Chest Pain Specialist in London

What causes chest pain?

Chest pain is one of the most common reasons people seek a cardiology opinion, and one of the most worrying. It can range from a fleeting twinge to a heavy, central pressure that radiates into the jaw or arm. Most chest pain is not caused by the heart, but distinguishing cardiac from non-cardiac chest pain reliably requires expertise, the right tests and unhurried time with a specialist.

Cardiac causes include angina from narrowed coronary arteries, inflammation of the heart muscle or its lining, valve disease and rhythm disturbances. Non-cardiac causes are broader still and include reflux, musculoskeletal strain, anxiety and lung problems. The job of a chest pain specialist is to confirm what it is, exclude what it isn't, and explain what to do next.

Symptoms and when to see a specialist

If you experience severe, sudden or persistent chest pain, especially with breathlessness, sweating or collapse, call 999. For chest pain that is recurrent, exertional, unexplained or simply worrying you, an urgent outpatient cardiology assessment is the right next step. Same-day or next-day appointments are often available.

• Tightness, pressure or heaviness in the centre of the chest, particularly on exertion
• Pain that radiates to the jaw, neck, shoulder or arm
• Chest pain associated with breathlessness, nausea or sweating
• Sharp chest pain that varies with breathing or posture
• Chest discomfort accompanied by palpitations or light-headedness
• A strong family history of coronary disease or sudden cardiac death

Our approach

Dr James Howard and Dr Ahran Arnold both see patients with chest pain at OneWelbeck Heart Health on Welbeck Street, as well as at Hammersmith and Charing Cross Hospitals. Both are senior academics at Imperial College London. Dr Howard's research focuses on cardiac imaging, including AI-enhanced cardiac MRI and the landmark SAMSON trial published in the New England Journal of Medicine, which transformed how the profession thinks about medication side effects. Dr Arnold brings additional expertise in heart rhythm disturbances that can present as chest discomfort.

Consultations are unhurried. Expect a careful history, examination and, in most cases, the relevant diagnostic tests on the same visit. You will leave with a clear explanation of what is and is not going on, a written plan and direct access to your consultant should anything change.

Tests we may recommend

The right test depends on your story, your risk factors and the examination findings. Most investigations can be performed on site at OneWelbeck, often during the first appointment, with results discussed face-to-face the same day or by phone shortly afterwards.

• Resting and exercise ECG
• Echocardiogram to assess heart muscle and valve function
• CT coronary angiogram, the gold-standard test for excluding coronary artery disease in most patients
• Cardiac MRI for detailed assessment of the heart muscle, including inflammation and scarring
• Ambulatory rhythm and blood pressure monitoring
• Targeted blood tests for cholesterol, diabetes risk and inflammatory markers