"Concern about conduct and focus of cardiology consultation"

I recently had an appointment was with a Consultant Cardiologist. This followed the departure of my previous cardiologist, who I had seen for over a decade.

Although I appreciated the longer-than-average consultation time, I found the nature of this appointment highly inappropriate and upsetting. I’ve had many cardiology consultations since 2011 — all conducted with professionalism and clear clinical focus. This one did not follow that pattern.

A significant portion of the appointment was spent discussing deeply personal and sensitive topics that felt unrelated to cardiology. I was questioned extensively about my relationship with my father, mother, and sister, my experience of divorce, any past admissions to mental health facilities, treatments for depression in the 1990s, and whether I had received psychological therapies such as CBT. The consultant also asked about my current personal relationships and dating life. These were intrusive questions, and the tone felt interrogative rather than exploratory. I felt exposed, pre-judged, and professionally diminished.

When it emerged that I occasionally check my own pulse — something many people do for general health awareness, especially those with a fitness background — the consultant asked me, repeatedly, why I really take my pulse, as if there must be a deeper psychological reason. The assumption seemed to be that I was checking it obsessively out of anxiety, rather than for simple cardiovascular awareness. It felt as though a conclusion had been reached about me before the consultation even began.

I fully understand that mental health can influence cardiac health, especially in conditions like atrial fibrillation. But there is a clear line between relevant clinical enquiry and inappropriate psychological probing — and in my view, this consultation crossed it. I feel the appointment was not centred on my heart or my follow-up care, but instead on constructing a psychological profile. That is not what I came to this appointment for.

I’ve since reviewed the letter that was sent to my GP after this appointment. It makes a brief reference to past mental health issues, but this does not reflect the tone or emotional intensity of what was asked. In the consultation itself, I felt the focus shifted heavily away from cardiology and into territory that felt personally intrusive — more akin to an unsought mental health assessment than a cardiology review.

What upset me further was that toward the end of the consultation, the consultant advised me to consider seeing a psychoanalyst privately. I asked whether they would be putting that recommendation in the letter to my GP. They said they would not. I left the consultation confused, unsupported, and emotionally shaken. It felt like a suggestion that carried no practical support or clinical accountability — as though I had been handed a vague suggestion and left to pursue it alone.

I am due a follow-up cardiology consultation in one year and a repeat echocardiogram in three years. I would prefer my future annual follow-up to be scheduled with a different consultant cardiologist within the Belfast Trust, ideally not at Royal Victoria Hospital, as I would find it very uncomfortable to see this same consultant again.

I want to continue receiving cardiology care within the Trust and have always valued the service I’ve received. My intention is not to undermine the consultant’s clinical experience or escalate unnecessarily, but to highlight a serious concern about professional boundaries and patient wellbeing.

No cardiology consultation should leave a patient feeling interrogated, diminished, or emotionally destabilised. This one did.

Thank you for taking the time to read this and for providing a platform that allows patients to be heard.