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Cardiology
Cardiovascular diseases continue to be the leading cause of death or disability in Portugal.
In recent years, there have been valuable advances in the diagnosis and treatment of these diseases, many of which are due to the development of Interventional Cardiology.
With specialised doctors, technicians, and nurses, it is possible not only to perform tests and diagnoses of cardiac and vascular catheterisations but also to provide immediate treatment for arterial blockages.
The HPA Health Group is also equipped for the diagnosis and treatment of cardiac arrhythmias, as well as for heart diseases in children and the implantation of pacemakers.
- Dr. Hugo de Mendonça Café
- Dr. Miguel Ventura
- Dr. Pedro Cordeiro
- Dr. Walter Alfama Santos
- Dr. Paulo Romão
- Dr. Paulo Romão
- Dr. Hugo Alex Costa
- Dr. João Pedro Tuna Moura Guedes
- Dra. Salomé Pereira
- Dra. Ana Fátima Esteves
- Dr. Gonçalo Cardoso
- Dra. Maria José Bento de Sousa
- Dr. Nuno Fonseca
- Dr. Luis de Moura Duarte
- Dr. José Serra
- Dra. Andreia Micaela Pereira
- Dr. Bruno Oliveira Silva
- Dra. Graça Caires
- Dr. João Adriano Sousa
- Dr. Nuno Santos
- Dr. Ricardo C. Rodrigues
- Dra. Susana Gomes
- Dra. Andreia Micaela Pereira
- Dr. Nuno Santos
- Dr. Ricardo C. Rodrigues
- Dra. Susana Gomes
Hospital Particular do Algarve - Gambelas
Hospital São Camilo - Portimão
Clínica Particular do Algarve - Guia
Clínica Particular SIIPEMOR - S. Brás Alportel
Hospital Particular do Alentejo - Sines
Clínica Particular de Beja
Clínica Particular de Vila Nova de Milfontes
Hospital Particular da Madeira
Madeira Medical Center
Most common cardiovascular diseases
Chest Angina
Chest angina is a symptom characterised by pain or discomfort in the chest, resulting from reduced blood flow to the heart, usually due to the narrowing or blockage of the coronary arteries. This condition is more common in elderly people and can be a precursor to more severe events such as a heart attack. Angina often manifests during exertion. Diagnosis is based on clinical history, supplementary tests such as echocardiography, and stress tests.
Cardiac Arrhythmias
Cardiac arrhythmias are disorders of the heart's rhythm that can affect the way the heart beats and its function. These disturbances occur when the electrical impulse that controls the heartbeat does not follow its "usual path", resulting in irregular, very fast, or very slow beats. Under normal conditions, the heart beats in a regular pattern, but in arrhythmias, the beats are irregular, disrupting blood flow and the heart’s efficiency.
Atherosclerosis
Atherosclerosis is a disease that affects the arteries and is characterised by the formation of fat plaques, called atheromas, on the walls of these vessels. These plaques accumulate mainly in areas with higher "turbulence" in blood flow, such as arterial bifurcations, and cause a progressive narrowing of the arteries, hindering blood flow. This process begins silently from a young age and can develop slowly, which is why it is important to adopt preventive measures early on. Atherosclerosis is responsible for various serious diseases such as high blood pressure, coronary artery disease, aortic aneurysms, and peripheral arterial disease, and it is one of the leading causes of death in Portugal.
Peripheral Arterial Disease
Peripheral Arterial Disease (PAD) is a condition characterised by the narrowing or blockage of the arteries, which hinders blood flow to the tissues, most commonly observed in the lower limbs. The main cause of this blockage is atherosclerosis, which affects around 3% to 10% of the population, and this number increases to 15% to 20% in adults over the age of 70. The disease is an important marker of cardiovascular risk and is associated with a significant increase in the chances of myocardial infarction and stroke (CVA).
Coronary Artery Disease
Coronary artery disease is a condition characterised by the formation of atherosclerotic plaques in the coronary arteries, which are responsible for supplying blood to the heart. When these plaques form and grow, they can narrow or completely block the blood vessels, preventing the heart from receiving the adequate amount of oxygen and nutrients. This process significantly increases the risk of acute myocardial infarction, also known as a heart attack.
Myocardial Infarction
Myocardial infarction, also known as a heart attack, occurs when there is a sudden interruption in the blood flow to a part of the myocardium, the heart muscle. The main cause of this blockage is atherosclerosis, that is, the accumulation of fat, cholesterol, and other toxic substances in the coronary arteries. This accumulation forms plaques that can obstruct the arteries, preventing the blood from reaching the heart adequately. When one of these plaques ruptures, blood clots can form, completely blocking the artery and interrupting the supply of oxygen and nutrients to the heart.
Hypertension
Although hypertension can become a chronic condition, it can be controlled with medication, but most importantly, with the adoption of healthy lifestyle habits, meaning we can prevent its progression.
Hypertension, as the name suggests, occurs when blood exerts excessive pressure on the walls of the arteries. It is the leading cause of cardiovascular diseases and premature death worldwide.
Heart Failure
Heart failure occurs when the heart is unable to pump blood effectively, compromising the distribution of oxygen and nutrients to the body. In Portugal, around 4.4% of the adult population is affected, with a higher incidence in people over 80 years old. This condition is often associated with diseases such as diabetes and obesity, making it essential to have a comprehensive treatment plan that addresses all underlying conditions.
Valvular Diseases
Valvular diseases are conditions that affect the heart valves, which are responsible for regulating blood flow between the chambers of the heart and the major vessels. When these valves do not open or close properly, a series of cardiovascular complications can occur. The most common valvular diseases affect the aortic and mitral valves and can result in symptoms such as shortness of breath, pain, and arrhythmias. If left untreated, they can lead to serious conditions such as myocardial infarction, stroke, or sudden death.
Other Cardiovascular Conditions
Abdominal Aortic Aneurysm
An aneurysm is an abnormal dilation of an artery that occurs when there is weakening of the arterial wall. This dilation causes the diameter of the artery to increase irreversibly. The abdominal aortic aneurysm (AAA) is one of the most common and occurs when the diameter of the artery exceeds 3 cm. The primary cause of this condition is atherosclerosis, which weakens the arterial wall. It is more common in individuals over 65 years old, especially in men, and in those with heart or vascular diseases.
Pulmonary Embolism
Pulmonary embolism is a severe condition caused by the sudden obstruction of a pulmonary artery, usually due to a blood clot originating, in most cases, from the veins of the lower limbs. This obstruction can severely compromise blood circulation to the lungs, leading to a generalised decrease in oxygenation and, in more severe cases, sudden death.
The use of anticoagulants such as heparin and warfarin is essential in preventing the onset of this condition. In more severe cases, treatment may include thrombolytic therapies, which dissolve the clots, or even surgical intervention to remove the embolus.
Endocardite
Endocarditis is an infection that affects the endocardium, the inner layer of the heart, usually caused by bacteria or, more rarely, by fungi. This pathology occurs when microorganisms enter the bloodstream and lodge in the heart valves or other areas of the heart. Endocarditis is a rare condition, but when not properly treated, it can lead to severe complications such as heart failure, stroke, or even death.
Pericarditis
The pericardium is a double-layered membrane that surrounds the heart and the associated blood vessels. The outer layer, called the fibrous pericardium, anchors the heart in place and prevents it from overexpanding. The inner layer, or serous pericardium, consists of two layers: the parietal pericardium, which is beneath the fibrous pericardium, and the visceral pericardium (or epicardium), which directly covers the heart. Between these layers lies the pericardial cavity, which contains a lubricating fluid, the pericardial fluid, which reduces friction during heart contractions.
Cardiology – Examinations
Electrocardiogram (ECG)
The electrocardiogram (ECG) is a quick and painless test that records the heart’s electrical activity. It is used to diagnose various heart conditions, including arrhythmias. During the test, electrodes are placed on the skin to detect electrical signals. It can be performed at rest or during physical exertion.
Exercise Stress Test
Assesses the heart’s response to physical activity. This test helps diagnose conditions such as ischaemia and arrhythmias. During the exam, the patient walks or runs on a treadmill or pedals a stationary bike while heart activity, blood pressure, and breathing are monitored. It is essential to evaluate cardiovascular fitness, detect issues not visible at rest, and guide safe treatment or exercise plans.
Holter Monitor
Monitors the heart’s electrical activity over 24 hours or more, enabling detection of arrhythmias and other changes that may not appear in a standard ECG. The patient wears a small portable device connected to skin electrodes and can go about daily activities normally. This exam is key for diagnosing unexplained palpitations, dizziness, or fainting, and for assessing treatment effectiveness.
Ambulatory Blood Pressure Monitoring (ABPM)
Measures blood pressure over a 24-hour period, allowing a more accurate assessment of variations throughout the day and night. The device takes regular readings while the patient maintains daily routines. It is vital for diagnosing hypertension, evaluating treatment effectiveness, and identifying patterns such as nocturnal hypertension or "white coat" effect (elevated readings due to anxiety during clinical visits).
Echocardiogram
An imaging test that uses ultrasound to assess the heart's structure and function in real time. It creates detailed images of the heart chambers, valves, blood flow, and muscle. It can diagnose various conditions such as heart failure, valve disorders, and cardiomyopathies. Depending on clinical needs, it can be performed in different modes: transthoracic, transoesophageal, or Doppler. It is a safe, painless, and essential tool for heart health assessment and treatment planning.
Types of Echocardiogram:
Transthoracic Echocardiogram (TTE)
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The most common and non-invasive type of echocardiogram, in which an ultrasound transducer is placed on the chest to capture heart images. It assesses heart size, muscle thickness, valve function, and ejection fraction (amount of blood pumped with each heartbeat). Essential for evaluating heart health and performance.
Transoesophageal Echocardiogram (TOE)
- This involves inserting a probe into the oesophagus to obtain more detailed images of the heart. It is especially useful when transthoracic imaging is unclear, and is commonly used to evaluate heart valves and detect intracardiac clots. The procedure typically requires mild sedation for patient comfort.
Doppler Echocardiogram
- Assesses blood flow within the heart and major vessels. It helps detect narrowing (stenosis), valve regurgitation, and pulmonary hypertension. A vital tool for diagnosing and monitoring cardiovascular diseases.
Stress Echocardiogram
- Performed during or after physical exertion, or via administration of dobutamine to simulate stress. It is used to assess cardiac ischaemia and heart function under stress.
Procedures/Treatments
Coronary Artery Bypass Surgery (CABG)
A surgical procedure to treat blocked coronary arteries, which supply blood to the heart. When these arteries are obstructed (e.g. due to fatty deposits), blood flow is impaired, potentially causing serious heart conditions. During the procedure, a new pathway for blood flow is created using a vessel from another part of the patient’s body. With the development of minimally invasive techniques, stents (tiny expandable mesh tubes) can also be used to restore blood flow.
Heart Valve Repair/Replacement
Performed when a heart valve (such as the mitral or aortic) is significantly damaged or dysfunctional. The procedure involves replacing the affected valve with a new one (biological or artificial). In some cases, repair is possible, restoring the valve’s function without full replacement.
Coronary Angioplasty
A minimally invasive procedure used to treat heart attacks by restoring blood flow in blocked arteries. A catheter with a balloon is inserted and inflated to widen the affected artery. A stent is often placed to keep the artery open and prevent future blockages.
Pacemaker Implantation
A pacemaker is a device implanted in the chest to regulate heart rhythm in patients with arrhythmias. It sends electrical impulses to correct irregular heartbeats, particularly in cases of bradycardia or other rhythm disturbances. The device is placed under the skin near the collarbone. It allows the patient to lead a more active and healthy life when the heart cannot maintain a proper rhythm on its own.
Doctors
HPA Cardiologists
