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Transoesophageal echocardiography before atrial fibrillation cardioversion prevents stroke by detecting hidden left atrial appendage clots. The greatest risk comes from atrial stunning after rhythm restoration, not existing thrombus. TOE enables safe early intervention.
PCSK9 binds to LDL receptors and directs them to be destroyed within the cell, rather than allowing them to recycle to the surface. When too much PCSK9 is present, fewer LDL receptors remain available to clear LDL from the blood. The result is simple: LDL levels rise. When that happens, the liver compensates by making even more cholesterol internally. This is why around 90% of the cholesterol in your blood is made by your liver, not absorbed from your diet.
Small dense LDL (sdLDL) particles are the most atherogenic type of LDL. They are smaller and heavier, stay in the bloodstream longer and more likely to oxidise and enter artery walls. High sdLDL is typical of metabolic syndrome, diabetes, and high triglyceride states linked to visceral fat.Because sdLDL testing is specialised, the ApoB level and the LDL-C : ApoB ratio can be used to estimate particle size predominance:
Troponin-negative presentations are often sent home without a timely work up or prompt imaging tests like a CT angiogram. A delay can be critical. Until these services become widely available, and in good time, patients experiencing unexplained chest symptoms who have not had clinical follow up and diagnosis confirmed are advised to 'vote with their feet'- either head back into hospital in event of further symptoms, or even consider arranging to fund their own urgent CT angiogram from an independent medical provider.
Before birth, the foramen ovale is a vital foetal opening between the right and left atria, allowing oxygen-rich placental blood to bypass the inactive lungs. After the first breath, pressure in the left atrium increases, closing the flap naturally. In around 25% of adults, the flap does not seal fully — this persistent communication is called a Patent Foramen Ovale (PFO) which is an important cause of cryptogenic stroke. All standard tests including an echocardiogram can be normal- it can be only be diagnosed using a bubble contrast study and once diagnosed, treatment with clam shell closure is high effective.
Men attending a heart clinic rarely come in with just one concern. Erectile dysfunction, prostate health and unexplained weight gain share biological pathways with cardiovascular disease. This article explores why one cardiology clinic built a dedicated men's health service, and what those links mean for patients and GPs.
Traditional upper limits for ALT (often ≤55 U/L in UK labs) were derived decades ago, before the epidemic of obesity and steatosis. Current evidence suggests these ranges are too high — and that values above 30 U/L may already indicate liver injury in people with metabolic risk. The British Society of Gastroenterology (BSG) guidelines emphasise that a result within the “normal range” may not be reassuring if the patient is metabolically high-risk
For much of modern cardiology, in its battle against coronary artery disease—one of mankind’s greatest threats—the “enemy” seemed clear. When I trained, the diagnostic armoury was focused on accurately identifying flow-limiting narrowing of one or more coronary arteries. Yet in the last decade, a profound paradigm shift has unsettled these foundations—and in some respects, turned them on their head.
An article written by Dr Edward Leatham, Consultant Cardiologist When unexplained fainting episodes (syncope) or certain types of stroke occur, the search for an underlying cause can be frustrating for patients and clinicians alike. In some cases, the usual tests — […]
The Eight-Month Metabolic Reset is a structured cardiometabolic programme designed to reduce visceral fat, preserve skeletal muscle strength, and improve glucose stability. Combining lifestyle change, targeted metabolic support, and clinical guidance, it helps break the cardiometabolic cycle and build sustainable long-term health beyond short-term weight loss.
An article written by Dr Edward Leatham, Consultant Cardiologist Tags: BP, CGM, Glucose, Telehealth, Homecare, NH1 search website using Tags to find related stories. Over the past decade, healthcare has experienced a remarkable evolution in how patients are monitored and managed […]
Having a stent or bypass is not the end of the story—it is the beginning of a new chapter in managing your cardiovascular health. With the right combination of medications, lifestyle changes, rehabilitation programmes, and vigilant follow-up using advanced diagnostic techniques, you can greatly reduce your risk of future events. Stay engaged with your healthcare team, keep informed about new therapies and guidelines, and commit to sustainable lifestyle adjustments to ensure the best possible long-term health.