A cardiologist is a heart doctor; a medical consultant specializing in diagnosing and treating heart disease. They work in emergency units or specialist wards in hospitals, and run clinics to support and treat patients with heart conditions.
Cardiologists use diagnostic tools like electrocardiograms (ECG or EKG) to assess the heart’s rhythm and electrical activity, and echocardiograms; ultrasound scans of the heart used to detect structural problems. This helps to plan appropriate treatment for cardiac problems.
Some heart diseases are preventable by making lifestyle changes, and an important part of a cardiologist’s job is helping people reduce their risk factors for future or further heart problems. Cardiologists work closely with many other medical and healthcare professionals, including specialist nurses, cardiac physiologists, physiotherapists, and dieticians.
Cardiologists treat diseases involving the heart’s functional ability, the blood vessels supplying the heart muscles, and the electrical activity of the heart, which makes it beat. Coronary artery disease means that there are areas of narrowing in the vessels that supply blood to the heart muscle, and this reduction in blood supply can cause angina or a heart attack, known as a myocardial infarction (MI). One of the most common diagnostic and therapeutic interventions used in coronary artery disease is an angiogram or angioplasty, the assessment of coronary arteries using a tube fed into the artery at the wrist or at the side of the groin which is used to inject a dye visible under x-ray to find narrowings or blockages caused by fatty deposits and clots. The same tube can be used then to compress and stabilise these deposits and insert a small tube which will remain in the coronary artery and keep that area open, improving blood supply to the heart muscle.
Disorders of the electrical conduction of the heart can cause arrhythmias, where the heart beats too fast or too slow, or in an irregular or dangerous rhythm. Fast heart rates can be treated with medications to slow the heart or maintain a regular beat. Very slow heart rates may require a pacemaker, a small device inserted under the skin which will detect a slow rate and give off an electrical impulse to kick-start each heartbeat. Hearts at high risk of very dangerous rhythms can require an implantable cardioverter-defibrillator (ICD), inserted like a pacemaker but which can detect serious arrhythmias and give a stronger impulse to try and ‘shock’ the heart into a normal rhythm. People with a certain type of irregular heartbeat, called atrial fibrillation (AF) require special monitoring and treatment with medications including blood thinners, as AF can increase their risk of developing a blood clot.
Cardiologists also treat chronic heart failure, also known as the congestive cardiac failure (CCF). This is a condition caused by structural abnormalities or damage to the heart which mean that its pumping ability is reduced, which can cause fatigue, build up of fluid in the tissues of the body, and reduce people’s ability to live as actively as they’d like. Heart failure can be well-managed with medication and sometimes surgical intervention.