September 23, 2021 by John Fernandez and Bethany Rundell
What to Expect at an Appointment With a Cardiologist
If you’ve been experiencing worrisome symptoms, have a family or personal history of heart or vascular disease, or simply want to learn how to lower your risk factors or prevent cardiovascular disease altogether, your primary care physician may recommend that you establish care with a cardiologist.
No matter what motivates you to seek the advice of a cardiovascular specialist, there are steps you can take prior to your visit to ensure you maximize the time you have with the cardiologist at your appointment.
“When a patient visits for the first time, we have a lot to accomplish,” said Tarak Rambhatla, M.D., a cardiologist and the director of inpatient cardiac services at Baptist Health’s Miami Cardiac & Vascular Institute. “We work to get a complete personal and family history, address symptoms and concerns, conduct blood tests, determine other necessary diagnostic tests and discuss cardiovascular risk reduction.”
Personal and Family Medical History
Dr. Rambhatla says the history he collects includes questions about past and current medical conditions, surgical procedures, overall health and well-being, how active the patient is and any symptoms experienced while being active or while resting. He also asks about any known family history or cardiovascular risk factors, especially that of parents and siblings.
He says its helpful for patients to bring results from any recent blood studies, EKGs or echocardiograms (ECHOs), any other imaging or diagnostic test results and a list of medicines and dosages currently being taken. He also advises to “Know Your Numbers,” including blood pressure, body mass index (BMI), cholesterol, blood sugar levels and A1C, and to report these numbers to your cardiologist.
The American Heart Association has developed its PACE Guide Sheet to help record helpful information about your cardiovascular concerns before your appointment with a cardiologist. PACE helps you:
- Provide information to your doctor about how you feel.
- Ask questions to ensure you understand.
- Clarify what you hear.
- Express concerns you may have.
If no recent blood work has been done, Dr. Rambhatla will order blood tests to check for cholesterol levels, kidney and liver function, and the amount of glucose and triglycerides in the blood. These measurements reveal information about possible risk factors for cardiovascular disease.
Dr. Rambhatla may also run a screening electrocardiogram, or EKG, a non-invasive test done in the doctor’s office to look at the heart’s rhythm patterns and ensure it’s beating properly. Arrhythmias can signal problems with the heart’s electrical system and any underlying heart conditions, such as structural defects or heart failure.
Lifestyle Risk Factors
Risk factors relating to lifestyles are also discussed at the initial appointment, Dr. Rambhatla says. He addresses if the patient is overweight or obese, any current or previous tobacco usage, stress levels, nutrition and exercise frequency, as each of these plays an important role in the potential risk of developing cardiovascular conditions.
Coronary Calcium Score
For patients with a higher risk of developing cardiovascular disease because of a personal or family history, Dr. Rambhatla recommends a non-invasive CT scan of the heart to determine the amount of calcium present in the coronary arteries. Unlike the calcium that’s beneficial to bone health, calcium found in the arteries through this coronary calcium scan indicates the development of atherosclerosis, or plaque buildup, that can lead to blocked arteries and heart attacks. This test, conducted at the hospital at another time, will assign a score that’s helpful for cardiologists to determine proper treatments. A score of 1 or above with borderline to high cholesterol levels, Dr. Rambhatla says, indicates that the patient may benefit from statin therapy, which has been proven to lower cholesterol levels. Miami Cardiac & Vascular Institute offers the coronary calcium scan with a doctor’s prescription.
“The coronary calcium scan is part of a primary prevention strategy and allows us to see early whether we need to take action to stop or significantly slow the progression of coronary artery disease with proper therapeutics and risk modifications,” he said.
Prevention and Early Intervention
Dr. Rambhatla stresses the importance of establishing a relationship with a cardiologist sooner than later, especially if you have risk factors or are experiencing symptoms that may be related to your heart. He says that if you’re worried about your heart health, even at 35 years old, it’s not too early to talk to your primary care physician about a risk profile assessment and the benefits of consulting with a cardiologist. Because many risk factors start to show up around the age of 50, but take hold much earlier, actions can be taken to lower risk and ward off disease progression.
“Your primary care physician is the gatekeeper to your care,” he said. “Many times, primary care doctors send their patients to me because they see a risk, or their patient is having symptoms. As a cardiologist, I work with your primary doctor and communicate back to him or her about what any tests uncover and any treatments we recommend. This is an important key to successful management of risk factors or of heart disease and cardiovascular conditions.”
While patients may think of needing to see a cardiologist as serious and frightening, Dr. Rambhatla takes his role in preventing heart problems as seriously as he does his role in treating heart problems. “I always tell patients that I’d much rather see them in the office than in an acute situation,” he said.
Now that you know what to expect, consider discussing the need for a cardiologist with your primary care doctor today.
Caption: Visiting a cardiologist for prevention, diagnosis or treatment of a heart or vascular condition requires some preparation to ensure that time spent in the office is maximized for the evaluation of your cardiovascular health.