Do I need a cardiologist, a GP or just an ECG?

Your heart flutters at odd moments. Or there's a pressure that comes and goes, a family history you've started to take seriously, or a watch that keeps telling you it skipped a beat. You want someone to look at it properly, and you're not sure whether that means a cardiologist, your GP, a quick ECG or something more urgent.

The short answer: if you want a heart specialist to assess what's going on, the first step is a consultation with Prof Darrel Francis, Consultant Cardiologist, at 117a Harley Street. You don't need a diagnosis or a referral to ask for one.

If you'd rather skip the reading, the £250 consultation can be arranged through our cardiology clinic or by calling 0207 499 1991.

When should chest pain be a 999 call?

Call 999 or go to A&E for severe chest pain, sudden severe breathlessness, collapse, or anything that makes you think you may be having a heart attack. The NHS describes heart attack pain as tight or squeezing, sometimes spreading to the arms, neck or jaw, and it may come with sweating, sickness, light-headedness or shortness of breath. If that's happening now, call 999 and don't drive yourself.

When symptoms feel urgent but not life-threatening, or you're unsure whether it's a 999 situation, NHS 111 can help online or by phone. A planned clinic appointment is for everything else.

When is a GP the better first appointment?

A new chest symptom that isn't an emergency, or a routine check of your cardiovascular risk, often starts well with a GP. They can take a history, examine you, check your blood pressure and decide whether an ECG, blood tests or a specialist opinion would help. Some people also like a heart health blood panel as a starting point.

Our GP service works in the same building as the cardiology clinic. A GP can also write the letter you later bring to Prof Francis, which gives him a head start. If a cough, a fever or a medicine review is the real worry, that belongs with the GP rather than the cardiologist.

Can I just book an ECG?

Yes. A resting ECG records your heart's electrical activity while you lie still, and you can book one online on its own, Monday to Friday between 10:00 and 17:30. It suits people who already know they need the recording: a GP asked for one, a work form names it, or a doctor wants a tracing before a later review.

One thing worth knowing: an ECG is a snapshot of your rhythm on the day. The interpretation comes from a doctor who has taken your history and examined you, and that's what decides whether you need a Holter, a stress test or a scan. If you want someone to make sense of symptoms, the consultation is where that happens. We'll explain how your standalone ECG report is shared when you attend.

When is it time to see a cardiologist?

People usually come to Prof Francis with palpitations that have gone on for weeks, breathlessness on the stairs that has crept up gradually, a cholesterol result alongside a family history, an old ECG nobody has talked through, or a GP letter suggesting a cardiologist should take a look.

Prof Darrel Francis, GMC 4062833, leads the cardiology service and sees you at 117a Harley Street, where Medical Express Clinic has practised since 1984. The clinic is CQC-registered. It helps to tell us whether a GP has already seen the same problem, so the consultation can pick up where they left off.

What happens in the consultation?

The visit covers a detailed medical history, a cardiovascular risk assessment, a physical examination and a management plan. Prof Francis starts with what's been happening and any results you already have, talks through your symptoms and risk factors, then decides whether examination and further tests would add anything.

Here's why that order matters. A Holter monitor, a treadmill test, a 24-hour blood pressure monitor and an ultrasound of the heart each answer a different question. Picking one yourself can mean paying for a test that doesn't address the original worry, while the consultant chooses the one that will actually change the plan, and explains it before it's arranged.

Appointments are arranged according to clinical need and current availability. Call 0207 499 1991 to hear what's free.

Which tests can be arranged afterwards?

When a further test would help, the clinic coordinates it at a nearby diagnostic centre, and the report comes back to Prof Francis to interpret alongside your history and examination.

Fees are discussed before any test is arranged, and a fuller list sits on our fees page, though those figures can change. Report times vary with the investigation.

Is a Well Man check the same as seeing a cardiologist?

They do different jobs. Well Man screening looks for risk in people who feel well. A cardiology consultation is for a heart concern you want a specialist to assess, so a screening isn't a substitute for it. If you have palpitations, you want someone taking a history of those, not just a cholesterol number.

What should I bring?

Bring any referral letter, previous results and a list of your medicines. If a smartwatch, a home blood pressure machine or a hospital discharge letter flagged something, bring that too rather than relying on memory. Putting it all in one envelope or one email means the history doesn't start from zero.

A few situations come up often. If a GP has already examined you, say so. If nobody has yet, that's fine, the consultation will simply cover more ground. If a wearable alert is what brought you in, treat it as a reason to get checked rather than a diagnosis. And if a past ECG was clear but palpitations keep coming back, that's worth raising too, because a clear tracing on one day can't promise they won't return.

Full details of the service are on the cardiology clinic page. Related reading: erectile difficulty as a wider health signal and when to see a private GP.