We estimate around 6,000 heart attacks in the UK have been avoided in the last decade,1 thanks to the introduction of new a routine heart scan.

Coronary computed tomography angiogram (CCTA) scans help doctors to identify coronary heart disease, narrowing and blockages in the arteries that supply the heart with blood. If left untreated, coronary heart disease can lead to a heart attack.

Coronary computed tomography angiogram trial

Since 2016, UK guidelines have recommended CCTA scans as one of the first tests for someone experiencing new chest pain. The results of our SCOT-HEART trial² fed into the evidence for the update. Now, our research, part funded by the British Heart Foundation and published in The Lancet, shows that the benefits of CCTA scans extend as far as a decade beyond a patient’s scan.

The benefits of CCTA
scans extend as far as a
decade beyond a patient’s scan.

CCTA scans reduce heart attacks

Our 10-year follow up of the SCOT-HEART trial³ found that the number of non-fatal heart attacks in the group who had a CCTA scan was 28% lower compared to those who had standard tests. Applied across the UK population and the current rate of CCTA use, we estimate that this equates to 6,000 heart attacks avoided over the last 10 years.¹ 

This is likely due to more people in the CCTA group being prescribed preventative medicines. At 10 years, 56% of the group were taking medicines — including aspirin and statins — to reduce their risk of a heart attack compared to 49% in the standard tests group. 

Improving long-term outcomes for more people

Early results showed that people who had CCTA scans were more likely to undergo additional proceduresin the first year after their scan. By five years, the number of procedures had evened out between the groups, but the CCTA group were less likely to have had a heart attack and more likely to be taking preventative drugs. 

However, access to CCTA scans remains variable across the country. We want to see more opportunities for testing across the UK to address this, such as the community diagnostic hubs being rolled out by the NHS in England, so that more people can benefit from this game-changing innovation.

[1] Piercy L. 2025. British Heart Foundation. Routine scans prevent thousands of heart attacks.
[2] The Lancet, Volume 385, Issue 9985, 2383 – 2391. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial.
[3] Williams Michelle C et al. The Lancet, Volume 405, Issue 10475, 329 – 337. Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland.

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Artificial intelligence (AI) is revolutionising the field of cardiology, offering new hope for patients with cardiovascular disorders. AI is no longer futuristic, it’s a real-world tool, transforming patient care and outcomes.

One of the key areas where AI is making a significant impact is in the early detection of cardiovascular diseases (CVD). Traditional methods often fail to diagnose CVD before symptoms appear, leading to delayed treatment and poorer outcomes. AI, however, can analyse vast amounts of data from electrocardiograms (ECGs) and other diagnostic tools to identify early signs of heart disease that might be missed by human eyes, which improves diagnostic accuracy and patient outcomes.¹

By analysing patient data, AI can help
doctors tailor treatments to individual needs.

Personalising cardiology treatment

AI also plays a crucial role in personalising treatment plans. By analysing patient data, AI can help doctors tailor treatments to individual needs, ensuring that each patient receives the most effective therapy. This personalised approach is particularly beneficial in managing complex conditions like heart failure, where treatment needs to be adjusted frequently based on the patient’s response.

AI-powered digital devices

The use of wearable and portable devices is another exciting development in AI cardiology. These devices, such as smartwatches and portable ECG monitors, enable continuous monitoring of heart health, providing real-time data to both patients and healthcare providers. This continuous monitoring can lead to early intervention and better management of chronic conditions, ultimately reducing hospitalisations and improving quality of life.²

Effective AI integration in healthcare

Despite these advancements, there are still significant challenges to overcome when it comes to getting healthcare professionals confident about realising the full potential of these AI-powered technologies and tools. Healthcare professionals already face an exponential rise in medical information which is doubling at least every 73 days.³ Furthermore, the integration of AI into healthcare systems requires robust data privacy measures and regulatory oversight to ensure patient safety and data security.⁴

Fully and safely realising AI capabilities

AI is poised to transform cardiology by enhancing early disease detection, personalising treatment and improving overall care quality. As technology continues to evolve, the potential for AI to improve outcomes for patients with cardiovascular disorders is immense; however, ongoing education is needed in its widespread adoption to ensure it is being utilised to its full capabilities. The future of cardiology is bright, with AI leading the way towards more efficient, accurate and personalised care.

[1] Attia, Z.I., et al. (2019). ‘An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction’, The Lancet, 394(10201), pp. 861–867. doi: 10.1016/S0140-6736(19)31721-07. 
[2] Khunte, A., et al. (2023). ‘Detection of left ventricular systolic dysfunction from single-lead electrocardiography adapted for portable and wearable devices’, NPJ Digital Medicine, 6(1), p. 124. doi: 10.1038/s41746-023-00869-w.
[3] Koenig, H.G. (2012) ‘Religion, spirituality, and health: The research and clinical implications’, International Scholarly Research Notices, 2012, pp. 1–33. doi: 10.5402/2012/278730.
[4] Chustecki M. Interact J Med Res. 2024;13:e53616; Davenport T, et al. Future Healthc J. 2019;6:94-98; Khera R, et al. J Am Coll Cardiol. 2024;84:97-114; Khera R, et al. JAMA. 2023;330:2255-2257.

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A landmark consensus in Heart1 (BCS/BMJ) confirmed that, despite heart disease being the leading cause of death in women, they remain underdiagnosed, undertreated and underrepresented in all aspects of care.

The article showed that women are less likely to receive life-saving treatment in an emergency, less likely to be given medication to prevent a heart attack or stroke and less likely to have their heart issues taken seriously. Women are also treated based on evidence gained from male-only research studies, whereas their symptoms and treatment needs can be different.

Heart disease prevention in women

Together, the group of authors from across the British Cardiovascular Society and our affiliated societies, led by Professor Vijay Kunadian of Newcastle University, proposes a series of over 50 measures across the different disease areas to improve women’s access to diagnosis, treatment and preventive care. These far-reaching measures will address all levels of the issue, from broad-based awareness campaigns to prevent heart disease and help women recognise their own risks to changing the way healthcare staff approach signs and symptoms more prevalent in women.

Healthcare professionals will
need training to become more
attuned to women’s specific needs.

Women-centred research and training

Specific recommendations include ensuring women are included in research studies and undertaking some women-only studies; identifying areas of practice where heart disease may present differently in women; reducing waiting times for tests and treatment; researching the right doses of drugs for women; and extra training for healthcare staff on heart disease in pregnant and menopausal women.

Importantly, the statement calls for a ‘holistic woman-centred approach to heart care that listens to and incorporates women’s experiences and insights’ and information that is tailored to the needs of women. It highlights heart conditions that predominantly or exclusively affect women. Healthcare professionals will need training to become more attuned to women’s specific needs, including women’s cardiac symptoms.

Women’s hearts matter

The final recommendation is that ‘every woman should feel that her heart matters.’ It will take time and effort to redress the balance in women’s cardiovascular health, but we are committed to making that a reality.

[1] Tayal U, et al. Advancing the access to cardiovascular diagnosis and treatment among women with cardiovascular disease: a joint British Cardiovascular Societies’ consensus document. Heart 2024;110:e3-e15. 

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Currently, up to 30% of individuals who have atrial fibrillation (AF) are undiagnosed and are at risk of complications, such as an AF-related stroke. So, it is important to know your pulse to know your heart rhythm.

What is atrial fibrillation?

Atrial fibrillation, or AF, is a heart condition that causes an irregular and often abnormally fast heart rhythm. It is the most common heart rhythm disturbance encountered by doctors, affecting around 1.4 million people in the UK. It can affect adults of any age but is more common as people get older; in the over-65-year-old age group, it affects about 10% of people.

AF causes irregular, rapid heartbeats

A normal heart rhythm should be regular and between 60 and 100 beats a minute when you are resting. In people with AF, it can be considerably higher than 100 beats a minute. This can cause problems including dizziness, shortness of breath and tiredness. You may be aware of noticeable heart palpitations, where your heart feels like it’s pounding, fluttering or beating irregularly — often for a few seconds or, in some cases, a few minutes.

AF is not a life-threatening heart rhythm problem, but it can be troublesome and often requires treatment. AF is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis or a heart valve problem.

AF increases stroke risk significantly

People with atrial fibrillation have a five times greater risk of having a stroke. In some cases, atrial fibrillation can also lead to heart failure. So, it is very important to know the signs, detect AF, protect against AF-related stroke and correct the irregular heart rhythm. 

A normal heart rhythm should be regular and between 60 and 100 beats a minute when you are resting.

Know your pulse

Typical symptoms such as palpitations, chest pain, shortness of breath, fatigue, dizziness and fainting. However, this does not apply to everyone. Some people experience no symptoms at all and are considered ‘asymptomatic.’ Therefore, it is important to ‘Know Your Pulse to Know Your Heart Rhythm’ — it could save your life. Detecting an irregular pulse is often the only symptom of AF.

Reducing stroke risk and managing symptoms

It is important to reduce the risk of an AF-related stroke with anticoagulation therapy. Treatment for AF aims to restore the heart’s normal rhythm. If that’s not possible, the goal shifts to slowing the irregular heart rate to relieve symptoms.

Global AF Aware Week

The AF Association hosts Global AF Aware Week (GAFAW) each year. GAFAW on 18–24 November 2024 aims to raise awareness of AF across the globe so that people can be detected, protected and treated earlier and live healthier and happier lives.

Raising awareness of AF is vital for the public to understand the associated dangers, its link to stroke and the importance of a regular pulse rhythm check. Currently, up to 30% of individuals who have AF are undiagnosed and at risk of complications, such as AF-related stroke.

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Trudie Lobban MBE

Founder and Trustee, Arrhythmia Alliance

We can make a lasting impact on the health and wellbeing of people in low and middle-income countries (LMIC) by recycling pacemakers, which are currently put into landfills.

Recycling explanted cardiac devices to countries where they would not otherwise have the opportunity to receive treatment for heart rhythm disorders can provide valuable medical support.

Inequity of life-saving cardiac technology

In the UK, cardiac implantable devices give approximately 68,000 individuals a second chance at life each year. Yet, when a device user dies, the device is buried with them, or if the deceased chooses to be cremated, it is discarded and goes to landfill. 

Many times, a device has many years of battery life left and yet, it is a ‘throwaway.’ In stark contrast, in LMIC, around 2.5 million people die every year because they do not have enough money or access to a lifesaving cardiac device operation.

This is an opportunity that can protect our planet from harmful waste and provide life-saving cardiac care to others.

How cardiac devices can save a life, twice

Arrhythmia Alliance Pace4Life (A-A P4L) is a charity that tackles this disparity head-on by donating cardiac devices to people in need in LMIC who otherwise would not be able to afford the lifesaving implant. The charity sources cardiac devices, identifies viable clinics in LMIC, sets up programmes at these clinics, trains local cardiac teams, organises pacing missions and provides ongoing online support to those programmes. This is an opportunity that can protect our planet from harmful waste and provide life-saving cardiac care to others.

Repurposing cardiac devices for impact

The key is connecting LMIC and higher-income countries (HIC) communities through the reuse and recycling of pacemakers and other cardiac devices once they are no longer needed. By gathering these life-saving devices from hospitals, funeral homes, crematoriums and mortuaries, this programme can make a real difference in the lives of those in need. The aim is to ensure that every cardiac device is given a second chance to bring hope and healing to those who need it most.

A-A P4L has created a system that allows the repurposing of explanted and end-of-shelf-life cardiac devices and equipment. By redirecting these items to a distribution centre, the used devices are collected by a re-processing company, cleaned, decontaminated, tested and re-packaged sterile. The devices can positively impact the lives of those in need while contributing to a sustainable future by avoiding landfill.

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New minimally invasive procedures can repair tricuspid valve regurgitation, a potentially serious heart condition — and avoid the need for open-heart surgery.

There’s a good reason why the tricuspid heart valve is known as ‘the forgotten valve’, notes Dr Robert Smith, consultant interventional cardiologist based at Royal Brompton and Harefield hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust. “Traditionally, if the valve leaks or fails, little can be done to treat it,” he says.

Tricuspid valve regurgitation consequences

Despite being historically overlooked, the tricuspid valve is crucial to heart health. A leak of the valve — known as tricuspid valve regurgitation — is common. It’s thought to affect up to 5% of the population in the UK aged over 75 and may be due to various factors including age and atrial fibrillation (AF). “However, severe cases are associated with significant mortality,” warns Dr Smith.

At an early stage, symptoms can be mild; but, as the condition worsens, patients may experience breathlessness, fatigue and swelling of the ankles and legs and, rarely, the abdomen. While diuretic medication may alleviate some symptoms, only reparative surgery can properly restore valve function. As this involves open heart surgery, it’s usually only performed while the patient is having an operation for another heart condition.

Two types of low-risk non-surgical intervention

A minimally invasive non-surgical treatment is now being used at a small number of hospitals globally, including Royal Brompton and Harefield hospitals. This could be a game-changer for patients with tricuspid valve regurgitation, particularly those who are too high-risk for open-heart tricuspid valve repair because they are older, have additional health issues or have advanced heart failure.

The procedure is performed with a catheter — a tube-like device, which delivers direct treatment to the heart via a small incision in the groin. “There are two treatments available to patients,” explains Dr Smith.

“The first is transcatheter edge-to-edge repair (TEER) where a clip is used to reduce the leak. The second is transcatheter tricuspid valve replacement (TTVR), a newer procedure where the valve is replaced and the leak is obliterated.” Both procedures are low-risk and take around two hours.

Tricuspid valve regurgitation procedure recovery

After a few days of monitoring, the patient is usually able to go home. Currently, the procedures are not available on the NHS, but Dr Smith hopes this will change. “One of our patients — who was elderly, frail and possibly facing a palliative care pathway — had the TEER procedure and, a month later, went salmon fishing,” he says. “There’s no doubt it can make a real difference to people’s lives.”

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Women and minorities often receive suboptimal cardiology care, facing delays and reduced access to life-saving procedures. Addressing these disparities through prevention, education and policy is crucial.

Cardiology combines fast-moving technology, successful medical procedures and innovative drug and device treatments — all of which we offer to patients to improve their quality of life and avoid early and unexpected death. However, not all of these treatments are offered equally to all patients.

Women badly served in cardiology

For example, women having a heart attack are up to 50% more likely than men to receive the wrong initial diagnosis and are more likely to have palpitation symptoms of heart rhythm disturbance passed on as panic attacks leading to delay in treatment.

There are also significant differences in access to heart valve replacement surgery, without which people are at risk of uncontrolled symptoms and worsening outcomes. Recent UK research has shown that women, ethnic minority populations and those living in deprived areas are much less likely to receive life-saving surgery to replace a failing heart valve (women 30% less, Black people 26% less, people of South Asian descent 22% less and people from deprived areas 24% less likely).

Women having a heart attack are up
to 50% more likely than men to
receive the wrong initial diagnosis.

Inequity among ethnic minorities and deprived populations

It is the people most in need of diagnosis and treatment who are missing out; people from ethnic minorities and deprived populations are already more likely to have major risk factors for heart disease such as hypertension, diabetes and obesity. This has been seen as a wider public health issue, with cardiologists becoming involved once the person has been identified as a patient, but it is clear going forward that primary prevention is key.

Timely, effective management of risk factors would reduce the incidence of heart disease, addressing all aspects of inequality. It will be difficult; cardiology has huge waiting lists and major workforce shortages — but having determined the extent of the problem, we owe it to our patients to address it urgently on all fronts.

Prioritising equal heart care

As doctors, we have the responsibility to do our best for the patients under our care. However, we also need wider societal measures — public education to encourage healthy lifestyles, legislation to ban advertising of unhealthy foods and, most importantly, a cross-government strategy to tackle all the factors that make people ill in the first place. As the newly elected BCS president, I will be making equality in access to heart treatment a priority.

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Professor Amitava Banerjee

National Specialty Lead for Cardiovascular Disease, National Institute for Health and Care Research (NIHR)

Cardiovascular disease is a leading cause of death in women. Better treatments are needed, so it’s vital that female patients with the condition participate in research studies.

It’s time to shatter the myth that only men are affected by cardiovascular disease (CVD), such as high blood pressure and stroke. In reality, it’s a leading cause of death in women in the UK and worldwide.

Cardiovascular disease risk in women

Women face additional CVD risk factors, including those related to pregnancy (such as preeclampsia, eclampsia and gestational diabetes) and menopause. Moreover, a high proportion of women with long-term health conditions, such as cancer, develop cardiovascular disease; while research shows that exposure to poor maternal health ‘in utero’ may increase the risk of a woman’s children developing CVD in later life. So, it’s vital that all women — and their clinicians — understand that CVD doesn’t discriminate and are aware of its symptoms.

“Take coronary artery disease, which kills one in 14 women in the UK,” says Professor Vijay Kunadian, National Specialty Lead for Cardiovascular Disease, National Institute for Health and Care Research (NIHR). “Yet, because it’s perceived as ‘a male disease,’ a clinician may not initially think that a woman with symptoms will have a heart issue.”

Consequences of lack of awareness

As an example, Prof Kunadian highlights the case of a 35-year-old female — a heavy smoker — who went to her doctor complaining of chest discomfort. After examination, the patient was prescribed antibiotics and sent home. However, she still felt unwell two days later, so she returned to her doctor and was prescribed indigestion medication.

It was only when she was taken to hospital in an ambulance six days later that the patient had an ECG; the results of which were suggestive of a major heart attack. This lack of awareness could have been fatal. “She is lucky to have survived,” says Prof Kunadian. “This (state of affairs) can’t be ignored anymore because most cardiovascular disease, and particularly coronary artery disease, is highly preventable.”

All the treatment and preventions
that we access or provide come
from clinical research.

Making it easier for women to access trials and research

One reason why women with CVD have been under-diagnosed and under-treated is because they have been under-represented in clinical research. In 2021, the Lancet Women and Cardiovascular Disease Commission published a series of new recommendations to reduce the global burden of CVD in women by 2030. These included appropriate representation of women in clinical trials and prioritising sex-specific research.

There are various factors behind low female research participation, notes Prof Kunadian, who works on the Commission. “For example, women may feel they don’t have time because of their caring responsibilities. It’s also about gaining trust. When I explain a study to a woman, it can take a lot longer because she typically has a lot of questions.”

Why research is vital for patient care and treatment

Professor Amitava Banerjee, National Specialty Lead for Cardiovascular Disease, NIHR, agrees that it must be made easier for male and female patients to seamlessly enter clinical trials and research.

“This can be challenging because they may view research as an extra hurdle to cross when they simply want quick treatment,” he says. “Yet, without that research, quick treatment would not be possible. When we explain this — and that it will potentially give them exposure to better treatment and increase our knowledge to benefit all patients — they tend to say ‘yes’.”

How to take part in clinical research

It’s important to get involved because research saves lives, says Prof Kunadian. “All the treatment and preventions that we access or provide come from clinical research,” agrees Prof Banerjee. “Without it, we can’t advance.”

Anyone interested in taking part in clinical research — including patients with a health condition, such as CVD, or those with no health condition — can find studies and register their interest via NIHR’s Be Part of Research website. The website helps people across the UK make informed decisions about taking part in research; explaining what research is and how you can get involved.

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Cardiovascular disease (CVD) claims over 20 million lives annually, often prematurely. Countries can reduce this toll by developing and implementing effective action plans.

Some cardiovascular conditions are genetic while many result from lack of access to care from birth and lifestyle consequences. All organs take wear and tear, but we should not think of heart disease as being inevitable just because we age.

Advocating for cardiovascular health

Health policies, combined with health systems that prevent, diagnose and treat cardiovascular conditions, promote wellbeing. The World Heart Federation (WHF) champions health for everyone. Improving cardiovascular health entails tailoring policies and care that respond to national, regional and local needs. Targeted care involves gathering data on CVD prevalence and respective risk factors. Effective, sustainable care is possible if properly resourced and covers all citizens.

WHF, along with other organisations worldwide, advocates for political actions that have a real impact on citizens’ lives. Thousands of people are lending their voices, demanding that governments establish national action plans or review existing ones.

The hallmark of tailored health
action plans is addressing all
phases of care for every citizen.

Cardiovascular health action plan

A cardiovascular health action plan is a strategic public health approach, powerful in promoting cardiovascular health for all. The hallmark of tailored health action plans is addressing all phases of care for every citizen.

Prevention entails monitoring CVD risk factors such as high blood pressure, cholesterol and diabetes through timely screening and early primary care. Proper nutrition, physical activity and avoiding tobacco are among the measures to urge and encourage.

Secondary prevention seeks to reduce the risk of recurrent cardiovascular disease. Lifestyle modifications and sticking with a prescribed treatment plan are key. Rehabilitation and recovery roll out targeted therapies, counselling and medicinal treatment to improve quality of life after a cardiovascular event.

Expand equitable healthcare

A comprehensive plan combines preventive, secondary and rehabilitative therapies so that no one is left out of their basic right to healthcare. Prevention of disease and premature mortality is an investment and a moral imperative.

Communities across the globe are becoming more aware of cardiovascular health risks and opportunities. The call is growing louder to tackle the greatest killer, improve cardiovascular health and promote wellbeing. In our respective ways, we must all respond, adding our voices and votes to expand equitable healthcare coverage for all.

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Find out how a cardiopulmonary resuscitation (CPR)-trained society will save more lives, improve public health and enhance community resilience during emergencies.

Our report, ‘Every Second Counts: Tackling inequalities in resuscitation’, reveals the huge disparities between rich and poor, and people from different cultural backgrounds, when facing the ultimate medical emergency.

CPR knowledge and access disparities

We spoke to people from African, Indian, Pakistani and Bangladeshi communities to understand their views and expectations about learning and performing CPR. Around 60% said they lacked the knowledge and skills to perform CPR, and 34% mentioned a lack of awareness of training opportunities.

Increasing CPR knowledge and training in underserved communities gives everyone an equal chance of surviving a cardiac arrest. Training resources must be tailored to people’s needs, where English may not be the primary language. Consideration must also be given to differences in technology literacy and digital access.

A lack of defibrillators

Defibs save lives, but our research suggests that they’re scarce in poorer parts of the UK. Almost half (44%) of these areas have no defibrillator registered on The Circuit, the national defibrillator network.

Increasing CPR knowledge and training in underserved communities gives everyone an equal chance of surviving a cardiac arrest.

We must change this by targeting public-access defibs in areas where the data tells us they’re needed most and ensure these devices are registered on The Circuit. This will be a significant step in reducing inequality and ensuring everyone has an equal chance of survival.

Closing the inequalities gap

We’ve made key recommendations for progress, and we’re asking decision-makers and our partners to work with us to adopt them. Collecting routine comprehensive data that effectivelyidentifies and targets out-of-hospital cardiac arrest hotspot areas will beinvaluable.

We also want CPR training to be part of the driver’s licence test and the DVSA’s Compulsory Basic Training (CBT) for motorcycles and mopeds. Around 180,000 moped and motorcycle drivers take the CBT test annually, which we believe could ensure greater CPR confidence in younger drivers, and many more from underserved communities.

Working together to save lives

Our success will require collaboration, commitment and ambition. We ask that Westminster and devolved governments work with us to fund a national public awareness campaign that targets CPR training in areas where it’s most needed. A CPR-trained society will save more lives, improve public health and enhance community resilience during emergencies.

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