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Decision Assist

Heart specialist

What does the specialist do?

A heart specialist is trained to diagnose and treat heart disease (also called coronary artery disease). Heart disease is a narrowing of the small blood vessels (coronary arteries) that supply blood and oxygen to the heart. Coronary artery disease usually results from the build-up of fatty material and plaque (atherosclerosis).

Atherosclerosis

As the coronary arteries narrow, blood flow to the heart can slow or stop, causing chest pain (stable angina), shortness of breath, heart attack, or other symptoms.

Coronary Artery Disease
Click the icon to see an animation showing coronary artery disease.

A heart specialist may use many tests to help diagnose heart disease. Usually, more than one test will be needed before the specialist can make a definitive diagnosis. Some of the tests include:

  • Electrocardiogram (ECG)
  • Exercise stress test
  • Echocardiogram
  • Nuclear scan
  • Coronary angiography (also called arteriography)
  • Electron-beam computed tomography (EBCT): This test can identify calcium within the plaque found in the arteries. The more calcium is visible, the higher the likelihood for heart disease.
  • Coronary CT angiography

Key points

  • Your heart specialist can help determine if the specific symptoms you are experiencing are related to heart disease, as well as assess your risk of a future heart attack.
  • Your heart specialist has been trained to interpret various cardiac tests and to know which test is probably best for you.
  • Most initial testing to evaluate for heart disease is noninvasive except for the occasional placement of an IV line. These tests are generally painless and can be done in the specialist’s office.
  • Some tests, such as a nuclear scan or a CT scan, use low amounts of radiation but generally do not pose an overall risk.
  • Your heart specialist may recommend invasive testing, such as an angiography. In general, this is a safe procedure. Angiography is considered the gold standard in evaluating heart disease.
  • Coronary CT angiography is a newer noninvasive imaging test to evaluate the narrowing of a heart artery. It is not, however, considered to be as accurate as angiography.

How much time this decision tool will take

  • 5 - 10 minutes

What this tool will provide

  • A personalized list of factors for you to weigh
  • Questions to ask your doctor
  • Alternatives to seeing a specialist
  • Recommended reading

Review Date: 9/12/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References:
  • Achenbach S and Daniel WG. Computed tomography of the heart. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 18.
  • Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007 Dec 4;116(23):2762-72. Epub 2007 Nov 12.
  • Gaziano JM,Manson, JE, Ridker PM. Primary and secondary prevention of coronary heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 45.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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