Introducing Dr Kalpa De Silva

20 November 2018

What made you choose cardiology as your speciality?

I became interested in cardiology while at medical school, for a number of reasons. Cardiovascular disorders pose interesting diagnostic challenges, which are often identified through the combination of clinical assessment and the use of adjunctive testing methods such as ECG and a variety of imaging techniques. Furthermore, I found the ability to be directly involved in the diagnosis and treatment of cardiac conditions such as heart attacks interesting and rewarding, enjoying the ability to treat patients with procedures such as percutaneous coronary intervention (a keyhole-type procedure that allows stent implantation into a coronary artery). This subsequently led me to pursue a career in interventional cardiology, meaning I specialise in treating patients with coronary artery disease who have angina or present with heart attacks, with a particular interest in research in this field and performing complex stenting procedures.


How can one keep the heart in good condition? 

Having a healthy heart mirrors practices that ensure our general wellbeing and health. There are no quick fixes to heart health, it requires the understanding that you need to invest time and effort to improve it. My three key tips would be to eat well, exercise regularly and avoid smoking. It’s never too late to improve and change your situation.  


Is heart disease the leading cause of death in the United Kingdom?

Yes, heart disease, specifically coronary artery disease remains a leading cause of death in the UK, and Worldwide.


What are some of the risk factors for coronary disease?

The main risk factors for coronary disease are:

  • High blood pressure (Hypertension)
  • High cholesterol (Hypercholesterolaemia)
  • Smoking
  • Diabetes mellitus
  • Increasing age
  • Family history
  • Male sex


Will over-the-counter supplements alone improve my heart health?

One of the key facets to cardiology is the appropriate reliance on evidence-based medicine and practice. Most, if not all, of the drugs that are given to patients with heart conditions have gone through rigorous, large-scale research, to ensure both safety and efficacy. There are no over-the-counter medications that I would recommend that would definitively improve your heart health.


Do all heart attacks have the same symptoms?

Unfortunately, heart attacks can present in a variety of ways. However, the commonest symptoms include a chest pain, heaviness or tightness, which is often band-like across the chest. The pain may move into your jaw or your arm and is frequently associated with sweating and feeling clammy. There are often more subtle symptoms that may occur in the days and weeks leading up to a heart attack, with chest tightness when you are performing your usual day-to-day activities - though this is not always the case and heart attacks can occur out of the blue.


Is coronary artery disease preventable?

This is a complex question, but in the main there are many things we can do to prevent the development of coronary artery disease. Ensuring we eat a balanced diet, which is low in fat and salt, and high in fibre and fruit and veg is key. The heart is like any other muscle in our body, if we exercise it, it will gain in strength and efficiency, while also preventing the coronary arteries from narrowing. Exercising regularly is therefore critical, with a mixture of cardiovascular and resistance exercise being optimal. Additionally, exercise is extremely important in maintaining a healthy weight. Excess weight is associated with higher levels of cholesterol and also in the development of Diabetes, both of which are important risk factors for developing coronary artery disease.


Can exercise and diet help me no longer need my cholesterol and blood pressure medications?

The medications that you may be on have been tailored to your individual situation and therefore I can’t say for sure whether exercise and diet alone would allow you to safely come off cholesterol and blood pressure medications. There are certain instances where this may be the case, however there are also many instances where despite regular exercise and a good diet, these medications may still be required. There are also specific circumstances, such as following a heart attack for example, whereby these types of medications may afford added protection in preventing further heart attacks in the future. Your management should be personalised to your individual circumstances and health needs.


If I am on medication to treat coronary artery disease, does that mean I am no longer at risk of a heart attack?

Sadly not. While the medications that you may be taking will help reduce the risk of heart attacks, there remains a chance that you may have further heart attacks in the future. However, the risk would be greater if you were not on certain drugs following a heart attack. The good news is that research is being done within the UK and all over the world to try and identify new ways of reducing the risk of heart attacks, so as time goes on, the hope is our therapies will become even better at preventing heart attacks.


To book a consultation with Dr De Silva, please contact us on 0117 321 1227 or enquire online.

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