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Cardiology umbrella · UK NHS + private

Non-invasive cardiology treatments, by a consultant cardiologist.

The first-line treatment for most cardiovascular disease - medicines, lifestyle and imaging - before anyone talks about catheters or surgery. NICE- and BCS-aligned, NHS via GP referral or private direct.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What non-invasive cardiology costs in the UK.

NHS-funded via GP referral for most patients. Private ranges below cover the common cardiology work-up - consultation, echo, CT-CA, cardiac MRI and rhythm monitoring.

In short

Consultation plus TTE echo, privately: £500–£900, results the same visit.

Service Indicative range
Cardiology consultation (private) £250–£450
Transthoracic echocardiogram (TTE) £250–£450
Stress echocardiogram £450–£800
CT coronary angiogram (CT-CA) £500–£900
Cardiac MRI £700–£1,200
24h / 7-day Holter monitor £250–£600
NHS pathway (GP referral) Free

Prices vary by clinic, cardiologist and whether add-on tests are needed on the day. Cardiac rehabilitation and drug therapy are usually NHS-funded.

The problem

The right cardiologist, the right regimen, the right monitoring.

Non-invasive cardiology is quietly the most under-optimised part of medicine - under-titrated drugs, missed SGLT2 pillars in heart failure, and NICE pathways skipped for the wrong test. We fix that before anyone talks about a stent.

  • Not sure it is a heart problem?

    History, ECG and a same-visit echo usually settle it before you commit to anything more expensive.

  • Already on medicines?

  • Want it done properly?

    A named consultant cardiologist and a written plan - with the NHS route flagged if it is faster.

When it helps

When non-invasive cardiology is the right step.

The conditions we see most, plus the one red flag that means 999 rather than an appointment.

  • Hypertension

    BP consistently above target - ABPM confirms it, then a stepped regimen per NICE NG136 gets it down safely.

  • High cholesterol

    Statins first, ezetimibe added if needed, PCSK9 inhibitors for high-risk patients failing standard therapy.

  • Heart failure (HFrEF)

    The four-pillar regimen - ACEi/ARNi, beta-blocker, MRA and SGLT2 inhibitor - improves symptoms and survival.

  • Atrial fibrillation

    Rate or rhythm control, plus a DOAC per CHA2DS2-VASc to prevent stroke. Cardioversion where appropriate.

  • Stable angina

    CT coronary angiogram first-line per NICE CG95. Beta-blocker or calcium channel blocker, then add-on therapy.

  • Post-MI or post-CABG rehab

    Structured cardiac rehabilitation - exercise, education, medicines optimisation - cuts recurrence and readmission.

  • Palpitations, unexplained

    Holter, event monitor or implantable loop recorder to catch the rhythm. Wearables help but do not replace medical review.

  • Red flag: chest pain at rest

    New chest pain at rest, pain radiating with sweating, or sudden severe breathlessness is 999, not a clinic booking.

Treatment options

The eight pillars of non-invasive cardiology.

What each option on the table actually involves - and which condition it fits. Emerging therapies such as mavacamten (Camzyos) for hypertrophic cardiomyopathy sit alongside the classics.

  • Lifestyle and cardiac rehabilitation

    DASH or Mediterranean diet, exercise prescription, weight loss, smoking cessation, structured rehab after MI, CABG or valve surgery.

  • Hypertension pharmacotherapy

    ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, spironolactone and beta-blockers - stepped per NICE NG136.

  • Cholesterol pharmacotherapy

    Statins (atorvastatin, rosuvastatin), ezetimibe, PCSK9 inhibitors (evolocumab, alirocumab), bempedoic acid, icosapent ethyl (Vazkepa).

  • Heart failure - four-pillar therapy

    ACEi/ARB/ARNi (sacubitril–valsartan), beta-blocker, MRA (spironolactone/eplerenone), SGLT2 inhibitor (dapagliflozin/empagliflozin) - NICE TA679/TA729.

  • Arrhythmia and anticoagulation

    Amiodarone, flecainide, sotalol, dronedarone for rhythm; DOACs (apixaban, rivaroxaban, edoxaban, dabigatran) or warfarin for stroke prevention.

  • Antiplatelet and angina therapy

    Aspirin, clopidogrel, ticagrelor, prasugrel per DAPT protocols; long-acting nitrate, ivabradine, ranolazine, nicorandil for stable angina.

  • Cardiac imaging and monitoring

    Echocardiography (TTE, TOE, stress echo), cardiac MRI, CT coronary angiogram, myocardial perfusion imaging, Holter and loop recorders.

  • Non-invasive rhythm interventions

    External DC cardioversion for AF, plus pacemaker, ICD and CRT programming - done in outpatients without new hardware.

Safety and monitoring

What to expect from the medicines and scans - honestly.

Non-invasive cardiology is safer than catheter or surgery, but not risk-free. The things worth planning are drug titration, monitoring, contrast and radiation exposure, and knowing when to escalate.

  • Medicines are titrated, not switched on

    Beta-blockers, ACEi/ARNi and SGLT2 inhibitors are started low and titrated over weeks. Bloods and BP are checked at each step.

  • Bleeding on anticoagulation

    DOACs prevent stroke in AF but raise bleeding risk. We balance CHA2DS2-VASc against HAS-BLED and review annually.

  • Contrast and radiation exposure

    CT-CA uses a small radiation dose and iodinated contrast.

  • Pharmacological hypotension and bradycardia

    BP-lowering and rate-slowing drugs can drop pressure or heart rate too far - dizziness or falls means the dose is wrong, not you.

  • Side effects worth knowing

    ACEi cough, statin muscle aches, amiodarone thyroid and lung effects, SGLT2 thrush and DKA risk in illness - flagged and monitored.

  • Cardiac rehab is medicine, not a class

    Structured post-MI and post-valve rehabilitation cuts recurrence and readmission - treat it as part of the prescription.

  • Wearables are useful but partial

    Apple Watch AF alerts and KardiaMobile ECG are helpful signals. They do not replace a 12-lead ECG or a cardiologist review.

  • When to escalate to catheter or surgery

    Persistent symptoms, worsening ejection fraction, high-grade coronary disease or valvular disease trigger referral to intervention.

  • Red flags

    New chest pain at rest, sudden breathlessness, syncope, or a fast irregular pulse with chest pain - 999, not a clinic booking.

Reading your cardiology plan

Your cardiology plan in four parts. Read the last one first.

Whichever condition you have, the letter the cardiologist sends you keeps to the same shape.

A UK consultant cardiologist reviewing a patient’s ECG and echo report

A quiet reminder

Cardiology language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the plan before your review, just ask.

  1. 01 Header

    Diagnosis and NICE pathway

    Why you are being treated - the condition, the risk stratification (CHA2DS2-VASc, QRISK, NYHA class) and the pathway used.

  2. 02 Technique

    Investigations and imaging

    Which tests were done - ECG, echo, CT-CA, cardiac MRI, Holter - and what each showed in plain English.

  3. 03 Findings

    Drug regimen and lifestyle plan

    The specific drugs, doses and titration plan, plus the DASH/Mediterranean diet and exercise prescription.

  4. 04 Impression

    Follow-up, monitoring and escalation

    Read this first: when to review, what to monitor at home, and the trigger points for escalation to catheter or surgery.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Most cardiology consultations, echocardiograms and CT-CA are covered by UK insurers when medically indicated.

Frequently asked

Everything we get asked about non-invasive cardiology.

Quick answers on which tests, which medicines, and when medicines end and catheter or surgery begins.

  • What counts as non-invasive cardiology?

    It is the first-line treatment for most cardiovascular disease - medicines, lifestyle, imaging and rhythm monitoring - without cutting the skin or passing a catheter into the heart. For hypertension, high cholesterol, heart failure, stable angina and most AF, it is where treatment starts and often stays.

  • Do I really need a cardiologist, or can my GP handle it?

    Uncomplicated hypertension and primary-prevention statins are usually GP territory. Heart failure, AF, unexplained palpitations, angina, a family history of sudden cardiac death, or anything not responding to standard treatment benefits from a consultant cardiologist.

  • What is the four-pillar therapy for heart failure?

    For heart failure with reduced ejection fraction (HFrEF), four drug classes together improve survival: an ACEi/ARB/ARNi (usually sacubitril–valsartan), a beta-blocker (bisoprolol, carvedilol or nebivolol), an MRA (spironolactone or eplerenone), and an SGLT2 inhibitor (dapagliflozin or empagliflozin). NICE TA679 and TA729 fund the SGLT2 pillar on the NHS.

  • CT coronary angiogram or exercise stress test for chest pain?

    NICE CG95 makes CT coronary angiogram the first-line test for stable chest pain of suspected cardiac origin in most adults. Exercise stress testing still has a role - assessing exercise capacity, provoking arrhythmia, or where CT is contraindicated - but it is no longer the default gatekeeper.

  • Which anticoagulant for atrial fibrillation?

    For non-valvular AF, a direct oral anticoagulant (DOAC) - apixaban, rivaroxaban, edoxaban or dabigatran - is first-line, chosen against CHA2DS2-VASc and HAS-BLED. Warfarin is still used for valvular AF and mechanical heart valves. Choice depends on kidney function, weight, drug interactions and bleeding history.

  • How much does a private cardiology work-up cost in the UK?

    Roughly £250–£450 for a consultation, £250–£450 for a TTE echocardiogram, £450–£800 for stress echo, £500–£900 for CT-CA and £700–£1,200 for cardiac MRI. Holter monitors run £250–£600. Most of this is free on the NHS via GP referral - we flag which route is faster or safer.

  • Is cardiac rehabilitation worth doing after a heart attack?

    Yes, and it is one of the most under-used treatments in cardiology. Structured post-MI, post-CABG and post-valve rehabilitation - exercise, education, medicines optimisation and psychological support - cuts recurrence and readmission. Treat it as part of the prescription, not an optional class.

  • Are Apple Watch or KardiaMobile ECGs reliable enough?

    They are useful - an Apple Watch AF alert or a KardiaMobile single-lead ECG can catch a rhythm your doctor would otherwise miss. They are not diagnostic on their own, though. A cardiologist confirms with a 12-lead ECG or a proper Holter before starting treatment such as anticoagulation.

  • When do I need catheter or surgery instead?

    When medicines and lifestyle fail to control symptoms, when ejection fraction keeps falling, when imaging shows severe coronary disease, or when valvular disease crosses the threshold for intervention. At that point a heart team MDT decides between PCI, CABG, valve repair or replacement, TAVI or ablation.

  • When should I go to A&E or call 999?

    New chest pain at rest, pain radiating to jaw or arm with sweating, sudden severe breathlessness, blackout, or a fast irregular pulse with chest pain are 999 calls - not a clinic booking. Do not drive yourself.

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