Written by Todd Neff on behalf of National Jewish Health
Cardiology is a medical specialty with many subspecialties. Intimidating names are common: electrophysiologist, interventional cardiologist, cardio-oncologist. If concerns about your heart are leading you to seek out expert help, the choices can seem daunting.
Fortunately, you don’t have to do the choosing. Clinical cardiologists are heart specialists with a broad viewpoint. They lead the diagnosis and treatment of heart and heart-related problems. They work with other heart specialists to make sure you’re getting the best-possible care.
Still, it’s helpful to know what cardiac specialists do. Sometimes the diagnosis and treatment depends on the type of cardiologist providing those services.
Clinical cardiologists – or, more often, “general cardiologists” or simply “cardiologists” – work with patients and their primary care doctors to diagnose and treat heart and cardiovascular problems. They are familiar with many diagnostic tools, including advanced cardiac imaging, and are well versed in a wide variety of treatments. Crucially, they know when to tap into the expertise of more specialized cardiologists. Think of clinical cardiologists as the quarterbacks of heart-related care.
Cardiac Imaging Specialist
Pinpointing a diagnosis in cardiology has traditionally been accomplished with ultrasound (echocardiography) and nuclear imaging to evaluate blood flow during stress tests. More recently, advanced diagnostic testing with magnetic resonance (MRI) and computed tomography (CT) has emerged. Cardiac imaging specialists are trained to use these tools to the greatest possible effect in diagnosing heart and cardiovascular problems. In doing so, they can provide clinical cardiologists and other specialists with the details they need to provide the most effective care.
Heart surgeons operate on the heart and the aorta to correct problems that medications, medical devices, and the minimally invasive approaches of electrophysiologists and interventional cardiologists can’t address. Cardiac surgeons perform coronary artery bypass grafting to ensure blood flow despite clogged arteries, repair or replace diseased heart valves, repair aortic aneurysms, install ventricular assist devices (VADs), and transplant hearts, among other procedures.
Cardio-oncologists work with patients who are undergoing or have undergone chemotherapy, radiation therapy, and other cancer treatments. These treatments, while crucial in treating cancer, can be hard on the heart and cause a disease called cardiotoxicity. Cardio-oncologists keep up on emerging cancer therapies and research on how those therapies affect the heart and blood vessels. Working with a cardio-oncologist during cancer treatment can lead to modifications that help cancer care continue while protecting the heart. Cancer survivors can benefit by catching heart problems triggered by prior cancer treatments earlier.
Electrophysiologists are experts in diagnosing and treating electrical problems in the heart that cause abnormal heartbeats (arrythmias). These specialists can address problems by implanting pacemakers and implantable defibrillators. They also can pinpoint where in the heart an electrical disturbance is coming from. Using minimally invasive techniques such as cardiac ablation therapy, they can correct the problem.
Interventional cardiologists use catheters to repair a wide variety of heart problems that once required risky open surgeries with long recovery times. These catheters enter blood vessels through small incisions near the neck or groin. They can place angioplasty balloons (to open arteries narrowed by plaque) and stents (to keep the arteries open). Interventional cardiologists can repair or replace heart valves. They also can fix heart abnormalities through these minimally invasive procedures.
Heart Failure Specialist
Heart failure specialists diagnose and treat heart failure, a condition affecting more than 6 million people in the United States alone. These physicians keep tabs on a growing number of medications and medical devices that can slow the progression of the disease and improve patients’ quality of life. Cardiologists with advanced heart failure expertise are also best to determine when heart transplantation is needed.
Pulmonary Hypertension Specialist
Pulmonary hypertension happens when blood pressure is elevated in the lung arteries. This can place added stress on the right side of the heart. The right side of the heart isn’t accustomed to that stress, and, over time, it can cause heart failure. Pulmonary hypertension specialists are expert in the complex interplay between the heart and the lungs, and the medications used to treat this condition.
Women’s Heart Specialist
Women’s hearts may beat the same way as men’s hearts do, but their risk factors for heart problems are different. For example, women can have heart attacks at older ages than men. Smoking, high blood pressure, high blood cholesterol, and other factors raise the risk of having a heart attack more than with men. Add to that the risk of heart problems created by a history of preeclampsia during or after pregnancy. Women’s heart specialists focus on diagnosing and treating heart problems among women.
More Cardiologists Still
While the above may cover a lot of cardiac-specialist ground, it’s not an all-inclusive list. That would include congenital heart specialists, preventive cardiologists, cardiac rehabilitation specialists, cardio-rheumatologists, critical care cardiologists, geriatric cardiologists and pediatric cardiologists, among others. The good news is, you don’t have choose. Your cardiologist will do that for you.