Cardiologist: do you need to see one?

Heart racing? Feeling faint? If you have symptoms that might suggest a heart problem, your GP may refer you to a cardiologist.

Cardiologists are doctors who diagnose and treat heart and blood vessel problems. They handle a variety of conditions, including arrhythmia (irregular heartbeats), hypertension (high blood pressure), heart disease present at birth, rheumatic heart disease, and coronary artery disease. They also treat heart failure, blood clots, and high cholesterol.

Do I need to see a cardiologist?

In most non-emergency cases, patients are referred to a cardiologist by their GP.

“The most common reasons why patients see a cardiologist is for heart palpitations, shortness of breath, angina (chest pain), swollen legs or extreme tiredness. It’s our job to determine if these symptoms are related to heart issues or have other causes,” says Dr Andile Xana, a cardiologist at Mediclinic Heart.

He warns that if chest pain is severe when walking but gets better with rest, it could be a sign of coronary artery disease, which is a leading cause of death worldwide.

Other reasons to visit a cardiologist include having a close family member with heart disease, having diabetes, or conditions like Down syndrome that cause heart problems. People who are HIV positive or have had a stroke should also see a cardiologist for screening.

Dr Xana says it’s important for people with a family history of early strokes or heart attacks to see a GP for regular check-ups starting at age 35. The GP will check for risk factors like high cholesterol. If you start having symptoms or if your GP thinks it's safer, they will refer you to a cardiologist, he explains.

What can I expect at my first appointment?

When visiting a cardiologist for the first time, you’ll normally have an electrocardiogram (ECG), which helps to estimate the size, rhythm and rate of your heart. It can also determine previous heart attacks.

The ECG is followed by an exercise stress test, where you walk on a treadmill to see how your heart reacts to exercise.

The third test is an echocardiogram, which uses ultrasound to check the size of your heart, the thickness and strength of the heart muscle, and how well the heart valves are working.

“Generally, after conducting these three tests, we have a very good idea of the patient’s condition. According to the patient’s risk profile, a cardiologist might then suggest a definitive test, such as a CT scan or a coronary angiogram, to look more closely at the blood vessels of the heart,” Dr Xana says.

He points out that unhealthy habits, like smoking, eating processed foods high in fat, sugar, and salt, and not getting enough exercise, can harm your heart and increase the risk of heart problems. “Even just half an hour of walking every day and eating a healthy diet can lower your blood pressure and reduce your risk of heart disease and diabetes.”

What procedures do cardiologists perform?

Cardiologists can treat some heart conditions with medication, but others may need procedures. These can include opening or bypassing blocked arteries. They can also put in valves or devices like pacemakers or defibrillators to help control the heart's rhythm.

“In South Africa, cardiologists are trained to open coronary arteries in an emergency when someone arrives at the hospital with a heart attack. This is done through a procedure called angioplasty, where a small balloon is used to widen the arteries, and a stent is placed to keep them open,” says Dr Xana.

A cardiologist is also trained to perform diagnostic tests like coronary angiograms. This involves injecting a special dye into the patient and taking X-rays to check for blocked or narrowed arteries, or any issues with the heart muscle or valves. In addition, they can open blocked blood vessels caused by clots or cholesterol.

• To book an appointment with a cardiologist, contact our Mediclinic Engagement Centre via WhatsApp 087 240 6367 or click here for alternative contact options