Cardiology services

Cardiology is a medical specialty concerned with diseases and disorders of the heart. It deals with the diagnosis and treatment of such conditions as coronary artery disease, heart failure, valvular heart disease and heart rhythm disturbances. Subspecialties of the cardiology field include cardiac electrophysiology, echocardiography, interventional cardiology and cardiac imaging.

The service provides investigation and treatments for the following conditions:

  • Arrhythmias and Palpitations
  • Chest pain in those patients not fulfilling the Urgent Chest Pain Service criteria
  • Ischaemic heart disease
  • Pericardial disease
  • Diseases of the thoracic aorta
  • Syncope
  • Heart failure
  • Valvular heart disease 
  • Cardiomyopathy
  • Breathlessness

The department consists of a 24 bedded ward (Merrow Ward) with a mixed sex 6 bedded CCU on E Level. The Outpatient services are located on B level and comprises of 3 echo rooms, 1 treadmill suite, a 5-bedded day ward supporting the Cardiac Catheterisation laboratory and cardiology out-patient service. The service also runs outpatient clinics from community locations including Haslemere and Cranleigh.

What will happen at the first appointment?

If this is your first appointment then you may be seen by the Consultant Cardiologist or he may have requested for you to be seen by the Specialist Nurses.

At your appointment you will have a full examination including a history of your symptoms and may be asked to have another ECG.   Following the outpatient appointment you may be sent for more diagnostic tests which may include:

  • 24 hour Heart Monitoring
  • Exercise ECG
  • Echocardiogram  (ultrasound of the heart)
  • Cardiac MRI
  • Angiography
  • Electrophysiology Study – this maybe done here at the Royal Surrey or you may be referred St George’s Hospital in London

When will you get the results of your tests?

Your GP will be written to after you have had all of your diagnostic tests.  This means, if you were referred for one test then your GP will get a results letter after this investigation has been done and reported.  If you have been referred for more than one diagnostic test, then your GP will get a letter after all of your results have been reviewed.  This will help your GP understand what is happening with your care and treatment.

What happens next?

There are three ways in which you maybe followed up after you have had your diagnostic tests:

Face-to-Face Outpatient Appointment 

Once your results have been reviewed by the Consultant or a member of his team, then you maybe recalled  back to an outpatient clinic appointment to discuss the results and any further treatment or monitoring that maybe required. 

Telephone  Appointment 

An alternative to a Face-to-Face appointment is a Telephone Appointment. This type of appointment allows you to stay at home or other convenient location rather than coming to the hospital site. It provides convenience for you and allows you to discuss any concerns that you still may have with a specialist member of the Cardiology Team.

Virtual Clinic  Appointment 

If your results indicate that your symptoms are not related to your heart or if you are having regular monitoring for your heart condition but do not need to see the Consultant each time you attend, then the clinical team may chose to write to your GP to advise them of your results and the next steps in your treatment.  This type of appointment is often used when your results show that it is not a heart problem that is causing your symptoms.

This type of appointment is called a ‘virtual’ appointment and  if this occurs then you will not be brought back to an outpatient clinic.  

Your Responsibility

If your GP has referred you to Cardiology or any of the services here at the Royal Surrey, then you have a duty to attend your appointment or inform the hospital if you cannot make or do not wish to be seen.

Patients who do not attend (DNA) or who reschedule more than once will have their case reviewed by the Consultant and may be discharged back to their GP to be referred back in at a later date when they are willing to attend for appointments.

If your GP thinks that there is a problem with your heart and has decided to make a referral then it is best that you keep the appointment dates to ensure prompt diagnosis and treatment. 

Access and referral information

Referrals into the outpatient service are for individuals aged 16years and over and are accepted via the national eRS system only.

The department also offers an Advice and Guidance service and open access:

  • Echocardiography
  • Holter Monitor/24 Hr Tape
  • 12-Lead ECG Interpretation

Patients requiring Cardiac Surgery or other specialised Cardiology intervention will be referred to one of our network centres in London; St George’s Hospital, Tooting, Royal Brompton Hospital or St Bartholomew’s. Consultant Surgeon’s from the London hospitals visit the Royal Surrey every month basis to discuss patients requiring surgery and to provide an outreach outpatient service.

What tests will the GP do?

If your GP suspects that you have a heart problem then they should send you for some diagnostic tests prior to referring you to the hospital based Cardiology. Tests that they may do include: ·

  • 12 Lead ECG – copy should be sent with the referral ·
  • 24 Hour Holter Monitor or other such rhythm recording – copy should be sent with the referral
  • Blood tests
  • Echocardiogram

It is important that your GP sends in ALL diagnostic test results that have been performed in primary care or other centres. This will ensure that your referral is managed appropriately and in a timely manner.

Your referral may be rejected if the diagnostics tests are not present.

Meet the team

There are 6 medical staff are supported by 2 Associate Specialists, a team of Cardiac Physiologists with national specialist accreditation (BSE or Heart Rhythm UK) who independently run pacemaker and echo clinics as well as supporting all laboratory activities. A team of hospital based Heart Failure, Arrhythmia, Chest Pain and Cardiac Rehab Nurse Specialists.

Dr Zia Zuberi – Clinical Director and Consultant Cardiologist and Electrophysiologist
Dr Mike Hickman – Consultant Cardiologist
Dr TP Chua – Consultant Cardiologist
Dr Tarique Musa – Consultant Cardiologist with an interest in Heart Failure
Dr Hannah McConkey — Consultant interventional cardiologist
Dr Nathan Gurunathan — Consultant Cardiologist

Nursing Leads:
Annette Coote – Project Manager / Matron
Julia Titchen – Interim Matron

Arrhythmia Nurses:
Andrea Grieger
Anita Hewinson

Heart Failure CNS Team:
Laura Greswell
Jennifer Simpkins
Cheryl Wood

Rapid Access Chest Pain CNS:

Cardiac Physiologists:
Nicola Montalbano - Head of Department
Matthew Davies - Clinical Measurements (Cardiac Cath Lab and Pacing)
Siva Ratnatheepan – Head of Department - Echocardiography

Managerial Leads: 
Jenni Friar – Head of Service
Jayne Reynolds-Lloyds – Service Manager
Amanda Newman – Assistant Service Manager

Cardiac Rehab:
Erin Douglas (Part-time)