At Home with Chris Jessen 2018 - 97

wires in the arteries, we can measure the
blood flow so we target the stents to
the most beneficial area.'
Experienced cardiologists using these
new tools has led to the best results.
Dr Nijjer says: 'When choosing to 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
and most patients resume normal
activities very quickly.'

Pump action

Another common heart problem is heart
failure. This is when the heart cannot
pump blood adequately around the
body, causing breathlessness or ankle
swelling. Dr Nijjer explains: 'Heart failure
is life threatening if not treated. There
are many possible causes - identifying
the causes and targeting them is key.'
The most common cause is a
narrowing of the heart arteries and
treating them may improve the heart's
function. A specialist ultrasound, called
an echocardiogram, is often needed:
'Echocardiography allows us to see
the heart and its valves,' says Dr Nijjer.
'We can quantify its function and see
where the problems are.'
Some patients will need an MRI
scan which involves going into a large
machine. With claustrophobic patients,
Dr Nijjer will use an open MRI scanner to
make the experience more comfortable.
Dr Nijjer says, 'MRI can really help the
diagnosis in complex cases. The level

of detail we can see is unsurpassed and
has revolutionised the way we treat this
life-threatening condition.'

A complex system of wires

An increasingly common issue involves
irregularities of the heart's rhythm. The
beating of the heart is controlled by
a complex system of wiring and
sometimes the signals can go awry.
Dr Nijjer explains: 'Many people feel
palpitations as extra heart beats or a
racing sensation of the heart. A clear
description of the symptoms can
really help diagnosis.'
In most cases, patients will need an
electrocardiogram and a Holter monitor -
where the ECG is recorded over

ARRHYTHMIA IS
FAST BECOMING A
PROBLEM AND CAN BE
TRIGGERED BY HIGH
BLOOD PRESSURE OR
FREQUENT ALCOHOL
24 hours. One arrhythmia in particular is
increasing, according to Dr Nijjer. 'Atrial
Fibrillation, or AF. is becoming a major
health problem as it can be triggered by
high blood pressure or frequent alcohol
intake,' he explains. 'It dramatically
increases the risk of stroke and we may
need to thin the blood to reduce this risk.'
Choosing which drug from the multitude

Case studies
RUNNING MAN WITH
A TICKING TIME BOMB
This 55-year old man
always thought he was
fit and regularly ran
marathons. However,
he had a family history
of heart problems
and was referred for
an assessment after
an episode of chest
discomfort. Dr Nijjer
found him to have a
critical blockage in
his main artery. After
considering the options,
the patient underwent
successful surgery and
is running again.
MAN HAD ALREADY
HAD HEART ATTACK
A 64-year-old man
had one heart attack
but was discharged

after treament and told
there was no problem -
despite new symptoms.
Dr Nijjer administered
a dobutamine-stress
echocardiogram, which
confirmed he did have
a heart problem. The
angiography confirmed
new artery blockages
which Dr Nijjer was
then able to treat.
PROMPT TREATMENT
FOR CHEST PAIN
A 66-year-old lady came
to Dr Nijjer following an
episode of acute chest
pain (and some delays)
at her local hospital.
Dr Nijjer arranged
admission to the
hospital the following
day and confirmed an
artery blockage using

a non-invasive CT scan.
He treated the blocked
artery and the patient
was allowed to go home
the same day.
MAKING SURE YOU
GET THE RIGHT
TREATMENT
This 42-year-old man
developed heart
problems after an
accident. Dr Nijjer found
a critical blockage and
together they discussed
the need for traditional
bypass surgery or a
minimally invasive stent.
After a full discussion
with Dr Nijjer and his
team, the patient chose
to have a stent. The op
was a success and the
man is back enjoying his
passion of martial arts.

MEET THE EXPERT
Dr Sukhjinder Nijjer
is a consultant
cardiologist at
the Hammersmith
Hospital and
Chelsea and
Westminster NHS
Foundation Trust
in London. He is
an internationally recognised expert
in interventional cardiology who
frequently lectures and teaches other
specialists on the latest techniques.
He uses advanced tools to deliver
precision-guided therapy for the heart,
including cardiac intervention, imaging
and pacemaker implantation.
Dr Nijjer trained in world-class
London hospitals, including the Royal
Brompton, Harefield and St Mary's.
He has had more than 70 articles
published in top medical journals and
his services are available seven days
a week, covering the full spectrum
of heart disorders.
Dr Nijjer always places the patient
at the centre of what he does and
is a compassionate and committed
physician. He was awarded a PhD
in coronary physiology by Imperial
College and in 2015 won a British Heart
Foundation prize for best Research
Abstract in Coronary Intervention.

available can be tricky, with Dr Nijjer
adding, 'In many ways there has been a
revolution in the drugs to treat this: the
new anticoagulants are making life much
easier than being on warfarin, but there
are nuances when choosing the right drug.
A patient-centred approach is essential.'

It can run in the family

Heart problems can also manifest as
high blood pressure, dizziness, loss of
consciousness (blackouts) or collapses.
In many cases, heart problems run in
the family. Dr Nijjer says: 'It's essential
that we look at the patient as a whole as
well as considering their family history.'
Whatever the problems, a careful
review by an expert cardiologist is
essential to get to the heart of the
matter and to the right treatment.

FOR MORE INFORMATION
Call Trudy Marr 020 7436 4568
Visit drnijjer.com
Email secretary@drnijjer.com
Dr Nijjer can be seen at Harley Street,
Cromwell Hospital and Wellington
Hospital in London and BUPA Clinics,
BMI Syon Clinic and Imperial
Private Healthcare
http://drnijjer.com/
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