Chest Pain

Chest pain is one of the most common reasons people seek medical help — and one of the most worrying. While many causes are not serious, chest pain can sometimes be the first sign of an underlying heart problem. Getting an expert assessment quickly gives you either the reassurance you need or the treatment you need, without delay.

I am Dr Ozan Demir, a Consultant Interventional Cardiologist practising in central London and Essex. I specialise in the investigation and treatment of chest pain, angina, and coronary artery disease, offering rapid private appointments with same-week access to advanced cardiac testing.

Chest pain has many possible causes. Some relate to the heart; many do not. 

Common causes include:

Heart-related (cardiac) causes:

• Angina — pain or tightness caused by narrowed coronary arteries restricting blood flow to the heart muscle, typically triggered by exertion or stress
• Heart attack (myocardial infarction) — a medical emergency caused by a sudden blockage of a coronary artery
• Pericarditis — inflammation of the sac surrounding the heart, often causing sharp pain that changes with position or breathing
• Heart valve disease — conditions such as aortic stenosis can cause chest tightness, particularly on exertion
• Coronary artery spasm — temporary tightening of the heart's arteries

Non-cardiac causes:

• Acid reflux and other digestive problems
• Muscle strain or inflammation of the chest wall (costochondritis)
• Lung conditions, including infection or blood clots
• Anxiety and panic attacks

The challenge is that these conditions can feel remarkably similar. That is why a thorough specialist assessment matters — the goal is never simply to rule things out, but to find the actual cause of your symptoms.

You should seek urgent medical attention (call 999) if your chest pain:

• Is severe, crushing, or feels like pressure or a heavy weight
• Spreads to your left arm, both arms, neck, jaw or back
• Comes with breathlessness, sweating, nausea or light-headedness
• Lasts more than 15 minutes and does not settle with rest

You should arrange a prompt specialist assessment if your chest pain:

• Comes on with exercise or exertion and eases with rest
• Is new, unexplained, or becoming more frequent
• Occurs alongside palpitations or breathlessness
• Runs alongside risk factors such as high blood pressure, high cholesterol, diabetes, smoking, or a family history of heart disease

Exertional chest tightness in particular should never be ignored — it is the classic pattern of angina and warrants investigation even if it settles quickly.

Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to narrowing of the coronary arteries (coronary artery disease). It is often described as tightness, heaviness or pressure rather than sharp pain, and typically:

• Comes on with physical activity, cold weather, heavy meals or emotional stress
• Settles within a few minutes of rest
• May spread to the arms, neck or jaw

Angina is important to diagnose because it signals underlying coronary artery disease — a condition that is very treatable, but which can lead to a heart attack if left unassessed. As an interventional cardiologist, I manage the full pathway: from diagnosis through to medication, angioplasty and stenting where needed.

Your first appointment lasts around 30 minutes and includes:

1. A detailed discussion of your symptoms — when the pain occurs, what it feels like, what triggers it and what relieves it. The pattern of chest pain often tells us a great deal before any test is performed.
2. A review of your risk factors — blood pressure, cholesterol, diabetes, smoking history, weight and family history of heart disease.
3. A physical examination and a resting ECG (electrocardiogram)
4. A clear plan — I will explain what I think is going on, which tests (if any) are needed, and what the results will mean for you.

Consultations are available in English and Turkish.

Depending on your symptoms and risk profile, I may recommend one or more of the following — all available rapidly at my London clinics:

• ECG — a simple recording of your heart's electrical activity
• Echocardiogram — an ultrasound scan of the heart's structure, function and valves
• CT coronary angiogram — a highly accurate, non-invasive scan of your coronary arteries, and the first-line test recommended by NICE for new chest pain
• Exercise or stress testing — assessing how your heart performs under exertion
• Blood tests — including cholesterol profile and markers of heart strain
• Invasive coronary angiography — a definitive assessment of the coronary arteries, performed by me personally, with the option to treat any significant narrowing with angioplasty and stenting during the same procedure where appropriate

Most patients complete their initial assessment and key investigations within one to two weeks.

Treatment depends entirely on the cause:

• If your heart is healthy, you receive clear reassurance and, where relevant, referral or advice for non-cardiac causes such as reflux or musculoskeletal pain.
• If you have angina or coronary artery disease, treatment may include medication to relieve symptoms and protect the heart, lifestyle and risk factor management, and — where narrowings are significant — coronary angioplasty and stenting (PCI), a minimally invasive procedure I perform regularly at leading London hospitals.
• If another cardiac condition is found, such as valve disease or pericarditis, I will manage this directly or coordinate your care with the right specialist team.

Because I am an interventional cardiologist, you will not need to be re-referred if a procedure is required — I can carry out your diagnosis and treatment as a seamless pathway.

• Consultant Interventional Cardiologist with subspecialty expertise in coronary artery disease and complex coronary intervention
• PhD from King's College London in coronary artery disease and advanced fellowship training in Milan, with over 100 peer-reviewed publications
• Rapid access — same-week appointments at Heart Health Welbeck London (Marylebone), Cromwell Hospital (Kensington) , The Wellington Hospital (St John's Wood), Bupa Health Care Canary Wharf, The Essex Cardiothoracic Centre (Basildon)
• End-to-end care — from first consultation through advanced imaging to angioplasty and stenting, under one consultant
• Consultations in English and Turkish
• Recognised by all major private medical insurers; self-paying patients welcome