Dr Guido Pieles
MD (Marb) PhD (Han) DPhil (Oxon) MScHE (LSE)
Congenital Paediatric and Adult Cardiologist
Specialist in Inherited Cardiac Conditions
CH&P provides a comprehensive evaluation of your cardiac function, performance and training adaptations using state of the art diagnostic tests and treatments. We offer a range of services to assess your cardiovascular health, from a basic cardiac assessment to in-depth assessment of aerobic and anaerobic cardiovascular fitness and performance.
Consultation and Clinical examination
Cardiac Blood Profiling
Cardiopulmonary Exercise Testing
Sports cardiology Assessment
For additional specialist services, we work together with selected experts in their fields.
Browse through our list of services to get more detailed information or contact our team.
CONSULTATION AND CLINICAL EXAMINATION
The start of every encounter will be a consultation including an exercise questionnaire, measurement of standard vital parameters such as blood pressure, a cardiovascular clinical examination but also a conversation on past medical and family medical history as well as assessing your exercise and training levels and goals.
An electrocardiogram (ECG) is a simple standard test used to check your heart's rhythm and electrical activity by attaching electrodes to your chest. It is a non-invasive, quick, safe test without side effects. A clinical assessment and the ECG are the primary tools to screen for underlying heart disease in athletes according to guidelines from the European Society of Cardiology.
Stress or Exercise ECG – This is carried out to monitor your heart rhythm while you are performing an exercise test on a bike or treadmill.
Ambulatory ECG – The electrodes are here connected to a small portable machine so your heart can be monitored continuously at home and for several days. The devices used by CH&P are cable-less and allow training and even competition while being monitored.
An echocardiogram is an ultrasound scan of the heart. Ultrasound waves are sent out and received by a probe put on to your chest and turned into a moving image of your heart that is displayed on a monitor while the scan is carried out.
It allows precise measurement of heart size and function, valve anatomy and function and can pick up signs of heart muscle disease. Echocardiography is recommended as a primary screening tool for professional athletes by many leading sports organisations and we use this also in non-professional athletes as it increases the pick-up rate for underlying heart disease.
Further tests that might be indicated if any symptoms or signs of heart disease are picked up or if pre-existing heart disease is present:
Exercise stress echocardiogram – an echocardiogram carried out while you are exercising on a reclining bike to directly assess your heart function while it is working harder. Dr Pieles and research colleagues have developed a method to combine this test with simultaneous measurement of fitness level and lung and muscle oxygen uptake. This allows for a comprehensive assessment of heart, lung and muscle function during exercise in one test.
CARDIAC BLOOD PROFILING & GENETIC TESTING
On some occassions we will perform blood tests to screen for risk factors such as high cholesterol, but also measure blood markers of underlying heart disease. Genetic blood tests might be performed if there is a clear suspicion of underlying inherited heart disease.
If clinically indicated we can also perform genetic testing for specific inherited cardiac conditions.
CARDIO-PULMONARY EXERCISE TESTING (CPET)
This test assesses lung and muscle function and fitness level objectively. We use it as a standard test to assess fitness and training status and the functional effects of underlying heart disease. Our innovative approach is to combine this test with an exercise echocardiogram and stress ECG during one setting. This provides a real time assessment of the major organ systems (heart, lungs, muscles) that define exercise performance. This novel methodology is now being used by our team at international sports academies (see our Links sub-page under the Research page).
BASIC SPORTS CARDIOLOGY ASSESSMENT
Basic sports cardiology assessment following FA, UEFA, FIFA and IOC protocols for international competitive athletes:
12-lead resting ECG
Family and personal medical history
Consultation with risk stratification and recommendations regarding eligibility for recreational and/ or competitive sport
Recommendations and performance of secondary tests
ADVANCED ATHLETE CARDIOLOGY ASSESSMENT
Advanced athlete cardiology assessment including all the basic assessment plus:
Exercise stress ECG
Cardio-pulmonary exercise test
Mobile ECG monitoring
Exercise stress echocardiogram
Tests are – dependent on age and level of sports – recommended annually or two- yearly.
In some cases further tests will need to be performed, which include cardiac magnetic resonance imaging (MRI) or a computed tomography (CT) or Electrophysiology studies (EP). CH&P works together with specialists in these areas and these tests can be conveniently performed locally.