Understanding Heart Care

A guide to common heart conditions and the specialists who treat them

When it comes to heart care, there are so many different physician specialties, conditions and terminologies that it can seem overwhelming.

“The better you understand basic heart conditions and the specialists who treat them, the better you can understand your own care,” says Kiyon Chung, MD, a cardiologist at Scripps Health.

Heart conditions

Heart attack: A heart attack is sometimes referred to as a myocardial infarction (MI). This occurs when one of the arteries bringing blood to your heart is blocked. This blockage can be caused by a blood clot or plaque or both. When part of the heart does not receive blood due to this blockage, symptoms such as chest pain (angina) can occur, signaling a heart attack.

Abnormal heart rhythm: Also known as arrhythmia, an abnormal heart rhythm can mean that the heart is beating too fast, too slow or unevenly. There are many causes and types of arrhythmia based on which chamber of the heart is not working correctly.

Sudden cardiac arrest: Sometimes referred to as sudden death, sudden cardiac arrest occurs when the electrical impulses that keep the heart pumping fail. It is not the same thing as a heart attack. There can be multiple causes of cardiac arrest and it can occur in people of all ages, many with no previous history of heart disease. During cardiac arrest, the heart completely stops beating.

Heart failure: Heart failure or congestive heart failure — is not cardiac arrest. Heart failure is a chronic, long-term condition in which the heart becomes enlarged, making it difficult to pump an adequate supply of blood throughout the body. There are many causes of heart failure but the most common causes in this country are due to blocked arteries and heart attacks or longstanding hypertension.

Heart valve disease: This is a defect in one or more of the heart valves, which open and close to allow blood to flow between the chambers of the heart. Defective valves do not open and close properly and cause symptoms such as shortness of breath and fatigue. Causes of heart valve disease include congenital defects, infection, or degeneration due to aging. The four heart valves are aortic, mitral, tricuspid and pulmonary.

Adult congenital heart disease: This is a type of birth defect in the heart’s structure; you are born with it. It can be diagnosed at birth, during childhood or even as an adult. Patients who have undergone surgery as an infant or during childhood will require continuing care as adults with a cardiologist specializing in congenital heart disease.

Peripheral vascular disease: Also referred to as peripheral artery disease (PAD), this condition is the buildup of plaque inside the arteries outside of the heart and throughout the body. This buildup reduces the amount of blood that can flow through the body from head to toe.

Cardiovascular specialists

“Depending on your condition, you may have multiple heart care physicians, each specializing in a different aspect of your care,” notes Dr. Chung. “Each of your heart care specialists should be board certified in internal medicine or cardiovascular disease, as well as in their sub-specialty area. Some heart care physicians may only treat a specific heart condition or are trained in specific heart care procedures.”

Cardiologist: A cardiologist is a physician who specializes in the diagnosis and medical management of heart disease. Cardiologists perform various diagnostic tests (such as echocardiograms, stress tests, or diagnostic cardiac catheterizations), prescribe medications and work with patients to make lifestyle changes and manage risk factors for heart disease. Some cardiologists specialize in managing specific conditions such as heart failure or arrhythmia, and may implant pacemakers.

Interventional cardiologist: These physicians perform procedures that include heart catheterizations for diagnosis; stent implantations, which open hardened, blocked or partially blocked arteries to prevent a heart attack; and angioplasty. They may also perform percutaneous valve placement, which is a minimally invasive procedure to replace damaged heart valves. Some interventional cardiologists are also trained in peripheral vascular angioplasty and stent procedures for the arteries in the legs, kidneys and neck.

Electrophysiologist (EP specialist): These physicians are the “cardiac electricians” who specialize in treating and correcting abnormal rhythms of the heart. They perform tests for abnormal heart rhythms and implant devices such as pacemakers and implantable cardioverter defibrillators (ICD) to help the heart beat normally. Many Electrophysiologists specialize in performing cardiac ablations to treat areas of the heart that are causing an abnormal heart rhythm, such as atrial fibrillation or other arrhythmias.

Heart surgeon: Heart surgeons are not cardiologists. The may also referred to as cardiac surgeons, cardiovascular surgeons or cardiothoracic surgeons, and they use surgical methods to correct a variety of heart conditions. They can replace or repair faulty heart valves, repair holes in the heart that can contribute to an abnormal heart rhythm, or perform coronary artery bypass grafts (CABG), a surgery which reroutes the blood and oxygen supply to the heart. Some heart surgeons are trained in minimally invasive and robotic surgical procedures.

Heart failure specialist: These are cardiologists who specialize in heart failure. In addition to their training in general cardiology, these doctors have received additional specialized training in taking care of people with advanced heart failure. As heart failure progresses, your general cardiologist may refer you to one of these subspecialists. Heart failure specialists usually are familiar with and have access to the most advanced therapies for heart failure, including experimental treatments, Left Ventricular Assist Devices (LVAD), and heart transplants.

This article was originally published on scripps.org.

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