When Should I See A Cardiologist? - GoodRx

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HomeHealth TopicHeart Health

When to See a Cardiologist

Written by Sarah Pozniak, MD | Reviewed by Mandy Armitage, MD
September 13, 2021

Basics

Heart disease is common. In fact, in the U.S., nearly half of all adults have cardiovascular disease, the collective term for atherosclerosis (the buildup of fatty deposits) of the heart and blood vessels. You likely know a friend or family member who has heart disease, or you may have had it yourself. The condition can be scary. In the U.S., heart disease is the most common cause of death for both men and women of most racial and ethnic groups. For groups in which it’s not the top killer, it is second only to cancer.

Heart disease can be serious — so it’s normal to be concerned about your heart health. You may wonder what you can do to keep your heart healthy over time, or whether you need to see a cardiologist to make sure your heart is OK. Cardiologists are doctors who are experts in heart disease. They see people with heart disease, people who have symptoms of heart disease, and those who are at high risk for heart disease. Not everyone needs to see a cardiologist, however. This depends on your own health, risk factors, and family history. Here’s a guide to help you decide whether you need to see a cardiologist, and when.

A magnifying glass zooming in on a human heart.

Why trust us

Dr. Sarah Pozniak is a board-certified internal medicine physician. She graduated from New York Medical College and completed her residency at Wake Forest Baptist Medical Center. She is a primary care physician and cares for patients with acute and chronic diseases, including heart disease. She is interested in the prevention of heart disease and coordinates care between her patients and their cardiologists.

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What do cardiologists do? 

Cardiologists specialize in diseases of the heart and blood vessels. They have training in internal medicine and at least three years in cardiology before receiving board certification by the American Board of Internal Medicine and the American College of Cardiology. They often work with physician assistants, nurse practitioners, and nurses who are part of the cardiology care team.

Cardiologists are experts in the heart. They stay up to date with frequently changing guidelines and clinical studies. Cardiologists have an advanced understanding of:

  • Managing and treating people's risk factors for heart disease

  • When and how to use heart scans and stress tests to diagnose and treat heart disease

  • Heart disease treatment options, and how to decide which treatments are best for each person

  • How to prevent serious complications, like heart attacks and strokes

Different types of cardiologists

Cardiologists can practice as general cardiologists. This means they see people with a range of heart conditions. Other cardiologists are more specialized and receive extra training in a certain area of cardiology. They may see only people with certain types of heart disease:

  • Electrophysiologists treat people with problems involving the heart’s electrical system that cause abnormal heart rhythms or arrhythmias.

  • Heart-failure specialists see people with heart failure or abnormalities in the heart’s ability to pump blood.

  • Interventional cardiologists specialize in performing certain procedures on the heart. These include cardiac catheterization, which allows them to look at the heart’s blood vessels and valves, and certain other treatments, like stents to open up blockages.

  • Transplant specialists work with people who have received heart transplants.

  • Adult congenital cardiologists take care of adults who have had heart disease since birth or childhood.

When to see a cardiologist instead of a primary care physician 

There are different reasons to see a cardiologist. These include having heart disease, risk factors for heart disease, and a family history of heart disease.

You have been diagnosed with heart disease

If you have been diagnosed with heart disease in the past, you may have already seen a cardiologist. Depending on the type of heart disease that you have, you may need to regularly see a cardiologist to keep your heart healthy. Keeping in touch with your cardiologist allows them to monitor your heart’s health and make changes to your treatments if necessary. This will help prevent complications over time.

Some types of heart disease you would see a cardiologist for include:

If you have been referred to a cardiologist by another provider and you haven’t gone, don’t put it off. Seeing a cardiologist can help you prevent long-term complications of heart disease.

You have risk factors for heart disease

Even if you don’t have a history of heart disease or any symptoms, it’s important to know your risk factors. Risk factors are conditions or behaviors that make heart disease more likely. Assessing heart-disease risk is complex because each person is unique, but experts know there are certain risk factors. These include:

  • Age and sex: Younger adults can get heart disease, but the risk increases with age for both men and women. This is because the heart and blood vessels change over time. The risk starts to increase at around age 55 for men and around age 65 for women.

  • Blood pressure: High blood pressure increases the risk for other types of heart disease, if it is not treated.

  • Blood glucose levels: High blood glucose levels, which occur in diabetes and prediabetes, increase the risk for heart disease by damaging blood vessels.

  • Cholesterol: High cholesterol is a risk factor for heart disease, so it’s important to keep this under control with healthy eating, exercise, and medications if necessary.

  • Excess weight: Having overweight or obesity, according to your body mass index, increases the risk for heart disease.

  • Dietary habits: Eating a healthy diet is important for heart health and can help you maintain healthy blood glucose levels and blood pressure, and a healthy weight. Diets high in sugar, carbohydrates, saturated fat, and red meat are unhealthy for the heart and should be replaced with diets high in fruits, vegetables, and lean proteins.

  • Exercise: Regular physical activity is important for reducing your risk for heart disease. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise per week for heart health.

  • Smoking and alcohol: Tobacco use and excess alcohol consumption increase the risk for heart disease.

Both cardiologists and primary care providers can assess and treat most risk factors for heart disease. There is no magic number for how many risk factors require a visit to a cardiologist. If you have one risk factor or more, you can see a cardiologist. They can make sure your risk factors are treated and help you decide whether any testing on your heart is needed (more on that below).

You have a family history of heart disease

Heart disease can run in families. This means that, if you have family members with heart disease — and particularly if anyone had it at a young age (before age 55 in men and age 65 in women) — you may be at greater risk of heart disease yourself. One study found that, in people aged 20 to 39 years, one in three people with the type of cardiovascular disease caused by plaque buildup in blood vessels had a family history of early cardiovascular disease.

You can find out your family history by talking to your family members. You’ll want to learn whether any of your close relatives, such as your siblings, parents, or grandparents, have had heart disease. Try to find out what type of heart disease they had, such as rhythm problems or blocked arteries. It’s also helpful to know how old they were when they were diagnosed. Sometimes your family members won’t know all the details, but try to get as much information as you can. You may need to ask every few years to learn any new information.

At what age should I see a cardiologist?

The right age to see a cardiologist varies from person to person. It depends on your concerns, whether there’s any history of heart disease in yourself or your family, and what your personal preferences are.

Heart disease can occur at any age in adulthood, but many types of heart disease are more common with aging. For this reason, it is often more common for people to see a cardiologist as they get older.

Adults under age 50 may consider seeing a cardiologist if they have a family history of heart disease at a young age or if they have symptoms of heart disease. Younger adults can be more likely to develop heart disease themselves if they have family members who had heart disease at a similar age.

When to see your primary care provider

If you don’t have any of the factors listed above, you are unsure, or you are concerned about your risk, your primary care provider may be able to help. They can help you sort through any symptoms or concerns and understand your risk factors. Then, you can come up with a plan together to manage them. Your primary care provider can also help you decrease your alcohol use and quit smoking to lower your risk.

Primary care isn’t a necessary step before you see a cardiologist — unless your insurance says so — but it’s often a great place to start.

It’s also a good idea to see your primary care provider if you have any ongoing symptoms that could be from heart disease. They can help determine if your symptoms might be heart-related and refer you to a cardiologist. If your symptoms are not related to your heart, they can work with you to find out what’s going on. Symptoms that could be related to heart disease include:

  • Chest pain or pressure

  • Shortness of breath

  • Irregular heartbeat

  • Leg swelling

  • Dizziness or lightheadedness

  • Fainting

  • Fatigue

If you don’t have a primary care provider, it’s a good idea to find one. They can help you with illnesses, complex medical conditions, and preventive care. They can also help determine when it’s necessary to see a specialist like a cardiologist. If you are looking for a primary care provider, consider asking friends and family for a recommendation, or inquire with your health insurance company.

What happens at a cardiologist appointment?

What happens at your appointment will vary depending on the cardiologist you see and why you are there. Most visits will start with the cardiologist or a member of the team checking your vital signs — your blood pressure, heart rate, and temperature — as well as your weight and height. Your cardiologist will ask you about your medical history and family history, so it’s a good idea to be prepared with this information. You may also be asked about whether you smoke and use drugs or alcohol. The visit may include a physical exam, bloodwork, and additional testing.

Different risk-assessment tools and calculators are used to assess heart-disease risk over time, including the ASCVD Risk Estimator Plus. Tools like this use your risk factors to calculate your risk of developing heart disease over a certain period of time. This information helps cardiologists advise you on lowering your risk of heart disease over your lifetime.

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Types of tests a cardiologist may perform

Your cardiologist may recommend certain tests to check your heart. Some tests may be done in your cardiologist’s office, and others may be done at a hospital or radiology center. Below are some of the tests your cardiologist may recommend or perform:

  • Electrocardiogram (ECG or EKG): This can usually be done in your cardiologist’s office. An EKG gives your cardiologist information about your heart rate and rhythm. This takes a few minutes and is done by placing electrodes on the chest, arms, and legs to measure the heart’s electrical activity.

  • Echocardiogram: An echocardiogram may be done in your cardiologist’s office or at a radiology center. It is an ultrasound of the heart that allows your cardiologist to see how your heart moves and pumps blood.

  • Stress testing: Stress testing is done to find out how the heart pumps blood when it has to work harder. There are different types of stress tests. Some use medications to make the heart work harder; others involve monitoring the heart while you exercise.

  • Coronary artery calcium (CAC) scoring: CAC scoring helps your cardiologist check your risk of heart disease. It is done by taking pictures of the heart using a CT scan to measure the amount of calcium in the coronary arteries (the blood vessels that bring blood to the heart). A high amount of calcium can mean there is more plaque in the arteries, which can increase your risk for a heart attack or stroke.

  • CT angiography: CT angiography, or CTA, uses contrast dye and CT scanning to look at the heart’s arteries. This can identify blockages or narrowing in the blood vessels.

  • Invasive coronary angiography: Also called cardiac catheterization, this test uses contrast dye to look at the heart’s arteries while X-ray pictures are taken of the heart. It allows your cardiologist to see how your heart functions and to even place stents in the heart vessels to open blockages, if needed.

Are heart scans and stress tests necessary for everyone?

No, these tests are not necessary for everyone. They are important for diagnosing and monitoring heart disease. If you have symptoms that could be from a heart problem, these tests can work out whether heart disease is the cause.

If you don’t have a history of heart disease and don’t have symptoms, you may not need a stress test or a heart scan. In fact, routine testing is not recommended for people who have no symptoms and are at low risk for heart disease.

The downside of testing people who have no symptoms is that it can lead to false positive results. False positive results are those that look positive, but are not truly positive. They often lead to unnecessary testing that can increase the risk of harm and drive up costs. When considering testing, it is important to discuss it with your healthcare provider so you can decide what is right for you.

Are cardiologist appointments covered by insurance?

Office visits with a cardiologist are often covered by commercial insurance plans, Medicare, and Medicaid. Before you go to your appointment, make sure your cardiologist accepts your insurance — so you don’t get an unexpected bill after the visit. Some insurance plans may ask for a referral from your primary care provider before you see your cardiologist.

Even if your insurance plan covers an office visit with your cardiologist, blood work and other tests may not be covered. Once you know what tests your cardiologist wants to do and why, you can check with your insurance plan to find out whether they are covered and whether there will be any cost to you. Costs and coverage are a concern for most people. It’s always OK to raise your concerns with your provider. They won’t know it’s an issue for you unless you tell them. And they may be able to help make sense of the number of tests you need.

How can I find a cardiologist near me?

Once you know you need to see a cardiologist, you can look for providers in your area. Some cardiologists work in private practice, whereas others are part of larger healthcare systems. Your primary care provider will have relationships with local cardiologists, so you can ask them for recommendations. Family and friends who have seen cardiologists near you can also give recommendations. The American College of Cardiology has a search tool called Find Your Heart a Home that compares cardiology services in your area.

Your insurance company can provide a list of cardiologists covered by your healthcare plan. It is a good idea to make sure the cardiologist you want to see is covered by your insurance before your appointment.

Keep in mind

It is important to know that heart disease has a large impact on women: In 2019, it was the number-one cause of death for women, followed by stroke. But it is often underdiagnosed, misdiagnosed, and undertreated in women. This is partly because women may have different warning signs. This is yet another reason to understand your personal risk factors.

The good news is that the medical community has taken notice. A new report was recently published with recommendations on how to improve the diagnosis and treatment of heart disease in women around the world by 2030.

Prevention is important when it comes to heart disease. Following a healthy lifestyle through diet and exercise, avoiding tobacco and excess alcohol, and maintaining a healthy weight help keep your heart healthy. Getting your blood pressure, cholesterol, and blood glucose regularly checked can help you spot signs of trouble early. Heart disease is common and can be scary — so don’t be afraid to ask questions to make sure you get the help you need.

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View All References

American College of Cardiology. (2018). Coronary artery calcium (CAC) scoring.

American College of Cardiology. (2021). ASCVD risk estimator plus.

American College of Cardiology. (2021). Experts urge action to reduce the global burden of CVD in women.

American College of Cardiology. (2021). Find your heart a home.

American College of Cardiology. (2021). Five things physicians and patients should question.

American Heart Association. (2015). Cardiac catheterization.

American Heart Association. (2015). Coronary artery disease.

American Heart Association. (2015). Echocardiogram. 

American Heart Association. (2015). Family history and heart disease, stroke.

American Heart Association. (2016). About arrhythmia.

American Heart Association. (2017). The American Heart Association diet and lifestyle recommendations.

American Heart Association. (2017). What is a stent?

American Heart Association. (2017). What is heart failure?

American Heart Association. (2018). Recommendations for physical activity in kids and adults.

American Heart Association. (2020). Changing the way we view women’s heart attack symptoms.

American Heart Association. (2021). Atrial fibrillation.

American Heart Association. (2021). Heart valve disease.

American Heart Association. (2021). Types of heart failure.

Arnett, D. K., et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation.

Centers for Disease Control and Prevention. (2020). Heart disease facts.

Moonesinghe, R., et al. (2019). Prevalence and cardiovascular health impact of family history of premature heart disease in the United States: Analysis of the National Health and Nutrition Examination Survey, 2007–2014. Journal of the American Heart Association.

National Heart, Lung, and Blood Institute. (2012). Electrocardiogram.

National Institute on Aging. (2018). Heart health and aging.

National Heart, Lung, and Blood Institute. (2019). Stress test.

National Heart, Lung, and Blood Institute. (2021). Cardiac catheterization.

Radiological Society of North America. (2019). CT angiography (CTA). 

Virani, S. S., et al. (2021). Heart disease and stroke statistics – 2021 update. Circulation.

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