Expert heart care, close to home
Compassionate, personal heart care in Whangārei: consultation, echocardiography, rhythm monitoring and coronary CT, from a physician who looks after the whole person, not just the heart.
Professional portrait of Dr NandraDr Raj NandraNau mai, haere mai
Your heart’s health comes first
This is a single-physician practice: you see Dr Nandra himself, and we care for you as a person, not just a heart.
Most tests are done here, so you do not need to travel to Auckland. Your consultation, tests and results are coordinated by one caring team, so you get answers sooner and your GP stays informed.
Dr Nandra is also a specialist physician, so he looks at the conditions around the heart too — diabetes, kidney function, breathing and multiple medications.
See Dr Nandra personally
One doctor who knows you, with care built around you.
Tests done here
Echo, ECG, monitoring, calcium score and CTCA. No trip to Auckland.
A clear written plan
Explained in plain language, with a letter to you and your GP.
Southern Cross & nib
Affiliated provider. Wheelchair access at 4 Vinery Lane.
Comprehensive care for your heart
Select any service to read more.
Specialist consultation
A thorough assessment of your heart and general health with Dr Nandra, a specialist physician and cardiologist, with a written plan for you and your GP.
Learn more →ECG & rhythm monitoring
Resting and exercise ECG, 24-hour Holter monitoring and 1–2 week event monitoring to find out what your heart rhythm is doing when you have symptoms.
Learn more →Echocardiography
An ultrasound scan of the heart that shows how well it pumps, how the valves work and, with a stress echo, how well the muscle gets its blood supply.
Learn more →24-hour blood pressure & spirometry
Ambulatory blood pressure monitoring shows your blood pressure through a normal day and night, and spirometry measures how well your lungs work.
Learn more →Elective electrical cardioversion
A planned procedure to restore a normal heart rhythm in selected patients with atrial fibrillation or atrial flutter.
Learn more →Cardiac CT
Coronary CT gives a detailed look at the heart’s arteries and can often avoid the need for an invasive angiogram.
Learn more →Don’t wait for an appointment — call 111. If your condition changes before your appointment, see your GP immediately.
Your heart deserves expert care
Ask your GP for a referral, then contact us. We are here to help you take the next step.
Dr Raj Nandra
MBBS, MD, FRACP, Associate FCSANZSpecialist Physician & Non-Interventional Cardiology, Whangārei
Caring for the hearts of Northland, with expertise earned across three countries.
Kia ora, I’m Raj Nandra. I trained in South India, graduating MBBS from Sri Venkateswara Medical College, Tirupati, in 1997 and completing my MD in General Medicine there in 2001. I then gained further experience in general cardiology at the Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, where I developed early expertise in echocardiography and the management of cardiac emergencies.
In 2002 I moved to the United Kingdom and spent several years working in hospitals across Cardiff and the South Wales valleys. Roles spanning cardiology, neurology, nephrology, endocrinology and stroke medicine gave me a broad and thorough grounding in internal medicine.
Drawn to New Zealand, I worked in Auckland, Tauranga, Hawke’s Bay and Palmerston North before making Whangārei my home, where I have practised as a Specialist Physician and Non-Interventional Cardiology since 2012. I am a Fellow of the Royal Australasian College of Physicians (FRACP) and an Associate Fellow of the Cardiac Society of Australia and New Zealand (CSANZ). I look forward to caring for you and your whānau.
Experience
- Cardiology
- Assessment and ongoing care of people with acute and chronic heart problems, including those needing heart surgery or valve procedures.
- Acute and general medicine
- Years of managing acutely unwell patients and the full range of medical conditions, including on-call work.
- Outpatient care
- Medical and cardiology clinics for people with chronic and complex conditions, including clinics in regional centres.
Areas of interest
- Cardiac CT
- After advanced training in comprehensive cardiac CT (AICCT, Sydney), he established the service at Whangārei Hospital.
- Atrial fibrillation
- A special interest in new and complex AF, working with the Electrophysiology team at Auckland City Hospital.
- Echocardiography
- Experienced in transthoracic echo.
- Clinical research
- As a Principal Investigator, he has been part of several international cardiology research projects.
Thorough, clear and personal
Thorough
A comprehensive, methodical assessment that takes your full history into account, so that nothing is overlooked.
Clear
Clear explanations in plain language, so that you fully understand your diagnosis and can make informed decisions about your care.
Personal
Care built around you and your family, with continuity from one visit to the next.
Experienced
Experience from India, the UK and New Zealand, and dedicated to the people of Northland since 2012.
The people behind your care
Cardiac conditions
Start with what you’re feeling. Open a topic to read what it might mean and which tests usually help.
Conditions we assess and manage
HypertensionPersistently raised blood pressure, which strains the heart and arteries.Read more
- Common signs
- Often no symptoms at all, which is why blood pressure is checked.
- How it is assessed
- Clinic readings and 24-hour blood pressure monitoring; an ECG or echo if the heart may be affected.
- How it is managed
- Lifestyle changes (less salt, activity, healthy weight), medicines when needed, and regular review with your GP.
Get urgent help if: Very high readings with chest pain, severe headache, vision changes or breathlessness. Call 111.
Cholesterol managementLowering high cholesterol and other blood fats to reduce the risk of heart attack and stroke.Read more
- Common signs
- High cholesterol causes no symptoms. It is found with a blood test.
- How it is assessed
- Blood tests and an overall risk review (blood pressure, diabetes, family history). A calcium score can help when risk is unclear.
- How it is managed
- Healthy eating, activity, and cholesterol-lowering medicines when appropriate, with regular blood tests.
Get urgent help if: Chest pain or breathlessness. These are not caused by cholesterol itself, but need prompt assessment. Call 111.
Diseases of the aortaProblems with the body’s main artery, such as widening (aneurysm) or tears.Read more
- Common signs
- Often none. Sudden severe chest or back pain is an emergency.
- How it is assessed
- Examination, echocardiography and imaging such as CT, depending on the problem.
- How it is managed
- Monitoring the size of the aorta, careful blood pressure control, and referral to a surgeon if treatment is needed.
Get urgent help if: Sudden, severe tearing pain in the chest, back or abdomen. Call 111.
Atrial fibrillationAn irregular, often fast, heart rhythm from the upper chambers that raises the risk of stroke.Read more
- Common signs
- Palpitations, breathlessness, tiredness or dizziness, though some people feel nothing.
- How it is assessed
- ECG, Holter or event monitoring, echocardiography and blood tests.
- How it is managed
- Reducing stroke risk (including blood thinners where appropriate), controlling the heart rate or rhythm, and cardioversion in selected patients.
Get urgent help if: Face drooping, arm weakness or speech difficulty (possible stroke), chest pain or fainting. Call 111.
ArrhythmiasHeartbeats that are too fast, too slow or irregular.Read more
- Common signs
- Racing, skipping or fluttering heartbeats, dizziness or fainting.
- How it is assessed
- ECG, Holter or event monitoring, and echocardiography to check the heart.
- How it is managed
- Depends on the type: monitoring, medicines, or referral for specialist treatment.
Get urgent help if: Palpitations with chest pain, severe breathlessness or fainting. Call 111.
Preventive heart diseaseLowering your risk of heart disease before it develops, or stopping it getting worse, through risk assessment, medicines and lifestyle changes.Read more
- Common signs
- Usually none. This is about preventing problems.
- How it is assessed
- A risk review: blood pressure, cholesterol, diabetes, smoking, family history, and sometimes a calcium score.
- How it is managed
- Lifestyle changes, treating risk factors, and medicines where they will help.
Get urgent help if: Chest pain or breathlessness. See your GP promptly. Call 111.
Cardiac screeningChecking for heart disease before symptoms develop, using a risk assessment and tests such as a calcium score.Read more
- Common signs
- Usually none. Screening is for people without symptoms.
- How it is assessed
- A risk assessment, resting ECG and blood pressure check, and a CT calcium score when it will help.
- How it is managed
- Results are explained and turned into a plan, which may be lifestyle changes or treatment.
Get urgent help if: Symptoms such as chest pain. See your GP promptly rather than waiting for screening. Call 111.
Coronary artery diseaseNarrowing of the heart’s arteries by plaque, reducing blood flow to the heart muscle.Read more
- Common signs
- Chest pain or tightness on effort, breathlessness or unusual tiredness.
- How it is assessed
- ECG, exercise ECG or stress echo, calcium score, and CT coronary angiography.
- How it is managed
- Medicines, controlling risk factors, and referral for angiogram, stent or bypass surgery when needed.
Get urgent help if: Chest pain at rest, or crushing pain that spreads to the arm, jaw or back. Call 111.
Valvular heart diseaseA heart valve that is narrowed or leaks, making the heart work harder.Read more
- Common signs
- Breathlessness, tiredness, swollen ankles or dizziness, sometimes only a heart murmur.
- How it is assessed
- Listening to the heart, echocardiography and an ECG.
- How it is managed
- Regular monitoring, medicines, and referral for valve repair or replacement when needed.
Get urgent help if: Sudden breathlessness, fainting or chest pain. Call 111.
CardiomyopathyDisease of the heart muscle that makes it harder for the heart to pump.Read more
- Common signs
- Breathlessness, tiredness, swelling, palpitations or fainting.
- How it is assessed
- Echocardiography, ECG, rhythm monitoring and blood tests, sometimes further imaging.
- How it is managed
- Medicines, monitoring, and checking close family members when the condition may be inherited.
Get urgent help if: Fainting, chest pain or severe breathlessness. Call 111.
Heart failureThe heart does not pump as well as the body needs, causing breathlessness, tiredness and fluid build-up.Read more
- Common signs
- Breathlessness, tiredness, swollen ankles and weight gain from fluid.
- How it is assessed
- Echocardiography, ECG and blood tests.
- How it is managed
- Medicines, advice on salt and fluids, treating the cause, and regular review.
Get urgent help if: Sudden or severe breathlessness, being unable to lie flat, or chest pain. Call 111.
Pericardial diseaseProblems with the sac around the heart, such as inflammation or fluid.Read more
- Common signs
- Sharp chest pain that eases when leaning forward, fever or breathlessness.
- How it is assessed
- ECG, echocardiography and blood tests.
- How it is managed
- Treating the cause, anti-inflammatory medicines, and draining fluid in hospital if needed.
Get urgent help if: Severe chest pain, severe breathlessness or fainting. Call 111.
Not sure if your condition is listed? Call (09) 438 7477 or ask your GP.
Common symptoms
SymptomChest pain or tightness
Chest pain has many causes, and most are not the heart. The aim is to work out, safely and quickly, whether yours is — often with a stress test or coronary CT.
What it might mean
Chest pain or tightness can come from the heart, but also from muscles, the oesophagus, the lungs or anxiety.
Heart-related pain is often a pressure or tightness brought on by effort or stress and eased by rest, and may spread to the arm, jaw or back — but it does not always look like this.
Because it is hard to tell from the symptom alone, a proper assessment is worthwhile.
Which tests usually help
Depending on your history, Dr Nandra may recommend an exercise ECG, a stress echo, a calcium score or CT coronary angiography. CT coronary angiography can often avoid the need for an invasive angiogram.
Specialist consultation · ECG & rhythm monitoring · Echocardiography · Calcium score & CT coronary angiography
- Severe, crushing or spreading chest pain
- Chest pain with breathlessness, sweating, nausea or feeling faint
- Pain that is getting worse or does not settle with rest
SymptomPalpitations or an irregular heartbeat
Feeling your heart race, skip or flutter is common and often harmless, but sometimes points to a rhythm problem such as atrial fibrillation. Catching the rhythm during symptoms is the key.
What it might mean
Palpitations are an awareness of your heartbeat. They can be triggered by caffeine, stress, illness or thyroid problems, or by an abnormal heart rhythm.
Atrial fibrillation is a common rhythm problem that raises the risk of stroke, so finding it matters.
Because palpitations come and go, a single ECG can miss them, which is why monitoring over a day or more is often used.
Which tests usually help
An ECG, a 24-hour Holter monitor or a 1–2 week event monitor can record the rhythm. If atrial fibrillation or flutter is found, treatment options can include elective cardioversion in selected patients.
ECG & rhythm monitoring · Specialist consultation · Echocardiography · Elective electrical cardioversion
- Palpitations with chest pain, severe breathlessness or fainting
- A very fast heartbeat that does not settle
SymptomBreathlessness or swollen ankles
Getting short of breath more easily, or noticing swollen ankles, can be due to the heart, the lungs or other conditions. How well the heart pumps and how the valves work can be checked with echocardiography, and the lungs with spirometry.
What it might mean
Breathlessness has many causes, including heart problems, lung disease, anaemia and being unfit.
Swollen ankles can be a sign of the heart not pumping as well as it should, but can also come from veins, kidneys, medicines or other causes.
Dr Nandra is also a specialist physician, so he can look at the heart, lungs, kidneys and medicines together.
Which tests usually help
An echocardiogram shows how well the heart pumps and how the valves work. Spirometry measures lung function, which helps separate heart causes from lung causes.
Specialist consultation · Echocardiography · 24-hour blood pressure & spirometry · ECG & rhythm monitoring
- Sudden or severe breathlessness
- Breathlessness lying flat or waking you at night
- Breathlessness with chest pain or fainting
SymptomDizziness or fainting
Dizziness and blackouts can be caused by slow or fast heart rhythms, valve problems or blood pressure changes, as well as by many non-heart causes. A careful assessment looks for those that matter.
What it might mean
Fainting is usually harmless, but sometimes it is the first sign of a heart rhythm or valve problem, so it is worth checking, especially if it happens without warning or during exercise.
Blood pressure dropping on standing, dehydration and some medicines are common causes.
A history of exactly what happens before, during and after an episode is very helpful, and a witness account can help.
Which tests usually help
Tests may include an ECG, Holter or event monitoring to look for rhythm problems, an echocardiogram to check the heart and valves, and blood pressure assessment.
Specialist consultation · ECG & rhythm monitoring · Echocardiography · 24-hour blood pressure & spirometry
- Fainting during exercise or without any warning
- Fainting with chest pain, palpitations or breathlessness
- Fainting with a head injury
RiskHigh blood pressure or cholesterol
High blood pressure and cholesterol usually cause no symptoms, but they raise the risk of heart attack and stroke. 24-hour blood pressure monitoring and a clear plan can bring your risk down.
What it might mean
A single reading in a clinic can be higher (or lower) than your usual blood pressure. 24-hour monitoring shows what it does through a normal day and night.
Treatment decisions work best when blood pressure, cholesterol, diabetes, kidney function and other risks are considered together.
Dr Nandra, as a specialist physician as well as a cardiologist, looks at the whole picture, including the medicines you already take.
Which tests usually help
Ambulatory blood pressure monitoring can confirm whether treatment is needed or working. A calcium score can help show your risk when it is unclear.
24-hour blood pressure & spirometry · Specialist consultation · Calcium score & CT coronary angiography · Echocardiography
- Very high readings together with headache, chest pain, vision changes or breathlessness
PreventionA heart health check
Family history, or worried about your risk? A coronary calcium score can show where you stand, and a specialist assessment can turn that into a clear plan.
What it might mean
Some people have no symptoms but have risk factors such as a family history, high blood pressure, high cholesterol, diabetes or smoking.
A CT coronary calcium score measures calcium in the walls of the heart’s arteries, which helps estimate your risk of heart disease.
The results are combined with your other risk factors to decide whether you need treatment or lifestyle changes.
Which tests usually help
A health check can include a consultation, resting ECG, blood pressure assessment and a CT calcium score, depending on your situation.
Calcium score & CT coronary angiography · Specialist consultation · 24-hour blood pressure & spirometry · ECG & rhythm monitoring
- If you have symptoms such as chest pain or breathlessness, please see your GP promptly rather than waiting for a routine check
Don’t wait for an appointment — call 111.
Procedures & tests
Most tests done here — no trip to Auckland. Open a service to see what it involves and what to expect.
Assessment
Heart imaging
Rhythm & monitoring
Procedures
What each service involves
ConsultationSpecialist consultation
A thorough assessment of your heart and general health with Dr Nandra, a specialist physician and cardiologist, with a written plan for you and your GP.
What it involves
Dr Nandra takes a detailed history, examines you and reviews any previous tests, letters and medicines.
Because he is a specialist physician as well as a cardiologist, he also considers conditions that affect the heart, such as diabetes, kidney function, breathing problems and the effect of taking several medicines.
Where tests are needed, most can be arranged through the same team.
When it can help
- Chest pain or tightness
- Palpitations or an irregular heartbeat
- Breathlessness or swollen ankles
- Dizziness or fainting
- High blood pressure or cholesterol
- A family history of heart disease
What to expect
- Your GP refers you, then you contact us to make your appointment.
- Bring your current medicines and any relevant letters or reports. A support person is welcome.
- Dr Nandra explains what he found and the options for your care.
- A letter goes to your GP, with a copy to you.
RhythmECG & rhythm monitoring
Resting and exercise ECG, 24-hour Holter monitoring and 1–2 week event monitoring to find out what your heart rhythm is doing when you have symptoms.
What it involves
An ECG records the heart’s electrical activity. A resting ECG takes a few minutes; an exercise ECG records it while you walk on a treadmill.
A Holter monitor is a small recorder worn for 24 hours while you go about your day.
An event monitor is worn for one to two weeks, which helps when symptoms come and go.
When it can help
- Palpitations, racing or skipping heartbeats
- Dizziness, light-headedness or fainting
- Suspected atrial fibrillation
- Chest symptoms on exertion
What to expect
- A technician attaches small sticky electrodes to your chest.
- For Holter and event monitors, you’re shown how to wear and use the device and what to note down.
- The recording is analysed and reviewed by Dr Nandra.
- Results and the next steps are explained to you, and sent to your GP.
Wear a top that is easy to remove or open. Exercise ECG: wear comfortable shoes and clothing.
Heart imagingEchocardiography
An ultrasound scan of the heart that shows how well it pumps, how the valves work and, with a stress echo, how well the muscle gets its blood supply.
What it involves
A resting echo uses an ultrasound probe on the chest to produce moving pictures of the heart. It is painless and uses no radiation.
A bubble study uses a small amount of saline to look for a hole between the heart’s chambers.
An exercise stress echo records images before and straight after exercise, to look for signs of reduced blood supply.
When it can help
- Breathlessness or swollen ankles
- A heart murmur
- Suspected heart failure or valve disease
- Chest pain assessment (stress echo)
- Monitoring of a known heart condition
What to expect
- You lie on your side on a couch while the scan is done. A scan can take from about 10 minutes to an hour, depending on the test.
- For a stress echo, you exercise on a treadmill under supervision.
- Your results are reviewed by Dr Nandra and sent to your GP.
Preparation depends on the test (for example, stress echo). We’ll tell you what to do when you book.
Calcium score & CT coronary angiographyCardiac CT
Coronary CT gives a detailed look at the heart’s arteries and can often avoid the need for an invasive angiogram. Dr Nandra established the Cardiac CT service at Whangārei Hospital.
Calcium score
A CT coronary calcium score is a quick scan of the heart that measures the amount of calcium in the walls of the coronary arteries. It needs no injection.
Calcium is a marker of plaque build-up. A score of zero is reassuring; higher scores mean more plaque and a higher risk of future heart problems.
The scan takes only a few minutes and uses a low radiation dose.
When it can help
- People without symptoms who want to know their risk
- A family history of heart disease
- Borderline blood pressure or cholesterol, to help decide on treatment
CT coronary angiography (CTCA)
CT coronary angiography uses contrast dye given through a vein, and a CT scan timed to the heartbeat, to show the coronary arteries in detail.
It can show whether arteries are narrowed or blocked, and the type of plaque, so it is often used to assess chest pain. A normal result can often avoid the need for an invasive angiogram.
You may be given medicine to slow your heart rate so the pictures are clear.
When it can help
- Chest pain, to work out whether it is coming from the heart
- Known or suspected coronary artery disease
- Avoiding an invasive angiogram where appropriate
What to expect
- These are arranged on a CT request form from Dr Nandra.
- The scan itself is quick. CTCA involves contrast dye through a drip, and your heart rate may need to be slowed.
- Dr Nandra reviews the images, explains the results and the options, and writes to your GP.
CTCA usually needs some preparation (such as food, caffeine and medicines). We’ll give you exact instructions when you book.
Blood pressure & lungs24-hour blood pressure & spirometry
Ambulatory blood pressure monitoring shows your blood pressure through a normal day and night, and spirometry measures how well your lungs work.
What it involves
For 24-hour monitoring, you wear a small cuff and recorder that takes readings automatically through the day and night. This is often more reliable than a single reading in a clinic.
Spirometry is a breathing test: you blow into a mouthpiece so we can measure airflow and lung volumes.
Dr Nandra is a nib and Southern Cross provider for cardiology, internal medicine and lung function.
When it can help
- Raised blood pressure readings
- Checking whether blood pressure treatment is working
- Breathlessness or a long-term cough
- Separating heart causes from lung causes of breathlessness
What to expect
- The cuff is fitted at the clinic and you go about your normal day, returning the device afterwards.
- Spirometry takes a short time and involves several firm breaths out.
- Results are reviewed by Dr Nandra and discussed with you and your GP.
Wear loose sleeves for blood pressure monitoring. Instructions for spirometry (such as inhalers) will be given when you book.
TreatmentElective electrical cardioversion
A planned procedure to restore a normal heart rhythm in selected patients with atrial fibrillation or atrial flutter.
What it involves
In atrial fibrillation or flutter, the upper chambers of the heart beat irregularly or too fast.
Elective electrical cardioversion delivers a controlled electrical shock to the heart, under sedation or anaesthetic, to reset it to a normal rhythm.
Whether it is suitable depends on your history, medicines and tests. Dr Nandra assesses this first.
When it can help
- Atrial fibrillation or flutter causing symptoms
- Selected patients where restoring the rhythm is appropriate
What to expect
- You first have a consultation and any tests needed, including blood-thinning and rhythm assessment.
- The procedure is planned, and you’ll be given clear instructions before and after.
- Dr Nandra follows up with you and your GP.
Detailed preparation and where the procedure takes place will be explained at your consultation.
If you need a procedure such as an invasive angiogram, stent or valve surgery, we arrange referral and stay involved in your care.
Your visit, step by step
What to expect from referral to follow-up.
Get referred
Your GP will refer you. Contact us on (09) 438 7477 or reception@vinerylane.surgery to make your appointment.
Your appointment
Bring your medicines and any letters or reports. A support person is welcome. Please arrive about 15 minutes early.
Tests, if needed
Most tests — echo, ECG, monitoring, calcium score and CTCA — are arranged through the same team.
A clear plan
We explain what we found and the options. A letter goes to your GP, with a copy to you.
Questions? We’re here to help
Can’t find your answer? Call (09) 438 7477.
Insurance
Dr Nandra is a Southern Cross Affiliated and nib provider for cardiology, internal medicine and lung function. We submit claims directly for members.
Do I need a referral to see a cardiologist?
Yes. A GP referral is required — your GP will refer you.
What should I bring to my appointment?
Your current medicines and any relevant letters or reports. A support person is welcome. Recent local radiology is available online.
Do you work with my health insurance?
Dr Nandra is a Southern Cross Affiliated and nib provider for cardiology, internal medicine and lung function. We submit claims directly for Southern Cross and nib members.
Which tests can I have here?
Consultations and follow-ups, ECG, exercise ECG, echocardiography, bubble study, exercise stress echo, Holter and event monitoring, 24-hour blood pressure monitoring, spirometry, calcium scoring, CT coronary angiography and elective cardioversion. See procedures & tests.
Is the clinic wheelchair accessible?
Yes, wheelchair access is available at 4 Vinery Lane.
What if my condition changes before my appointment?
See your GP immediately. In an emergency, call 111.
Privacy
We collect and hold your health information to provide your care, in line with the Health Information Privacy Code 2020 and the Privacy Act 2020. We share it only with people involved in your care, such as your GP, other specialists, hospitals and testing services, or where the law requires or allows it. If you are insured, we share what your insurer needs to process your claim with your consent.
Your records are stored securely. You can ask to see or correct the information we hold about you at any time by contacting us on (09) 438 7477 or reception@vinerylane.surgery. If you have a privacy concern you can also contact the Office of the Privacy Commissioner at privacy.org.nz.
For GPs & referrers
Easy referral, fast letters back.
Consultation and Investigations
Consultation and investigations, with a clear management plan for ongoing care in the community. Urgent appointments can be provided within a week, and correspondence is sent within 2 to 3 days.
Location & contact
Find us in Vinetown, Whangārei.
4 Vinery Lane
Vinetown, Whangārei
Northland 0110
(09) 438 7477
(09) 438 7478
drnandra
4 Vinery Lane, Vinetown
Whangārei, Northland 0110
PO Box 201
Whangārei Central 0110
Request an appointment
A GP referral is required. Once you have one, call or email us and we’ll arrange a time that suits you.
Please include your name, phone number and referring GP, but don’t send detailed medical information by email. In an emergency, call 111.