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Cardiology is a speciality of medicine that deals with diseases of the heart. The doctors who specialise in this field are known as cardiologists. They are trained in diagnosing and treating conditions of the heart such as congenital heart diseases, infections, infarctions, heart failure, or valvular heart diseases.
There is a multitude of disorders of the cardiovascular system that need individual attention and clinical expertise to be treated. These include acute coronary syndrome, atherosclerosis, angina pectoris, coronary heart disease, and restenosis.
Other common disorders include cardiac arrest; disorders of the myocardium, or the muscle of the heart, known as cardiomyopathy, disorders of the pericardium, or the outer lining of the heart, which include types of pericarditis diseases of the valves such as aortic, mitral, pulmonary and tricuspid valves; congenital heart defects, like an atrial or ventricular septal defect, certain diseases of the blood vessels, known as vascular diseases, such as deep vein thrombosis, varicose veins, aneurysm, vasculitis, and others.
Cardiologists not only limit themselves to surgical treatment modalities but also have expertise in using several devices such as balloons and defibrillators, a pacemaker, and a stethoscope used for diagnosing and treating numerous heart ailments.
Cardiologists use some strategies to combat cardiovascular diseases, such as percutaneous coronary intervention, percutaneous transluminal angioplasty, coronary artery bypass surgery, and stenting. Cardiologists also use different diagnostic methods such as computed tomography (CT scans), cardiac stress tests, echocardiography or electrocardiography, blood tests, and magnetic resonance imaging (MRI) techniques.
Cardiologists require more than ten years of studies that include internal medicine and specialised programs to become qualified practitioners. After they receive their licensure and certification, they practice at private or public hospitals or start with their own private clinics.
Types of cardiology
The different types of cardiology categories can be described as follows:
- Cardiac Electrophysiology
- Interventional cardiology
- Echocardiography
- Nuclear Cardiology
On the other hand, cardiologists can specialise in the following fields:
- Clinical cardiology
- Cardio-oncology
- Heart failure specialist
- Cardiac imaging specialist
- Congenital heart specialist
- Peripheral interventional specialist
- Critical care cardiologist
- Sports cardiologist
- Geriatric cardiologist
- Cardio-rheumatologist
- Electrophysiologist
- Preventive cardiologist
- Cardiac rehabilitation specialist
Cardiology Symptoms
The following symptoms indicate heart disorders and the need to see a cardiologist immediately.
- shortness of breath
- chest pains
- dizziness
- high blood pressure
- changes in heart rate or rhythm
- pain in the left hand, jaw, or neck indicates a heart attack.
When to see a Cardiologist?
A patient must consult a cardiologist for a heart murmur, an abnormal heart rhythm, a history of heart attack or other heart ailments. In addition, patients who wish to undergo major surgical treatments such as organ transplants, knee replacement surgeries, and others must consult a cardiologist before the surgery. This is because surgeries significantly impact the heart in terms of altered blood flow or medications. Hence, a green signal from cardiologists is necessary. In case any heart ailment such as atherosclerosis (blocked blood vessels) is diagnosed at the time of consultation, the issue is addressed before scheduling the surgery.
Diseases that cardiologists treat
Heart diseases that a cardiologist treats are:
- Atherosclerosis
- High Blood Cholesterol and Triglycerides
- Hypertension
- Ventricular Tachycardia
- Atrial Fibrillation
- Coronary Heart Disease
- Congestive Heart Disease
- Arrhythmias
- Congenital Heart Disease
- Pericarditis
In addition to the above, cardiologists also advise preventing heart diseases in the future. People can visit them for a routine check-up even without having any symptoms. This is especially true if they have a family history of diabetes or high cholesterol or personally have habits such as smoking or drinking. Preventive care also aims to guide pregnant women at a higher risk of developing heart diseases and a history of pre-eclampsia.
Cardiology Diagnosis
Cardiologists often begin by reviewing a patient's medical history, followed by a physical examination. They may advise some tests such as ECG to assess heart rhythm. Interventional cardiologists perform basic procedures such as stenting, valvuloplasties, angioplasties, congenital heart defect corrections, and coronary thrombectomies.
Some tests that they may advise are:
- Electrocardiogram (ECG or EKG): Electrocardiography is a procedure in which the electrical activities of the heart are recorded. Tiny patches are connected to the machine and placed over several places on the chest.
- Ambulatory ECG or Holter monitoring: This type of ECG involves the recording of heart rhythms while the person is working out or performing an activity. Electrodes are attached to the chest, and wires are connected to a Holter monitor to record heart rhythms.
- Event monitoring: Event monitoring is advised when long-term heart functioning readings need to be assessed.
- Blood tests: These tests are required to assess medical conditions like thyroid and diabetes that may cause atrial flutter.
- Magnetic resonance imaging (MRI): In recent years, MRIs are proving to be helpful in evaluating aortic pathology owing to the ability of MRI to assess the dynamics of the flow. Other heart ailments can also be assessed with MRI.
- Transesophageal echocardiography (TEE): This procedure is most helpful in diagnosing dissection in the aorta with high sensitivity. It is considered an ideal diagnostic modality for intubated patients.
- Conventional angiography (aortography): Not used frequently nowadays. It has low sensitivity and requires a high contrast load.
- An exercise test or stress test: Some kinds of tachycardia are triggered by exercise or strenuous physical activity. The heart's activity is monitored during a stress test while walking on a treadmill or riding a stationary bicycle.
- Pulmonary angiography: This test uses X-rays to examine how the blood flows through the valve and requires injecting contrast material into a vein. Healthcare providers use angiography to locate any structural changes in the valve and the extent of narrowing of the valve.
- Cardiac catheterisation: Cardiac catheterisation allows a catheter to be directed through a blood vessel to the heart. This procedure can help diagnose or treat certain heart conditions, such as embolisms or arrhythmias. In addition, cardiac catheterisation provides essential information about the components of the heart, such as heart valves, heart muscles, and blood vessels.
- Nuclear cardiology: Nuclear imaging techniques utilise radioactive materials to help diagnose cardiovascular disorders. This technique is non-invasive. Some examples include planar imaging, and infarction imaging, single-photon-emission computed tomography (SPECT).
- Electrophysiology study (EPS) of the heart: This test involves threading a catheter into the vein in the groin region. Using fluoroscopy, images are taken to guide the way to the heart. The catheter is then used to measure the electrical signals of the heart. A cardiac electrophysiologist provides treatment for abnormal rhythms, including cardiac ablation, implantable cardioverter defibrillators, or pacemakers.
Review
Reviewed by Dr. Balbir Singh, Chairman, Cardiac Sciences, Cardiology, Cardiac Electrophysiology-Pacemaker on 12-Jan, 2023.
Cardiology explained
Cardiology explained
Dr. Balbir Singh, Chairman, Cardiac Sciences, Cardiology, Cardiac Electrophysiology-Pacemaker
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