Cardiologist, Cardiothoracic Surgeon, Heart Failure Specialist, Interventional Cardiologist

Heart disease, heart risk factors and a heart check

Heart disease is often a complex and overwhelming topic. Dr Shane Nanayakkara discusses with Shane Bassett, Clinical Content Director at Connect The Docs, heart health risk factors and how personal observations and having a heart check can help you with early identification and treatment.


By taking the time to learn about heart health, the rewards will help you with both prevention and treatment

Dr Nanayakkara guides you through the complex topic of heart health, helping you understand: what is heart disease, signs and symptoms for you or loved ones to be aware of, the gender disparity of the difference in heart health presentation between men and women plus the importance of a heart check.


Heart Disease

Your heart is essentially a pump, designed to squeeze blood and push it around your body. There are lots of different parts of your heart that make it work properly. Dr Nanayakkara helps to explain heart disease, “In general, there are four separate parts, in a way, like structures of a house.” He further shares these four areas in relation to heart disease:

  • Heart failure –  There are walls in your house and walls in your heart, which is your heart muscle. When the muscle doesn’t squeeze or relax properly, it can lead to a condition called heart failure.
  • Heart valve disease –  The valves in your heart are designed to help blood flow in the correct direction, like hallways guiding you to the right room in your house. Two issues can arise: the valves narrow so blood cannot flow through it properly or they can leak, meaning blood goes backwards in your heart.
  • Coronary heart disease – Your heart has a system of blood vessels that allow blood from your heart to nourish your heart muscle as it works to pump blood around your body. Similar to the plumbing in your house, these blood vessels can become clogged, limiting the amount of blood getting to your heart muscle. This can lead to chest pain, also known as angina, and a heart attack.
  • Arrhythmias or electrical problems of the heart – Like the electrical cables in your house, your heart also has an electrical wiring system, known as the conduction system, made up of special types of nerve cells. The conduction system is responsible for your heart rate. Sometimes this system can wear out or become irritated, causing irregularities in your heartbeat, like going too slow or too fast, or skipping a beat.


Risks of Heart Disease

You are at risk of heart disease at any age but often people think it occurs only as we age. Lifestyle factors and genetic factors both play a role in heart health and general wellbeing.

There are things you can do to manage risk factors and Dr Nanayakkara suggests, “The most common ones are your age, your cholesterol, your diet, your level of exercise and your blood pressure. There are many factors that we can control – even ones that we typically consider out of our hands. Take age for example – depending on our diet, exercise, and how we manage our chronic health conditions we can age in a healthy or unhealthy way.”

 There are many different complex risk factors such as genetics, ethnicity, socio/economic background and gender that interplay with your heart health and general wellbeing. Dr Nanayakkara says that it is important for you too, “Understand what your own risk profile is and understand which ones are in your control, then work with your local doctor and heart specialist to get them managed for better heart health.”


Regular Heart Check

The sooner you get diagnosed with a problem, the less risk you have; the longer we let conditions progress, the harder they get to treat. Dr Nanayakkara shares, “Your heart is an incredibly important organ, and when we look at how people die, your heart is a major contributor to that, in Australia as well as overseas.”

Not everyone gets symptoms of heart problems before they develop a heart problem. Dr Nanayakkara says, “A heart check means checking in with your GP and seeing that you are managing your risk factors appropriately and picking up on things that you may not notice, such as hypertension (high blood pressure).”

He compares this to the butterfly effect, “Problems that you might have thought were quite small can have a major impact on your health over the long term. A little change early in your blood pressure means a big change for your heart health later.”


Common clinical presentations

There are signs and symptoms that you may observe within yourself and ones that family and friends may notice. These should not be dismissed and are vital to discuss with your GP/heart specialist.

What is it that may prompt you to arrange a heart health check? Dr Nanayakkara mentioned earlier there are four different types of heart disease: heart failure, heart valve disease, coronary artery disease and arrhythmias, or electrical problems of the heart.

He identifies the most common symptoms doctors want patients to tell them about are:

  • Chest discomfort, such as tightness or pressure,
  • Chest pain,
  • Shortness of breath,
  • Swelling of the legs,
  • Episodes of dizziness or lightheadedness,
  • Pain in the arm, the left arm (in particular) or the neck,
  • Shortness of breath, nausea or pain in the abdomen,
  • Shortness of breath when you lay down, particularly at night, or
  • Heart palpitations, which may feel like an extra beat (or several) of the heart.

In particular, it is critical to note if these symptoms develop on physical activity and improve with rest. If your experience any of these symptoms, it is important to see your GP as soon as possible and get a heart check.


Gender disparity in symptom presentations

There can be a difference in heart health presentation between women and men when it comes to symptoms of heart disease.

Dr Nanayakkara shares, “A lot of the early descriptions of heart disease, particularly coronary artery disease (where there are blockages in the blood vessels to the heart) are based on men but increasingly we are aware that women are under-recognised when it comes to heart symptoms.”

He continues, “Heart symptoms such as shortness of breath, nausea and pain in the abdomen are more likely in females than males and so it is critical for us to recognise these symptoms, often attributed to something else, when actually it is related to their heart.”

For women, a heart health check increases awareness, screens you for risk factors and provides a critical focus on heart health as Dr Nanayakkara shares, “…. more women die of heart disease than they do of breast cancer.”


GP heart check

If you are concerned in any way or symptoms are occurring, Dr Nanayakkara advises, “The number one thing is to arrange an appointment with a GP for a heart check.” If it is an emergency or symptoms worsen, call 000 in Australia.



Patient awareness is key to understanding heart disease and the range of conditions that affect your heart. A heart check is key to GP’s and heart specialists being able to help you with both treatment and prevention. Hope for Hearts appreciates Dr Nanayakkara sharing his knowledge, expertise and time, assisting you to understand your symptoms and managing your heart risk factors.


Dr Shane Nanyakarra Interventional CardiologistDr Shane Nanayakkara is an interventional cardiologist working at leading hospitals in Melbourne, Australia. He works at The Alfred, Cabrini and Epworth hospitals and is a researcher with Monash University and the Baker Heart and Diabetes Institute.  Dr Nanayakkara is passionate about ensuring patients understand their heart conditions. He treats people with narrowing in blood vessels around their heart, treating problems with valves in the heart and a condition known as heart failure.


Authored by Dr Shane Nanayakkara (Interventional Cardiologist) and Shane Bassett (Clinical Content Director, Connect The Docs, RN/BN/CCRN)