expert type icon EXPERT

Jonathan C. Pitts Crick

Cardiologist

Dr. Jonathan Pitts Crick is a cardiologist practicing in Bristol, City of Bristol. Dr. Pitts Crick specializes in diagnosing, monitoring, and treating diseases or conditions of the heart and blood vessels and the cardiovascular system. These conditions include heart attacks, heart murmurs, coronary heart disease, and hypertension. Dr. Pitts Crick also practices preventative medicine, helping patients maintain a heart-healthy life.
Jonathan C. Pitts Crick
  • Bristol, City of Bristol
  • Medicine
  • Accepting new patients

When should one choose angioplasty over a bypass surgery?

In general, angioplasty is better because of the lower complication rate and much quicker recovery, but some blockages are in such critical places in the coronary arteries that READ MORE
In general, angioplasty is better because of the lower complication rate and much quicker recovery, but some blockages are in such critical places in the coronary arteries that angioplasty would be at significant risk of causing a heart attack, possibly fatal, and for these bypass surgery is safer.

Does diabetes have an impact on the heart?

Yes, diabetes increases the risk of progressive arterial disease. Having both problems makes it even more important to treat the risk factors: statins for cholesterol, strict low READ MORE
Yes, diabetes increases the risk of progressive arterial disease. Having both problems makes it even more important to treat the risk factors: statins for cholesterol, strict low carbohydrate diet for overweight, perfect blood pressure control (especially with ACE-inhibitors), regular exercise, good dental care (plus obviously not smoking). Diabetes and previous CABG can also make the symptoms of angina less clear so any progressive reduction in exercise capacity should be investigated with a stress test of some sort (treadmill exercise, stress echo, nuclear scan or stress cMRI)

Can mild chest pain be a symptom of a heart attack?

If it comes on or worsens with exercise (walking uphill) it is probably angina and should be investigated urgently. If not it is probably not a heart problem.

Are there any risks involved in a bypass surgery with a major blockage?

There are risks but a lot less than leaving it alone. His surgeon will discuss the risks with him and you could arrange to be in on that meeting.

Gum disease and heart disease

Yes and no! Any grumbling inflammation increases the risk of a heart attack but there is no direct connection between dental plaque and arterial plaques.

My mother has been experiencing frequent heart palpitations. What could be causing this?

It is likely the palpitations are caused by a heart arrhythmia, which may or may not be serious. She should have a heart recording for long enough to catch a palpitation attack, READ MORE
It is likely the palpitations are caused by a heart arrhythmia, which may or may not be serious. She should have a heart recording for long enough to catch a palpitation attack, to identify the cause. Her GP can arrange that directly or through the local hospital.

Is congestive heart failure hereditary?

It can be hereditary – you could have an echo-cardiogram or cardiac MRI scan to check for early signs. Also consider genetic screening as there are a number of well-established READ MORE
It can be hereditary – you could have an echo-cardiogram or cardiac MRI scan to check for early signs. Also consider genetic screening as there are a number of well-established genes linked to the condition and identifying one of them could help guide treatment.

My hemoglobin levels are very low. Can this affect my heart?

Yes, anemia makes it necessary for the heart to pump more blood around all the time. Also iron deficiency can directly interfere with energy supply to your heart muscle.

What should my ideal blood pressure be?

There is now strong evidence that your systolic blood pressure should be kept BELOW 125 mm Hg on an average of several readings all at rest. Occasional higher readings are normal READ MORE
There is now strong evidence that your systolic blood pressure should be kept BELOW 125 mm Hg on an average of several readings all at rest. Occasional higher readings are normal and not a worry.

Will my stress cause me to have a heart attack?

Probably not in the short term, but you should treat the hypertension whatever the cause. Regular exercise can be very helpful in reducing work-related stress and giving you a READ MORE
Probably not in the short term, but you should treat the hypertension whatever the cause. Regular exercise can be very helpful in reducing work-related stress and giving you a good night's sleep. Challenging stress is good, oppressive stress is bad.

Why do I have high cholesterol after my bypass surgery?

It could be a temporary reaction to the (physical) stress of the surgery, random variation or that your statin dose has been changed. There is no immediate worry but recheck it READ MORE
It could be a temporary reaction to the (physical) stress of the surgery, random variation or that your statin dose has been changed. There is no immediate worry but recheck it in two months.

When I'm stressed, my heart rate increases and I feel my hands trembling. What could this mean?

These are the symptoms of your body producing adrenaline (to cope with a potential "fight or flight" need). It can be helped by taking some vigorous exercise to use the adrenaline READ MORE
These are the symptoms of your body producing adrenaline (to cope with a potential "fight or flight" need). It can be helped by taking some vigorous exercise to use the adrenaline in a positive way.

Does my weight cause pressure on my heart?

Being overweight means that your body has to do a lot more work doing anything physical (except maybe swimming). It can also restrict the volume of your lungs, especially when READ MORE
Being overweight means that your body has to do a lot more work doing anything physical (except maybe swimming). It can also restrict the volume of your lungs, especially when stooping. Both of these will make you feel breathless even if your heart is fine.
But being overweight definitely increases your risk of a heart attack or heart failure and even more so if you become diabetic. So it's really urgent to get your weight down and if you have tried everything else it's worth considering bariatric surgery.

Are there super foods one should have for a healthy heart?

None. Just avoid too much obvious junk food and keep your weight down. Enough vitamins are important especially B1 (thiamine).

What is the normal resting heart rate for a 78 year old elderly person?

That is borderline fast. It is worth checking that the rhythm is normal with an ECG – if it is atrial fibrillation she may need to be on anti-coagulation to prevent a stroke.

I do not eat oily food at all and do yoga everyday. I still have a block in my heart. Why?

The risk is mainly genetic, but you can guard against it by: 1) checking that your blood pressure is normal or low (less than 125/80) and treating it if not 2) taking a statin READ MORE
The risk is mainly genetic, but you can guard against it by:

1) checking that your blood pressure is normal or low (less than 125/80) and treating it if not
2) taking a statin regularly
3) obviously, not smoking

Oily foods do NOT increase the risk; regular moderate exercise (but not just yoga) does reduce it. You have to remember that it is quite natural to die of coronary disease and if you're over 40, evolution is "not interested in" keeping you alive. So, unnatural drug treatment is worthwhile if you want to live to a ripe old age.

Is a hypertension patient more prone to cardiac arrests?

Yes – and if your BP is still high you are not taking enough medication. When you have got it under control (average home reading less than 125/80) your risk will return to near-normal READ MORE
Yes – and if your BP is still high you are not taking enough medication. When you have got it under control (average home reading less than 125/80) your risk will return to near-normal

How can diabetes affect my heart?

Yes, high glucose levels seem to damage the lining of your arteries. It is important to get good glucose control by adjustment of your diet and treatment. If you have type-2 (non-insulin-dependent) READ MORE
Yes, high glucose levels seem to damage the lining of your arteries. It is important to get good glucose control by adjustment of your diet and treatment.
If you have type-2 (non-insulin-dependent) diabetes it is also genetically linked to high blood pressure, which damages the arteries more – so worth checking.
ACE-inhibitor treatment seems to give some protection.

My stress test showed a very high heart rate. Should I be worried?

It depends on how high. You should (normally) be able to reach your "age-predicted maximum," which is 220 minus your age. Even if it's slightly above that, provided you feel OK, READ MORE
It depends on how high. You should (normally) be able to reach your "age-predicted maximum," which is 220 minus your age. Even if it's slightly above that, provided you feel OK, it's probably nothing serious and the person conducting the test would have told you if the tracing showed anything to worry about.

My father suffered cardiac arrest. What should be follow up treatment?

It depends on whether the cardiac arrest was caused by a myocardial infarct or not. If it was, then the standard heart attack treatment and follow-up rehabilitation should be sufficient. READ MORE
It depends on whether the cardiac arrest was caused by a myocardial infarct or not. If it was, then the standard heart attack treatment and follow-up rehabilitation should be sufficient. If not, he should have tests to find out why it occurred, and in the mean time he should probaby have an implantable defibrillator fitted in case it happens again. Either way he can stay reasonably active but avoid extreme exertions or stresses.