Cardiology is the study of and treatment of heart and blood vessel disorders. Any individual with cardiovascular disease or heart disease may be referred to a cardiologist.
Cardiology is an internal branch of medicine. A cardiologist is not necessarily the same as a cardiac surgeon. A cardiac surgeon will open the chest and perform heart surgery.
A cardiologist specializes in cardiovascular disease diagnosis and treatment. The cardiologist may conduct examinations, and they can conduct other procedures, such as heart catheterization, angioplasty, or pacemaker insertion.
Heart disease is specific to the heart, while cardiovascular disease affects the heart, blood vessels, or both.
To become a cardiologist in the United States, it is mandatory to complete four years of medical school, three years of internal medicine training, and a total of three years of cardiology specialization.
When would I need a cardiologist?
If a person has signs of a heart disease, they may be referred to a cardiologist by their doctor.
Symptoms which may imply a problem of heart include:
- shortness of breath
- chest pains
- changes in heart rate or rhythm
- high blood pressure
A cardiologist may perform a heart murmur test or an abnormal heart rhythm test.
Heart disorders which can be treated by a cardiologist include:
- atrial fibrillation
- congenital heart disease
- coronary heart disease
- congestive heart disease
- high blood cholesterol and triglycerides
- ventricular tachycardia
- high blood pressure, or hypertension
The cardiologist will provide guidance on how to avoid heart disease.
Even without signs, a person may need to see a cardiologist if they have a family history of heart disease or high cholesterol, are or were a smoker, have diabetes, or start a new exercise plan.
What does cardiology involve?
A cardiologist will review the medical history of a patient, and conduct a physical test.
They can check the weight, heart, lungs, blood pressure, and blood vessels of the person, and conduct some testing.
An interventional cardiologist may do procedures such as angioplasties, stenting, valvuloplasties, congenital heart defect corrections, and coronary thrombectomies.
They may also carry out or order tests as listed below:
Electrocardiogram (ECG, or EKG): tracks the heart’s electrical activity.
Ambulatory ECG: this tracks heart rhythms while the person is doing exercise or their daily work. Tiny metal electrodes are attached to the chest and connected to a Holter monitor by wires, which tracks the rhythms.
An exercise test, or stress test: this indicates changes in the rhythm of the heart as you rest and work out. This tests the heart’s strength, and limitations.
Echocardiogram: this is an ultrasound image that displays the heart chambers and surrounding areas structure and can demonstrate how well the heart functions.
Echocardiography, known as cardiac output, will calculate how efficiently the heart pumps blood. It can detect inflammation around the heart, known as pericarditis. Also, it may detect structural abnormalities or heart valve infections.
Cardiac catheterization: a small tube in or near the heart collects data and may help relieve a blockage. It can take pictures and check the functioning of the heart and the electrical system. Catheter-based techniques with fluoroscopy can be used to treat congenital cardiac, valvular, and coronary artery diseases.
Nuclear cardiology: nuclear imaging methods using radioactive materials for noninvasive study of cardiovascular conditions and diseases.
Examples include infarction imaging, computed tomography (SPECT) with single-photon emission, planar imaging, and myocardial perfusion imaging.
Cardiac electrophysiology is a Cardiology subspecialty. The doctor looks at how electric currents work inside the tissue of the heart muscle, how the current spreads and what the currents pattern means.
Electrophysiology study (EPS) of the heart: a catheter is threaded to a vein at the top of the leg in this study. Guided by fluoroscopy, it is making its way into the heart. In the heart, the catheter tests the electrical signals.
An EPS of the heart can:
- help to show what is causing symptoms
- help decide if a patient needs a pacemaker
- help decide the best treatment for patients with arrhythmia, or abnormal heart rhythm
- determine how likely a patient is to experience tachycardia or an accelerated heart beat
A cardiac electrophysiologist can provide treatment for abnormal rhythms including cardiac ablation, implantable cardioverter defibrillators, or pacemakers.
Choosing a cardiologist
The doctor sometimes refers patients to a cardiologist, however they may prefer to choose their own specialist.
The American Heart Association (AHA) urges people to make sure their cardiologist is accredited as a board member. This can be tested by patients through the American Board of Internal Medicine (ABIM) or the American Board of Family Medicine (ABFM).
Choosing a doctor whose communication style suits them, is also important.
If the cardiologist proposes a medication that appears dangerous or costly, or if the patient is unsure as to why they need this treatment, then the AHA suggests getting a second opinion.