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Cardiology,
or the discipline of medicine that specializes in heart
disease, is a complex and sophisticated field. Generally,
three types of cardiology specialists care for your
heart.
A cardiologist has special training
and skill in finding, treating, and preventing diseases
of the heart and blood vessels in adults.
A pediatric cardiologist has special
training and skill in finding, treating, and preventing
heart and blood vessel disease in infants, children,
and teenagers. In some cases, the pediatric cardiologist
begins diagnosis and treatment in the fetus and continues
into adulthood.
A cardiac surgeon has special
training and skills to perform delicate operations on
the heart, blood vessels, and lungs.
Training
 After
four years of medical school, these highly-trained doctors
spend from six to eight more years in specialized training.
A cardiologist receives three years of training in internal
medicine and three or more years in specialized cardiology
training. A pediatric cardiologist receives three years
of training in pediatrics, and three or more years in
specialized pediatric cardiology training. A cardiac
surgeon must complete five years of training in general
surgery before starting a two-or three-year cardiothoracic
training program. Some cardiac surgeons have additional
training to perform pediatric or transplant surgery.
Qualifications
At each stage of their training, these specialists must
pass rigorous exams that test their knowledge and judgment,
as well as their ability to provide superior care.
Cardiologists, pediatric cardiologists, and cardiac
surgeons must first become board-certified
in their primary specialty (internal medicine, pediatrics,
and surgery respectively), and then certified in their
subspecialty (cardiology, pediatric cardiology, and
cardiothoracic surgery respectively).
 Membership
in the American College of Cardiology
If
your cardiology specialist adds F.A.C.C. - Fellow of
the American College of Cardiology - to his or her name,
it is a sign of significant accomplishment and commitment
to a profession, to a specialty, and to the provision
of the best health care for the patient.
Election
to ACC membership is based on training, specialty board
certification, scientific and professional accomplishments,
length of active participation in a cardiovascular-related
field, and peer recognition. Members are expected to
conform to high moral and ethical standards.
Cardiologists
Referral to a Cardiologist
Any time you have a significant heart or related condition,
you may require the attention of a cardiologist. Symptoms
like shortness of breath, chest pains, or dizzy spells
often require special testing. Heart murmurs or ECG
changes are best evaluated by a cardiologist. Most importantly,
cardiologists treat heart
attacks, heart failure,
and serious heart rhythm
disturbances. Their skills and training are required
for decisions about heart catheterization,
balloon angioplasty,
heart surgery, and other procedures.
Diagnostic
tests which may be necessary
 Your
cardiologist will review your medical history and perform
a physical examination which may include checking your
blood pressure, weight, heart, lungs, and blood vessels.
While some problems may be diagnosed from this examination,
your cardiologist may order an ECG,
X-ray, or blood tests. In addition, an ambulatory
ECG, echocardiogram,
exercise test, heart
catheterization and/or nuclear
imaging may be required.
The
Cardiologist and your Primary Care Physician
The cardiologist usually serves as a consultant to other
doctors, although many provide general medical care
for their patients. Your primary care physician may
recommend a cardiologist or you may choose one yourself.
As your cardiac care proceeds, your cardiologist will
guide your care and plan tests and treatment with the
doctors and nurses who are looking after you.
Pediatric
Cardiologists
Referral to a Pediatric Cardiologist
Children who have heart murmurs are often referred for
evaluation. Many of these turn out to be normal and
no follow-up by the pediatric cardiologist is necessary.
About one in every 100 babies is born with heart disease
(congenital heart disease) which requires a pediatric
cardiologist's care.
Referrals are also made for cyanosis
("blue-baby" condition), rapid breathing,
heart enlargement, high blood pressure, infections involving
the heart and blood vessels, chest pain, heart rhythm
disturbances, fainting episodes, and questions about
participation in sports. Some pediatric cardiologists
see and advise congenital heart patients into adulthood.
The skills of a pediatric cardiologist are required
whenever decisions are made about procedures such as
heart catheterization and
heart surgery. The pediatric cardiologist may also advise
about the prevention of
heart attacks in later life and screen for high
cholesterol levels.
The
Pediatric Cardiologist and your Pediatrician
A pediatric cardiologist usually serves as a consultant
to other doctors. Your pediatrician may recommend a
pediatric cardiologist, or you may choose one for your
child. As your child's cardiac care proceeds, your pediatric
cardiologist will guide the care and plan tests and
treatments with the doctors and nurses who are looking
after your child. If heart surgery is indicated, your
child's pediatric cardiologist and cardiac surgeon work
as a team. In follow-up, the pediatric cardiologist
keeps you, your pediatrician, and/or surgeon informed.
Cardiac
Surgeons
Cardiac surgeons perform many operations—coronary
artery bypass, pacemaker
insertion, heart rhythm surgery, valve replacement or
repairs, heart transplants, and repairs of complex heart
problems present from birth (congenital heart disease).
They are also qualified to operate on organs other than
the heart, such as the lungs, esophagus, and blood vessels.
Referral
to a Cardiac Surgeon
 If
your general medical doctor, pediatrician, or cardiologist
feels that surgery may be the best treatment for your
heart condition and that medication alone will not be
enough, then you will be referred to a cardiac surgeon
for further evaluation. The surgeon will review your
medical records and test, especially the heart
catheterization results, if bypass, cardiac valve,
or heart surgery for a congenital defect is being considered.
The cardiac surgeon will then discuss your case with
you and your doctors, to give further advice about the
risks and benefits of surgery.
The
Cardiac Surgeon and your Cardiologist
The cardiac surgeon leads a team of doctors and nurses
responsible for the immediate evaluation prior to surgery,
final decision for surgery, as well as the recovery
period after the operation until you are discharged.
After leaving the hospital, you will usually be seen
by both the cardiac surgeon and the cardiologist to
assure that your recovery period is progressing smoothly.
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