way we diagnose and treat this life-threatening condition." — Dr Nijjer
Heart Rhythm — Wiring Problems
An increasingly common issue involves irregularities of the heart rhythm. The beating of the heart is controlled by a complex electrical system, and sometimes the signals go awry. Many people feel palpitations as extra heartbeats or a racing sensation — a clear description of the symptoms can really help diagnosis.
One arrhythmia in particular is rising in prevalence: atrial fibrillation (AF). It can be triggered by high blood pressure or frequent alcohol intake, and dramatically raises the risk of stroke. Choosing the right anticoagulant from those available requires a patient-centred approach — the newer agents have made management far easier than the old warfarin regimens.
"Many people feel palpitations as extra heartbeats or a racing of the heart. A clear description of the symptoms can really help diagnosis." — Dr Nijjer
Hereditary Risk — Family History
Heart problems can also manifest as high blood pressure, dizziness, blackouts, or collapses. In some patients, the underlying risk runs in the family. If a first-degree relative developed heart attacks at a young age, this is an important factor in your individual risk assessment. Blood pressure and cholesterol levels can similarly be linked across families.
Some conditions have a strong genetic component: Familial Hypercholesterolaemia causes persistently elevated cholesterol due to a defect in cholesterol receptors. Hypertrophic cardiomyopathy — an abnormal thickening of the heart muscle — can cause sudden collapses and significant arrhythmia. Both need careful assessment and consideration of genetic testing.
"It's essential that we look at the patient as a whole as well as considering their family history." — Dr Nijjer
From Dr Nijjer's Practice
Four Patient Case Studies
Each case is an account of a real patient. Names and identifying details have been changed to protect confidentiality. The clinical details, investigations, and outcomes are factual.
Could This Be You?
You exercise regularly — perhaps more than most. You have always considered yourself fit and healthy. You put the occasional chest tightness down to indigestion, a pulled muscle, or just working too hard. But fitness is not the same as a healthy heart. Coronary artery disease can develop silently in even the most active people, particularly when there is a family history of heart problems. The first symptom is sometimes the last warning before something far more serious.
What Happened
This 55-year-old executive ran marathons regularly and had always considered himself fit. He had a family history of heart disease but had never investigated his own cardiac health.
After a single episode of squeezing chest discomfort — not severe enough to alarm him, but notable — he was referred to Dr Nijjer for assessment.
Dr Nijjer arranged a CT coronary angiogram — a non-invasive scan that precisely images the coronary arteries. It revealed a critical blockage in his main heart artery.
The blockage was assessed using physiological measurements to confirm the degree of blood flow restriction. Given its location and severity, the options were discussed: targeted angioplasty with a stent, or surgical bypass grafting.
After full discussion with the patient and the cardiac surgical team, he underwent successful coronary artery bypass surgery.
Outcome
He made a full recovery and is back running marathons — now with the reassurance that his heart has been properly assessed and treated. A single symptom that he almost ignored turned out to be the most important warning of his life.
Could This Be You?
You have already had a cardiac event — perhaps a heart attack some time ago. You were treated, discharged, and told things were fine. But you do not feel fine. New symptoms have appeared that you cannot explain. When you raise your concerns, they are attributed to anxiety or the aftermath of your previous illness. Trusting your instincts and seeking a second specialist opinion can make all the difference.
What Happened
This 64-year-old gentleman had a previous heart attack and had been discharged. Despite new symptoms developing, he was told that there was no problem — his concerns were not thoroughly investigated.
He sought a second opinion from Dr Nijjer, who took his symptoms seriously. A dobutamine stress echocardiogram was arranged — a specialist ultrasound that stresses the heart with medication to reveal areas of poor blood supply that are invisible at rest.
The stress echocardiogram confirmed that he did have a significant heart problem. A coronary angiogram was then arranged to directly visualise the arteries.
Angiography confirmed new artery blockages — distinct from those caused by his original heart attack — which had developed in the intervening period.
Dr Nijjer treated these using the latest angioplasty techniques, guided by pressure wire measurements to precisely target only the blockages responsible for his symptoms.
Outcome
With appropriate diagnosis and targeted treatment, his symptoms resolved. This case illustrates why new or changing symptoms should always be investigated — even in patients who have previously been told everything is fine. A second specialist opinion can be life-changing.
Could This Be You?
You experienced an alarming episode of chest pain. You went to your local hospital, but the experience was frustrating — long waits, inconclusive tests, and a sense that no one was quite sure what was wrong. You were sent home unsatisfied. Women in particular can present with atypical cardiac symptoms that are sometimes under-investigated. Timely access to a specialist who can arrange the right tests quickly is invaluable.
What Happened
This 66-year-old lady came to Dr Nijjer following an episode of acute chest pain. She had experienced significant delays at her local hospital and was looking for a prompt, definitive answer.
Dr Nijjer arranged admission the following day — avoiding further delays — and organised a CT coronary angiogram. This non-invasive scan confirmed the presence of an artery blockage.
Having identified the culprit artery, Dr Nijjer proceeded directly to treatment. Using angioplasty, the blocked artery was opened and a stent placed to keep it open — typically performed through the wrist, with minimal recovery time.
From admission to discharge, the entire episode was managed swiftly and efficiently.
Outcome
The patient was home the same day. What had been weeks of uncertainty and anxiety resolved into a definitive diagnosis and successful treatment within 24 hours of seeing Dr Nijjer. This case highlights how access to prompt specialist investigation avoids prolonged distress and unnecessary risk.
Could This Be You?
You are younger than the typical heart patient — active, fit, and not expecting to be sitting in a cardiologist's office. Perhaps an incidental investigation revealed something unexpected, or symptoms appeared after a period of stress or illness. Heart disease does not discriminate by age. What matters most is that when a problem is found, you receive a full, honest discussion of your options — not a default referral to the one treatment that suits everyone.
What Happened
This 42-year-old gentleman developed cardiac symptoms following an accident. He was active and physically fit, and a heart problem was not expected.
Dr Nijjer investigated and found a critical coronary artery blockage using invasive coronary angiography, confirmed with pressure wire physiology to quantify the functional severity.
The treatment options were discussed openly: traditional coronary artery bypass surgery, or a minimally invasive stent placed during the same procedure. Both carry distinct advantages depending on the patient's anatomy, lifestyle, and priorities.
Following a full "heart team" discussion — involving Dr Nijjer, a cardiac surgeon, and the patient himself — the patient chose to have the stent placed. His anatomy was suitable and his desire to return to training quickly was a central consideration.
The procedure was performed through the wrist under local anaesthetic. He was discharged the same day and began a supervised recovery programme.
Outcome
He is back to his passion of martial arts. This case illustrates the importance of individualised treatment: not every critical blockage requires open surgery, and not every young patient should be offered the most invasive option by default. The right answer comes from an honest conversation with an experienced specialist.
"I had no idea I had such a serious heart condition. Fortunately, Dr Nijjer explained my scans and treatment to my wife and I in a thorough and professional manner. I knew I was in the best hands with Dr Nijjer."
A grateful patient — Marathon runner, treated by Dr Nijjer
Do You Recognise
Your Own Symptoms?
If any of these cases resonate with you — or if you have symptoms you have been unable to explain — a specialist consultation is the right next step. Appointments are typically available within the same week.