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Dr Robin van Lingen

Consultant Cardiologist

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Dr Robin van Lingen,

MBChB (UCT), FRCP (Eng)

I am a Consultant Cardiologist in Cornwall with over 25 years experience as a doctor. I carried out my undergraduate training at the famous Groote Schuur Hospital, University of Cape Town, and my postgraduate specialisation in Medicine and Cardiology in the South West of England.  I have a wide range of interests and experience in most fields of Cardiology. I have an interest in innovation and entrepreneurship with several active projects.

I believe in patient centred compassionate care. I strive to offer high quality care, explained simply. I am a strong advocate of patient choice.

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07900 201201
Fiona.Tucker3@nhs.net

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Pathways

These are common symptoms that people can experience that can cause concerns that they may have problems with their heart.

Chest pain

One of the most common symptoms of suspected heart disease, chest pain can be a sign that your arteries getting narrowed or blocked with fatty cholesterol deposits called atherosclerosis. This cause Ischaemic Heart Disease (IHD) and results in a lack of oxygen to the heart muscle on exercise. This discomfort or pressure in the chest can spread to the arm or neck and is known as angina pectoris. But there are many causes of chest pain from the lungs, bones, muscles, nerves and stomach that can also mimic heart pain. A typical pathway to investigate this would be a consultation with an ECG, echocardiogram and a CT coronary angiogram. Sometimes a stress test is needed or a catheter angiogram. This usually provides the answer to whether you have significant coronary artery disease, and we would plan therapy with appropriate medication and possible stents or bypass surgery.

Breathlessness

This could be a sign your heart is struggling to pump blood properly (called heart failure), a valve is failing or again that your arteries are narrowing. But lung disease, lack of physical fitness or anaemia are also common causes. A typical investigation pathway would be a consultation, an ECG, an echocardiogram and a CT coronary angiogram. We would then discuss the results and treatment options.

Palpitations

This is the awareness of your beating. Although this can cause a lot of anxiety and distress it is often not a significant rhythm problem to be afraid of. The most common cause will be extra beats called ectopics, but other more significant rhythm abnormalities like atrial fibrillation (AF or A Fib) are also common. A typical investigation pathway would be a consultation, an ECG, an echocardiogram and a prolonged rhythm recording of your heart such as a 7 day Holter monitor to capture your symptoms.

Murmurs

This is a noise heard with a stethoscope as blood passes across a heart valve. This can be normal, but we would normally perform an ECG and echocardiogram in this situation to ensure there is no significant narrowing (stenosis) or leaking (regurgitation) of any of your valves.

Blackouts or dizzy spells

A very challenging condition to diagnose – changes in blood pressure, rhythm, inner ear problems or brain problems can all cause these symptoms. From a heart perspective, following a consultation and an ECG, we tend to do an echocardiogram to ensure your heart is normal, prolonged rhythm recording with a 7 day Holter to ensure you don’t need a pacemaker and a Tilt table test. We sometimes implant a loop recorder to monitor the rhythm of the heart for up to 2 or 3 years in difficult situations.

This could be a sign your heart is struggling to pump blood properly (called heart failure), a valve is failing or again that your arteries are narrowing. But lung disease, lack of physical fitness or anaemia are also common causes. A typical investigation pathway would be a consultation, an ECG, an echocardiogram and a CT coronary angiogram. We would then discuss the results and treatment options.

FAQ

Do you offer face to face and virtual consultations?

Yes – I offer both. I prefer face to face consultations, but there are situations where a phone or video call may be more appropriate (eg. long journey times, isolating, difficulty with transport).

Can I bring someone with me to the consultation?

Yes, but because of Coronavirus restrictions it is best to let us know beforehand so we can confirm this is possible. I highly recommend bringing a partner or loved one with you if you are happy to share your personal medical information, but the organisation rules are continuously changing in an effort to keep Covid out of hospitals and it is best to check first.

Can I exercise with heart disease?

Yes – within symptom limits. Before a formal diagnosis I would advise you to stay active but to stop and rest with the onset of symptoms. If you already have a diagnosis of heart disease we will discuss specific recommendations with you, but in general we advise moderate exercise to a level where you are able to walk and talk in a short full sentence.

What is a CT coronary angiogram?

We use a CT scan machine, that is used for many scanning applications of the body, to do a very rapid scan of the beating heart to look for narrowing of the coronary arteries. You need a drip in your arm to have contrast, and we usually give you beta blockers first to slow your heart rate down and a spray under the tongue to widen the arteries. It takes about half an hour in all, although the scan itself usually only take a few minutes.

What is an echocardiogram?

Also known as an echo this where an ultrasound machine (identical to a scan on pregnant women to check their babies) is used to scan the heart looking at the muscle and valve function. It is safe and painless other than a bit of pressure from the probe and takes about half an hour.

Do you offer face to face and virtual consultations?

Yes – I offer both. I prefer face to face consultations, but there are situations where a phone or video call may be more appropriate (eg. long journey times, isolating, difficulty with transport).

What is an ECG?

An ECG (electrocardiogram) is where we put sticky tabs all over your chest and arms to take an electrical trace of your heart.

What is an echocardiogram?

An ECG (electrocardiogram) is where we put sticky tabs all over your chest and arms to take an electrical trace of your heart.

Do you offer face to face and virtual consultations?

An ECG (electrocardiogram) is where we put sticky tabs all over your chest and arms to take an electrical trace of your heart.

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Duchy Hospital, Peventinnie Lane, Truro, TR1 3UP
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