What do we treat?

Our cardiologists treat all types of heart disease, including:

  • Myocardial infarction.
  • Coronary heart disease.
  • Aortic valve disease.
  • Mitral valve prolapse.
  • Myocardiopathies.
  • Arrhythmia.
  • Hypercholesterolaemia.
  • Heart failure.
  • High blood pressure.
  • Syncope or loss of consciousness.
  • Cardiovascular symptoms:
    • Chest pain (angina pectoris)
    • Fatigue or shortness of breath
    • Leg swelling

Treatment options include:

  • Medication. Treatment adjustments
  • Therapeutic procedures
  • Lifestyle and diet recommendations

Myocardial Acute Infarction

This is the acute occlusion of an artery of the heart as a result of a blood clot, causing a complete lack of blood supply to a part of the myocardium.

Diagnosis involves assessing the patient's symptoms and conducting an electrocardiogram whenever an infarction is suspected, followed by an immediate coronary angiography. Thin tubes called catheters are inserted through an artery, usually in the arm, and advanced into the coronary arteries (arteries of the heart) to inject contrast dye and detect the blockage. Once the complete absence of blood flow in an artery has been diagnosed, various devices are introduced into the artery through catheters to restore blood flow, and in most cases a stent (metal spring) is implanted in the area of the clot to keep the artery open.

Aortic valve disease

The aortic valve is one of the 4 valves inside the heart. It is located between the main pumping chamber of the heart (left ventricle) and the main artery of the body (aorta). It can deteriorate for a number of reasons, producing what we call valvulopathy or aortic valve disease. These causes may be congenital (i.e. from birth) or acquired over the years (age-related deterioration, rheumatic disease, etc.). It can often be symptomless for many years. However, over time, symptoms and signs such as murmurs, shortness of breath (dyspnoea), dizziness or fainting (syncope), chest pain or swelling of the legs (oedema) may appear.

The two main types of aortic valve disease are:

  • AORTIC STENOSIS: The aortic valve leaflets do not separate well, preventing the valve from opening correctly. This is due to the altered condition of the leaflets, characterised by increased rigidity or fusion, disrupting the aortic valve's normal opening movement.
  • AORTIC INSUFFICIENCY: In this case, the aortic valve does not close properly, allowing blood flow to leak back into the left ventricle.

Although, in the early stages of the disease, treatment is only necessary if cardiovascular risk factors are present, valve repair or replacement is required whenever there is a severe alteration of valve function that generates symptoms or overloads the heart. This treatment generally requires surgical intervention, although in recent years, treatments have been developed specifically for aortic stenosis that allow the aortic valve to be replaced by catheterisation (without the need for surgery) in selected patients.

Mitral valve prolapse

Mitral valve prolapse is a condition characterised by the valve's leaflets not closing properly during systole, causing them to bulge into the upper left chamber of the heart (left atrium) during cardiac contraction (systole). Mitral valve prolapse sometimes causes blood to flow in the opposite direction to the left atrium, a condition called "mitral valve insufficiency". The vast majority of cases are symptom-free and with low risk of complications.

There are several causes of mitral prolapse, the most frequent being:

  • Myxoid valve prolapse, with redundant tissue of both leaflets, preventing correct closure.
  • Prolapse in relation to rupture of the chordae tendineae (mitral flail), preventing proper valvular closure.

The diagnostic technique of choice for mitral prolapse is echocardiography, which can be used to see the mitral anatomy and the severity of the insufficiency. Treatment depends on the degree of valvular involvement and of mitral insufficiency, and surgery may be required.

In some cases of severe valvular prolapse with high surgical risk, a "mitra-clip" can be inserted through cardiac catheterisation to reduce valvular regurgitation by clipping the anterior and posterior mitral leaflets in the region with the most significant leakage.


Cardiomyopathies are a group of diseases that produce intrinsic abnormalities of the muscular layer of the heart. They are grouped according to the specific form and function of the disease they produce. The European Society of Cardiology describes the following groups:

  1. Hypertrophic cardiomyopathy: A disease characterised by abnormal growth of the heart muscle that is not secondary to other pathologies such as arterial hypertension or aortic stenosis. Alterations also occur in cardiac cells that do not occur in other diseases. This pathology may be hereditary.
  2. Dilated cardiomyopathy: A disease where the heart may undergo dilation, resulting in a weakened cardiac function that impairs its ability to adequately pump blood throughout the body. Symptoms such as shortness of breath or swelling in the feet may therefore appear. There are some forms that are genetic in origin.
  3. Arrhythmogenic right ventricular dysplasia: In this disease, the muscular layer of the heart (particularly the right ventricle) undergoes structural modifications where the cardiac muscle cells are substituted by non-contractile scar and adipose tissue. This disease can be serious as it sometimes causes malignant arrhythmias.
  4. Restrictive cardiomyopathy: In this group of diseases, heart contraction strength remains normal but there are alterations in relaxation during diastole, leading to inadequate filling and insufficient blood flow to the rest of the body.
  5. Other cardiomyopathies: This includes other less common diseases of the heart muscle such as non-compaction cardiomyopathy, fibroelastosis or mitochondrial cardiomyopathies.


Cardiac arrhythmias are a group of heart diseases in which there is an alteration of normal heart rhythm, with either slow (bradyarrhythmias) or rapid (tachyarrhythmias) heart rates.

Bradycardias are due to a disorder in the formation or transmission of the cardiac impulse. They lead to insufficient heart rates, compromising adequate cardiac activity. Symptoms may include dizziness, syncope, fatigue or dyspnoea. Diagnosis can be made with a simple electrocardiogram or a Holter monitor (an electrocardiogram that lasts from one day to 3-4 weeks). More complex techniques are sometimes required, such as a stress test, a subcutaneous Holter monitor (lasting up to 3 years), or even an electrophysiological study, which is a type of simple catheterisation to study the cardiac electrical system in depth. Treatment for this type of disorder varies, but often requires fitting a pacemaker.

Tachycardias are heart rhythm disorders in which the heart rate is very fast. There are various types, depending on the underlying mechanism, the point of origin, and the presence of other concurrent heart abnormalities. This group includes extrasystoles, supraventricular tachycardias, atrial fibrillation and flutter, and ventricular tachycardias. Symptoms usually include palpitations, chest pain, dizziness, syncope or even sudden death. Diagnosis generally requires the same tests as for bradyarrhythmias. Treatment is highly variable, depending on the type of tachycardia. Treatment might not be required if they are benign and asymptomatic, while in other cases antiarrhythmic drugs are used. Most arrhythmias can currently be treated using ablation techniques, which involve cardiac catheterisation to eliminate the source of the arrhythmia by applying radiofrequency (heat) or cryoablation (cold).


Cholesterol is a natural fatty substance present in every cell in the human body, playing a crucial role in the proper functioning of the organism. Most of it is synthesised in the liver, although in smaller amounts it is also obtained from certain foods. Although there are several types of cholesterol, they are generally separated into good cholesterol (known as HDL) and bad cholesterol (known mainly as LDL).

In general, hypercholesterolaemia is defined as total blood cholesterol levels > 200 mg/dl, although it is preferable to know the LDL level, which should be below 116 mg/dl in the general population and even lower in patients with cardiovascular disease or at heightened risk of developing it. The primary consideration is that there are generally no initial symptoms, emphasising the importance of identifying hypercholesterolaemia through a blood test to proactively prevent complications arising from persistently high blood levels; these elevated levels can deposit in the walls of blood vessels, leading to the formation of atheroma plaques (atherosclerosis) and ultimately a range of cardiovascular diseases, including angina pectoris, acute myocardial infarction, stroke and similar conditions.

Preventing hypercholesterolaemia begins with good diet and avoiding sedentary lifestyles and obesity, which will also help avoid arterial hypertension and diabetes. However, certain patients with a hereditary predisposition to the onset of hypercholesterolaemia require medical intervention immediately upon diagnosis.

As mentioned, in individuals without additional risk factors or cardiovascular issues, LDL should be below 116 mg/dl; the higher the cardiovascular risk, the lower the LDL target. Patients with a high cardiovascular risk, including those who have previously had a heart attack, have traditionally aimed to keep LDL levels below 70 mg/dL, although the latest guidelines from the European Society of Cardiology now recommend a target of less than 55 mg/dL. Fortunately, the cardiovascular area is constantly evolving and multiple drugs are now available to lower cholesterol levels, such as statins, fibrates, ezetimibe, and, more frequently, so-called PCSK9 inhibitors.

Heart failure

This is a disorder in which the heart is unable to adequately supply the body with oxygenated blood, or can only do so through continuous overexertion.

It is estimated that between 1-3% of adults in developed countries have heart failure (HF). This pathology is much more prevalent in patients over 75 years of age, totalling 16% in our country. In Spain, it is the leading cause of hospitalisation among patients over 65 years of age, the 4th cause of mortality, and an important reason for readmissions. The most frequent (but not the only) causes of HF are ischaemic heart disease (e.g. myocardial infarction), heart muscle disease (cardiomyopathies), arrhythmias, and cardiac valve abnormalities.

Preventing HF is a matter of great importance, given the enormous implications of HF in terms of mortality and decreased quality of life. A heart-healthy lifestyle is recommended, avoiding smoking, obesity and sedentary lifestyles, as well as drinking alcohol in moderation and controlling other cardiovascular risk factors such as arterial hypertension, diabetes and high cholesterol levels.

Early diagnosis of HF is hugely important in establishing treatments that can cut mortality rates and alleviate the decline in quality of life associated with this disease. This is achieved through medical interviews, physical examination, and imaging tests such as electrocardiogram (ECG), chest X-ray and echocardiogram, along with certain laboratory tests.

Treating heart failure involves the use of medications that regulate the mechanisms in the body that are activated in this syndrome and can potentially have harmful effects on the heart. These drugs include beta blockers, angiotensin inhibitors, neprilysin inhibitors and aldosterone antagonists. Diuretics, which are drugs that help to eliminate liquid, are also very useful.

High blood pressure

Blood pressure is the force exerted by the blood on the walls of the arteries. There is a direct correlation between blood pressure and cardiovascular problems, i.e. the higher the blood pressure, the more likely a person is to develop cardiovascular events. For this reason, high blood pressure (HBP) is defined as the level of blood pressure at which the benefits of treatment (lifestyle or drugs) outweigh the risks of this intervention, defined as any BP equal to or over 140/90.

HBP is present in 40% of the adult population, and in most cases does not cause symptoms (which is why it is important to take blood pressure regularly to ensure early detection). Some people may have headaches or nosebleeds, but these are non-specific and may not be due to HBP.

HBP should be treated because it can lead to an increase in the incidence of cardiovascular events (myocardial infarction, stroke, heart failure, intracranial haemorrhage, etc.), combined with lifestyle changes and pharmacological treatment whenever necessary to reduce this risk.

Syncope or loss of consciousness

Syncope is a transient loss of consciousness that is followed by immediate, complete recovery. It is very common, and up to 40% of people suffer one in their lifetime. Prognosis is generally favourable, although a small percentage of cases are due to severe diseases, meaning an accurate diagnosis and treatment are required.

The most frequent syncopes are so-called vasovagal or neuromedial syncopes, which are due to a sudden drop in blood pressure. They are most common in adolescence, but can occur at any age. The second most frequent type of syncope is called orthostatic syncope, which occurs when standing up or sitting up abruptly. The least frequent group is cardiogenic syncope, which is due to diseases of the heart itself, such as arrhythmias or structural diseases. A good medical history is generally enough for diagnosis, although additional tests such as an electrocardiogram, Holter monitor, electrophysiological study or even studies by the Neurology Service may be necessary on occasions.

Treating syncope varies greatly depending on the type and cause involved. Treatment may range from postural measures and lifestyle changes through to the use of drugs, implementing a pacemaker or defibrillator, or other more specific treatments.

Chest pain and coronary artery disease

Although there are always exceptions, chest pain of coronary origin is usually oppressive and not localised in a specific point but rather in the region of the sternum and/or the left side of the thorax. Pain most commonly radiates to the left arm, jaw and back. The pain usually appears with exertion, and disappears a few minutes after the exertion has subsided. It is not uncommon for anginal pain to be associated with nausea or vomiting, shortness of breath or sweating. The patient should go to A&E if the pain becomes increasingly more intense, appears with less effort, takes longer to disappear, or even occurs at rest.

The cardiac cause of this pain is usually coronary artery disease. These are narrowings in the coronary arteries due to the presence of atherosclerosis plaques. Such plaques contain cholesterol, among other components, and their development is due to cardiovascular risk factors (smoking, high cholesterol, diabetes, hypertension, etc.). Significant narrowing can lead to chest pain during exertion or stress, commonly referred to as angina.

It is important to note that diagnosis of suspected angina pectoris is clinical, i.e. it is based on the physician's inquiries. The tests to be performed vary depending on the characteristics of the pain and the patient. The most invasive test that confirms the presence of coronary artery disease is the coronary angiography. This test is conducted urgently in cases of acute myocardial infarction, while in other instances it may be performed urgently, or even scheduled, if there is a strong suspicion of coronary artery disease, based either on the clear clinical characteristics of the pain or on indications from diagnostic tests.

A very useful, fast and convenient test for both the patient and the physician is the coronary CT, which allows direct visualisation of the coronary arteries and is particularly beneficial when the physician assesses a low probability of the pain originating from a coronary source.

Other tests widely used, both for their diagnostic value in patients with no history of coronary problems and because they provide prognostic information, are the stress tests and the pharmacological provocation tests described above.

Coronary artery disease is treated with, among others, antiplatelet drugs, which reduce the blood's ability to form thrombi, and lipid-lowering drugs, which lower cholesterol. It may also be necessary to open the narrowed area of the coronary arteries by implanting a stent by catheterisation or, in more severe cases, perform bypass surgery, in which the obstructed area is bypassed with a vein from the legs or with an artery.

Fatigue or shortness of breath

Dyspnoea is a subjective sensation of laboured breathing, usually referred to as "shortness of breath". It can be distinguished according to severity, which ranges from exertional dyspnoea through to resting dyspnoea with intolerance to decubitus, possibly accompanied by leg swelling, palpitations and anxiety. Dyspnoea is a cardinal symptom of heart disease (although not exclusive to it, as it is also present in pulmonary diseases).

Consulting a physician to investigate the underlying cause is very important whenever an individual experiences dyspnoea. It should be noted that dyspnoea is not synonymous with a lack of oxygen, but rather is a subjective symptom. This means there may be patients with dyspnoea and a cardiac problem who nevertheless have normal blood oxygen.

Most heart diseases can produce dyspnoea due to what is known as cardiac insufficiency. The most common are poor left ventricular function (often due to one or more previous infarctions) and valvular disease.

Leg swelling

Lower limb oedema refers to swelling of the soft tissues of the lower extremities. In most cases, this swelling is due to hydrosaline fluid retention.

Oedemas due to hydrosaline retention may be a symptom of heart failure, which in turn may be caused by a range of heart diseases (infarction, congenital or acquired heart muscle diseases, inflammatory diseases such as myocarditis, cardiac toxicity due to drugs, hypertensive crisis, tachycardia, etc.) or extracardiac causes (anaemia, hyperthyroidism, protein deficiency, malnutrition, renal diseases, serious diseases, etc.).

To rule out cardiac-related leg oedema, a thorough physical examination is necessary to identify additional indicators of heart failure, with the main recommended complementary examinations including a chest X-ray, electrocardiogram, blood tests and echocardiogram, with a view to assessing heart function and assisting in diagnosis. These tests can be complemented with other more advanced tests as mentioned above if necessary.

Recommended links: