Cardiologist

A cardiologist is a medical doctor who specializes in treating diseases affecting the heart, arteries, and veins. Cardiologists are responsible for the medical management of ailments including congestive heart failure, valvular heart disease, and peripheral vascular disease. Patients are usually first referred to cardiologists from a primary care physician once a complex diagnosis affecting the heart is made. At the initial visit, the cardiologist inquires about the patient's symptoms to gather information about the patient's illness. The cardiologist then performs a thorough cardiovascular exam in which he or she listens carefully for flow abnormalities, or irregular heartbeat patterns.

[Page 347]Often, cardiologists perform electrocardiograms (ECG), echocardiographs (echo), blood tests, or chest radiographs to gain further insight into the disease process. An ECG measures the electrical activity of the heart while a Doppler echo allows the cardiologist to create sound waves to produce an image of the heart and view the blood flow through the heart. Cardiologists also perform stress treadmill tests to help elucidate how the heart responds to increased exertion. In patients with persistent chest pain, a cardiac catheterization may be performed to view the heart and its blood supply. Under the guidance of a televised viewing screen, the cardiologist inserts a small catheter into the femoral artery of the thigh.

The catheter is threaded into the heart and the pressure and blood flow is measured. A contrast dye is then injected into the blood vessels to visualize any blocked vessels. If there are numerous partially or completely occluded vessels, the cardiologist is likely to consult a cardiothoracic surgeon to perform a surgical bypass operation. This operation replaces the diseased heart blood vessels with veins from the lower leg. Cardiologists also prescribe medications to decrease the likelihood of cardiovascular events including heart attack and stroke.

Cardiologists working in private practice or hospitals must undergo several years of education and training. Individuals must first complete four years of undergraduate education, four years of medical school training, and three years of internal medicine residency at accredited institutions. The individual then passes the Internal Medicine Board Certification examination and begins three additional years of fellowship training in general cardiology. After passing the examination for board certification in cardiovascular diseases, he or she may pursue a subspecialty in interventional cardiology, electrophysiology, or nuclear cardiology or may simply begin his or her practice as a general cardiologist. The path toward pediatric cardiology is very similar. Individuals also obtain an undergraduate and medical degree, but then complete a pediatric medicine residency and a fellowship in pediatric cardiology. The average annual salary for cardiologists is $200,000 depending on location and expertise.