What is Cardiology?
Cardiology is the study and treatment of disorders of the heart and the blood vessels. A person with heart disease or cardiovascular disease may be referred to a cardiologist.
Cardiology is a branch of internal medicine. A cardiologist is not the same as a cardiac surgeon. A cardiac surgeon opens the chest and performs heart surgery.
A cardiologist specializes in diagnosing and treating diseases of the cardiovascular system. The cardiologist will carry out tests, and they may perform some procedures, such as heart catheterizations, angioplasty, or inserting a pacemaker.
Heart disease relates specifically to the heart, while cardiovascular disease affects the heart, the blood vessels, or both.
To become a cardiologist in the United States, it is necessary to complete 4 years of medical school, 3 years of training in internal medicine, and at least 3 years specializing in cardiology.
Types of Cardiovascular Diseases
Arteriosclerosis Disease
Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff — sometimes restricting blood flow to your organs and tissues. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. A blood pressure reading is given in millimeters of mercury (mm Hg)
Arrhythmia
Heart rhythm problems (heart arrhythmias) occur when the electrical impulses that coordinate your heartbeats don’t work properly, causing your heart to beat too fast, too slow or irregularly.
Heart arrhythmias (uh-RITH-me-uhs) may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.
Congenital Heart Disease
If your child has a congenital heart defect, it means that your child was born with a problem in the structure of his or her heart.
Some congenital heart defects in children are simple and don’t need treatment. Other congenital heart defects in children are more complex and may require several surgeries performed over a period of several years.
Learning about your child’s congenital heart defect can help you understand the condition and know what you can expect in the coming months and years.
Cardiac Arrest
Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from a problem with your heart’s electrical system, which disrupts your heart’s pumping action and stops blood flow to your body.
Sudden cardiac arrest isn’t the same as a heart attack, when blood flow to a part of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest.
Heart Failure
Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn’t pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.
Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer. Lifestyle changes — such as exercising, reducing sodium in your diet, managing stress and losing weight — can improve your quality of life.
When would I need a Cardiologist?
If a person has symptoms of a heart condition, their physician may refer them to a cardiologist.
Symptoms that can indicate a heart problem include:
- Shortness of breath
- Dizziness
- Chest pains
- Changes in heart rate or rhythm
- High blood pressure
What does cardiology involve?
A cardiologist will review a patient’s medical history and carry out a physical examination. They may check the person’s weight, heart, lungs, blood pressure, and blood vessels, and carry out some tests.
An interventional cardiologist may carry out procedures such as angioplasties, stenting, valvuloplasties, congenital heart defect corrections, and coronary thrombectomies.
Tests
- Electrocardiogram (ECG or EKG): This records the electrical activity of the heart.
- Ambulatory ECG: This records heart rhythms while the person carries out exercise or their regular activities. Small metal electrodes are stuck on to the chest, and these are connected by wires to a Holter monitor, which records the rhythms.
- An exercise test, or stress test: This shows the changes of heart rhythm when resting and exercising. It measures the performance and limitations of the heart.
- Echocardiogram: This provides an ultrasound picture that shows the structure of the heart chambers and surrounding areas, and it can show how well the heart is working. Echocardiography can measure how well the heart is pumping blood, known as cardiac output. It can detect inflammation around the heart, known as pericarditis. It can also identify structural abnormalities or infections of the heart valves.
- 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 techniques use radioactive materials to study cardiovascular disorders and diseases in a noninvasive way.
- Examples are infarction imaging, single-photon-emission computed tomography (SPECT), planar imaging, and myocardial perfusion imaging.
Cardiac Electrophysiology
Cardiac electrophysiology is a subspecialty of cardiology. The physician looks at how electric currents inside the heart muscle tissue work, how the current spreads, and what the pattern of the currents means.
Electrophysiology study (EPS) of the heart: in this test, a catheter is threaded into a vein at the top of the leg. Guided under fluoroscopy, it makes its way to the heart. The catheter measures the electrical signals within the heart.
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.
Cardiac Treatments
Angioplasty and Stents
Coronary angioplasty (AN-jee-o-plas-tee), also called percutaneous coronary intervention, is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to help widen it and improve blood flow to your heart.
Coronary Artery Bypass Graft Surgery
Coronary bypass surgery redirects blood around a section of a blocked or partially blocked artery in your heart. The procedure involves taking a healthy blood vessel from your leg, arm or chest and connecting it below and above the blocked arteries in your heart. With a new pathway, blood flow to the heart muscle improves.
Heart Valve Surgery
Pacemakers
Implantable cardioverter defibrillator (ICD)
Prevention
Heart disease is a leading cause of death, but it’s not inevitable. While you can’t change some risk factors — such as family history, sex or age — there are plenty of ways you can reduce your risk of heart disease.
Get started with these seven tips for boosting your heart health:
- Don’t smoke or use tobacco: One of the best things you can do for your heart is to stop smoking or using smokeless tobacco. Even if you’re not a smoker, be sure to avoid secondhand smoke.
- Get moving: Aim for at least 30 to 60 minutes of activity daily: Regular, daily physical activity can lower your risk of heart disease. Physical activity helps you control your weight and reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and type 2 diabetes.
- Eat a heart-healthy diet: A healthy diet can help protect your heart, improve your blood pressure and cholesterol, and reduce your risk of type 2 diabetes. A heart-healthy eating plan includes: Vegetables and fruits, Beans or other legumes, Lean meats and fish, Low-fat or fat-free dairy foods, Whole grains, Healthy fats, such as olive oil
- Maintain a healthy weight: Being overweight — especially around your middle — increases your risk of heart disease. Excess weight can lead to conditions that increase your chances of developing heart disease — including high blood pressure, high cholesterol and type 2 diabetes.
- Get good quality sleep: A lack of sleep can do more than leave you yawning; it can harm your health. People who don’t get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes and depression.
- Manage stress: Some people cope with stress in unhealthy ways — such as overeating, drinking or smoking. Finding alternative ways to manage stress — such as physical activity, relaxation exercises or meditation — can help improve your health.
- Get regular health screenings: High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won’t know whether you have these conditions