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General Cardiologist
A general cardiologist is the first cardiologic physician the adult patient sees when referred for a cardiac problem by a primary care physician. The general cardiologist will take a history, perform a physical, interpret an electrocardiogram (EKG) and make a diagnosis. Further tests such as a stress test (standard or nuclear), an echocardiogram and/or a chest x-ray may be ordered to help the physician make a clear diagnosis. Depending on the test results, a general cardiologist may refer the patient to another cardiovascular specialist, such as an interventional cardiologist or an electrophysiologist. A general cardiologist may also prescribe medications, discuss prevention strategies and risk factor modification, as well as follow patients over time.
Invasive Cardiologist
An invasive cardiologist will often provide all the services of a general cardiologist, as well as perform a diagnostic test called cardiac catheterization, should such be deemed necessary.
Noninvasive Cardiologist
A noninvasive cardiologist may perform all the services of a general cardiologist, with a special expertise and focus on noninvasive testing. For example, this physician performs and interprets both painless echocardiograms of the chest (known as transthoracic echocardiograms) and minimally invasive echocardiograms requiring patients to swallow a transducer (known as transesophageal echocardiograms or TEEs). This cardiologist is also skilled in nuclear medicine techniques (e.g., nuclear stress tests such as the thallium stress test).
Interventional Cardiologist
An interventional cardiologist performs diagnostic cardiac catheterizations in order to determine the extent of artery blockage and also specializes in non-surgical techniques for opening clogged coronary arteries, such as balloon angioplasty and/or stenting. Some interventional cardiologists also perform balloon angioplasty/stenting on peripheral arteries to treat peripheral vascular disease.
Electrophysiologist
An electrophysiologist is a type of cardiologist who specializes in abnormal heart rhythms (arrhythmias). This physician may perform tests such as electrophysiology (EP) studies and tilt tests table. An electrophysiologist may also perform procedures such as ablations, maze procedures and the surgical insertion of pacemakers, biventricular pacemakers and implantable cardioverter defibrillators (ICDs).
Pediatric Cardiologist
A pediatric cardiologist performs all the services of a general cardiologist, but specializes in working with children. This physician is skilled in diagnosing and treating various types of congenital and pediatric heart diseases. He or she may refer to another pediatric cardiovascular specialist, such as a pediatric cardiovascular surgeon, if necessary.
Cardiac Surgeon
A cardiac surgeon performs open-heart surgery such as coronary artery bypass surgery or heart valve procedures. Some cardiac surgeons are also skilled in minimally invasive cardiac surgeries such as minimally invasive direct coronary artery bypass (MIDCAB) surgery or minimally invasive heart valve surgery. Cardiac surgeons typically work only with adults and may refer pediatric patients to a pediatric cardiovascular surgeon.
Vascular Surgeon
A vascular surgeon specializes in diseases of the blood vessels and performs any necessary surgery on the blood vessels. A vascular surgeon repairs aneurysms using surgical techniques or minimally invasive techniques such as stent-grafting. Vascular surgeons are also skilled in performing peripheral bypass surgery, such as a femoral-femoral (“fem-fem”) bypass or a femoral-popliteal bypass, which are types of bypass surgeries performed in the leg. Furthermore, vascular surgeons perform carotid endarterectomy, which strips away the plaque-filled lining of a blocked carotid artery and reduces the risk of stroke.
Nuclear Cardiologist
A nuclear cardiologist specializes in radionuclide scans. For example, this physician performs nuclear stress tests (e.g., thallium stress tests or Cardiolite stress tests), which help to differentiate between healthy and unhealthy parts of the heart. A nuclear cardiologist may also perform a multi-gated acquisition scan (MUGA), also known as a nuclear ventriculogram, which provides the physician with a comprehensive look at blood flow and the function of the lower chambers of the heart (ventricles).
Heart Failure Specialist
A heart failure specialist specializes exclusively in the diagnosis and treatment of heart failure and patients with a heart transplant. A heart failure specialist is familiar with the latest medications and devices used to treat this condition. He or she is also skilled in monitoring a heart failure patient’s ejection fraction, which is the percentage of blood that is pumped out of the heart with each heartbeat. An ejection fraction between 55 and 75 is typically considered normal, and an ejection fraction below 40 could indicate some degree of left-sided heart failure.
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