Cardiology Second Opinion
When a cardiology second opinion can help
A second opinion is an independent review of your heart diagnosis, test results and treatment by another consultant cardiologist. It is not a sign that you distrust your current team. It is a way of checking that you understand your condition, that the diagnosis fits the evidence, and that the proposed plan is the right one for you.
Many people ask for one because they:
- have been given a diagnosis they do not fully understand or are unsure about
- have been advised to have a procedure, such as an angiogram, stent, valve operation, ablation or device implant
- still have symptoms despite treatment
- have test results that seem to say different things, or that no one has explained clearly
- want reassurance before starting long-term medicines such as a statin, blood thinner or heart failure treatment
- are facing a long wait and want to understand their options in the meantime
A second opinion is your right, and most doctors are comfortable with patients seeking one.
Why a second look can matter
Cardiology decisions often involve a judgement between several reasonable options. For example, in the ISCHEMIA trial of people with stable coronary disease and moderate or severe reduced blood flow, an initial invasive strategy (angiography followed by stenting or bypass surgery where suitable) did not reduce the main combined outcome of cardiovascular death, heart attack and other major events compared with starting with medicines and lifestyle measures alone. Which approach suits one person depends on their symptoms, test results and preferences. A second opinion helps you weigh these options with the full picture in front of you.
Common reasons for a second opinion
These are some of the situations in which people most often seek an independent view. Each is also covered by its own guide on this website.
Coronary artery disease, angina and stents
If you have been told you have narrowed heart arteries, or have been offered an angiogram, stent or bypass operation, it is reasonable to ask which option is likely to help your symptoms, which will reduce future risk, and what the alternatives are. See coronary artery disease, angina and CT coronary angiogram.
Heart valve disease
Timing of valve surgery or a transcatheter procedure depends on the type and severity of the valve problem, your symptoms and the effect on the heart muscle. A second opinion can check that severity has been graded consistently on echocardiography and that the proposed timing is appropriate. See heart valve disease, aortic valve stenosis and mitral regurgitation.
Atrial fibrillation and other rhythm problems
Decisions about blood thinners, rate and rhythm control, cardioversion and ablation are individual. A second opinion can review your stroke risk, your monitor results and the options on offer. See atrial fibrillation and palpitations.
Heart failure and cardiomyopathy
If you have a reduced pumping function or a thickened or enlarged heart muscle, a second opinion can check that the diagnosis is secure and that your medicines and monitoring follow current guidance. See heart failure, hypertrophic cardiomyopathy and dilated cardiomyopathy.
Abnormal ECG, echocardiogram or heart murmur
Some findings are important and some are normal variants. If you have been told something abnormal but have not had a clear explanation, a review can establish whether it matters. See ECG reporting, echocardiogram and heart murmur.
High cholesterol and cardiovascular risk
If you have been advised to start or stop cholesterol-lowering treatment, or your risk has been assessed differently by different clinicians, a second opinion can bring the information together. See high cholesterol.
Symptoms with no clear cause
Chest pain, breathlessness, dizziness, fainting or palpitations that have not been explained after tests are a common reason to seek a fresh look. See chest pain, shortness of breath and fainting.
What can be reviewed
You can send the information you already have, for example:
- ECG tracings and reports
- echocardiogram, CT, MRI and angiogram reports, and images where you have them
- heart monitor results (24-hour, multi-day or event recorders)
- hospital discharge summaries and clinic letters
- blood test results, including cholesterol
- your current list of medicines
Dr Salloum reviews these before your appointment so that the time is spent on your questions rather than on gathering information. If a test would help clarify the picture, he can advise which one and why; see cardiac tests.
If you do not have all of your records
Send what you have. Most people do not hold every report, and it is still possible to give a useful opinion. Dr Salloum will tell you what is missing and how to request it, for example from your hospital records department or GP practice. If your main need is to have existing results explained, see the Cardiac Investigations Review Consultation.
How a second opinion consultation works
The steps
- Choose a video consultation, telephone consultation or face to face consultation, and book online.
- Send your documents and a short summary of your concern before the appointment.
- Dr Salloum reviews your records, discusses your history and symptoms, and examines you if you are seen in person.
- He explains whether he agrees with the diagnosis and plan, and gives his reasoning, in plain language.
- You receive a clear written letter with the findings and recommended next steps, which you can share with your own doctors.
What happens in the appointment
The appointment starts with your own account: what you have been told, what you are worried about and what you would like to know. Dr Salloum then goes through your records with you, explains what they show, and gives his view on the diagnosis and the options. There is time for questions, and you are encouraged to bring a family member if you wish.
Choosing the type of appointment
- Video or telephone: suitable for most second opinions, because the review of your records and the discussion are the main part of the consultation. Available across the UK, usually at short notice and including weekends
- Face to face: helpful if you would like an examination, an ECG or a test on the day, or if you prefer to be seen in person. Clinics are held in Peterborough and Corby
What you will receive
After your consultation you receive a written letter that sets out:
- a summary of your history and the records reviewed
- Dr Salloum’s opinion on the diagnosis
- whether he agrees with the current treatment plan, and why
- any other options worth discussing with your team
- any further tests he suggests, and the reasons
- a clear list of next steps
The letter is written so that you and your own doctors can use it. It is a record of an independent opinion; it does not replace the care of the team responsible for you.
Preparing for your appointment
A little preparation makes the consultation more useful.
Before you book or attend
- Write down your main question in one or two sentences, for example “Do I need the stent I have been offered?” or “Is this the right treatment for my valve?”
- Note your symptoms: what they are, when they occur, what brings them on and how they have changed
- Gather your reports and letters in date order, and your current medicines with doses
- Check whether you have a date for a procedure or a decision, so that the review can be arranged in time
Questions that are worth asking
- What is the diagnosis, and how certain is it?
- What do my test results actually show?
- What are my options, including doing nothing for now?
- What are the benefits, risks and likely recovery of each option?
- What would happen if I waited?
- Are there other tests that would change the decision?
- What symptoms should make me seek help urgently?
What a second opinion can and cannot do
What it can do
- confirm your diagnosis and treatment
- point out other options to discuss
- suggest further tests
- explain your results and your condition in plain language
- give you the reasoning to make a more confident decision
What it cannot do
It cannot replace the care of the team looking after you, and it is not suitable for emergencies. If you have severe chest pain, collapse or sudden breathlessness, call 999.
Any change to your treatment is best agreed with the clinicians who know you and will be responsible for your ongoing care, so please take the written letter to your next appointment.
A remote review is also limited by the information available. If an examination or test is needed to answer your question, Dr Salloum will say so and advise the best way to arrange it.
Common questions
Will asking for a second opinion upset my current doctor?
No. Doctors are used to patients asking for a second opinion, and a clear written letter can help your own team.
Do I need a GP referral?
You can book directly. If you are using private medical insurance, please check with your insurer whether a referral is required before you book.
What should I send before the appointment?
Any ECG, scan or monitor reports, hospital letters, blood results and your medicine list. If you are unsure, send what you have and mention what is missing.
Can you give a second opinion on an NHS diagnosis?
Yes. You can use the letter to discuss the findings with your NHS team.
Can I have a second opinion by video or telephone?
Yes. Many second opinions are based mainly on a careful review of your records and a detailed discussion, which works well remotely. A face to face appointment is available if you would like to be examined or have a test on the day.
Can you review scan images, or only the reports?
Reports are the most useful starting point, and images can be reviewed where you have them. If the images are needed to answer your question and you do not hold them, Dr Salloum can advise how to request them from the hospital.
Will you take over my care?
Not unless you wish. A second opinion is a single, independent review. If you would like ongoing follow-up with Dr Salloum, you can arrange this separately.
Can I ask about a procedure I have already been booked for?
Yes, and it is best to do so before the date. A second opinion can help you decide whether to go ahead, ask for more information or consider a different option.
Can a second opinion say my diagnosis is wrong?
Sometimes the opinion differs, sometimes it confirms the original plan, and often it adds detail or explains the reasoning more clearly. Dr Salloum will give his honest assessment and explain it. If he disagrees, he will suggest how to take the matter up with your treating team.
Is a second opinion confidential?
Yes. Your records and the consultation are handled in line with the practice privacy policy.
Can my family join the consultation?
Yes. Many people find it helpful to have a relative with them on the video call or in the clinic.
When should I not wait for a second opinion?
If you have severe or worsening chest pain, collapse, sudden breathlessness or symptoms of a stroke, call 999. A second opinion is for non-emergency decisions.
To get a second opinion on a diagnosis, test result or treatment plan, you can book a video consultation or telephone consultation from anywhere in the UK, or a face to face consultation in Peterborough or Corby. If your main need is to have existing results explained, see the Cardiac Investigations Review Consultation.
Book Your Cardiology Second Opinion
Personalised care
Your history, tests and questions are reviewed so the advice fits you.
Consultant-led care
Seen and assessed by a consultant cardiologist.
Clear
next steps
A written letter with your findings and next steps.
Advanced
diagnostics
Specialist in echo, stress echo, cardiac CT, MRI and heart failure.
Medically reviewed by Dr Salam Salloum, Consultant Cardiologist. Last reviewed: . This page is for general information and does not replace personal medical advice.