If you or a loved one has been scheduled for a first visit to a cardiologist, you may have a number of questions. Does a referral to a cardiologist mean that a serious heart problem is present? What is the cardiologist going to do? Is any preparation necessary? These concerns are all valid and normal. To make the process easier, it is often helpful to gain some background and understanding of a cardiologist’s role in heart disease management before your first visit.
Before the first visit to your cardiologist
A little preparation can help you make the most of the upcoming appointment. If you are feeling too anxious to focus on these tasks, stress management techniques can teach you how to relax in a healthy way and identify the source of your anxiety before going any further.
When you are ready to start preparing for the appointment, one of the first things to do is to learn everything you can about the cardiovascular system. A cardiologist will try to explain things in as basic terms as possible, but it’s easier to understand vital health matters when you have a basic understanding of heart-related terms, such as left anterior descending (LAD) coronary artery and so forth.
Once you have a general understanding of the cardiovascular system, you are still likely to have many questions about your specific medical situation. Write down a list of these questions to help make sure they will all be answered. It is common for people to have unanswered questions soon after leaving a doctor’s office. Writing those questions down in advance, and even handing the list to the cardiologist, can help ensure that all of your questions will be addressed.
The more medical information you prepare in advance, the better. The cardiologist (or his or her staff) is going to be asking for:
Your insurance information.
Your list of medications and dosages.
Your medical allergies.
Your social history. Marital status, profession, and medical habits of importance, such as smoking and alcohol consumption.
Your doctor’s name, address and phone number.
Any symptoms that you have been experiencing in as much detail as possible.
Your personal medical history. You can obtain a copy of your personal medical history directly from your doctor to bring with you, or you can ask your doctor’s office to send/fax a copy of the record to the cardiologist.
Copies of previous test results (e.g., electrocardiograms, chest x-rays, blood tests).
Your family medical history, including family members who may have had heart disease, stroke or other cardiovascular conditions.
If you were not given specific instructions when the cardiologist appointment was made, call the office to find out whether it will be important to:
Stop eating and/or drinking before any blood work
Wear comfortable clothing for a stress test
Arrange for a ride home from the office
Make any other preparations beforehand
You may also want to know how long the appointment is expected to take and which tests (if any) you can expect. To learn more about the tests that are expected to be performed, use the Search feature at the top of the page to find the name of the test(s). Learning about the test(s) to be performed can be very helpful, but learning about a condition that might be present can be unhelpful because it can cause unnecessary anxiety before a diagnosis is made.
Arrival at the cardiologist’s office
You may be asked to arrive a little early for the appointment in order to sign in at the reception desk and fill out some paperwork. If you brought all the necessary information, you will probably save some time. If you have any questions about your health insurance policy and/or what it will cover, the people at the front desk can answer those questions for you.
When you are called in from the waiting room, staff members other than the cardiologist may be involved in the process. For example, blood pressure and weight might be taken and recorded by a medical assistant or another staff member rather than the cardiologist. Similarly, a nurse or cardiology fellow may obtain a medical history and give a physical examination. To avoid any confusion, be sure that you know the name and role of each person who is involved in the process.
History and physical examination
A staff member will obtain the medical history of you or your loved one. Most medical histories cover the following areas:
Personal medical history. The personal medical history is information about the current problem (chief complaint) that prompted you or your loved one to seek medical attention, as well as the patient's past history of illnesses, surgeries, allergies and other relevant information. For example, "What were the symptoms or event that prompted you to seek medical attention?" It is often helpful to write down the symptoms beforehand and read them to the physician. After hearing these vital clues, the physician may ask some follow-up questions that could take about 20 to 30 minutes in an initial visit. The physician will also conduct a review of symptoms, which is a "laundry list" of symptoms related to various organ systems in the body. These questions are designed to discover additional information that you or your loved one may have forgotten to tell to the physician.
Family medical history. A family medical history is detailed information about the present and past health of the patient's family members. The patient's family medical history can greatly increase (or decrease) the risk of the patient developing certain medical conditions, including heart-related problems. Even family illnesses that do not seem important to the patient may ultimately allow a physician to make a more accurate diagnosis or to begin screening for certain conditions as soon as possible. A little documentation can go a long way towards preserving an individual's health, prolonging life and preventing the development of certain familial illnesses such as young-age heart attack. A complete family tree traces the medical history of an individual (and his or her spouse, if applicable), through at least several generations.
Social history. A staff member may also ask about the social history of you or your loved one, which might include information about diet, exercise, smoking or sex. The physician may also inquire about work or family life. This information helps the cardiologist to make better decisions and offer more effective counseling regarding current prevention and early treatment. By law, such information cannot be shared with anyone else unless written permission has been obtained.
You or your loved one will then be given a cardiovascular exam, which is far more focused on the condition and function of the heart and blood vessels than a more general physical examination. This exam will concentrate on the function and performance of the heart, veins and arteries.
A healthcare professional will listen to the heart, lungs and various blood vessels through a stethoscope (a process called auscultation) to detect any unusual sounds. For example, a crackling sound in the lungs (rales) could signify congestion in the lungs and, possibly, heart failure. Or a heart murmur could be a sign of valvular heart disease. Similar, a particular sound called a bruit in the carotid artery in the neck could be a sign of carotid artery disease, increasing the risk of stroke.
In addition to listening through the stethoscope, the healthcare professional will also use a finger or two to lightly press (palpate) the area over certain arteries and veins to feel the blood flowing just beneath the skin. A weakened or abnormal pulse in any part of the body could be a possible sign of heart-related disease. For example, a paradoxical pulse may be a sign of pericardial effusion, and a water hammer pulse is a telltale sign of aortic regurgitation.
Lastly, the healthcare professional may use a bright light to look into each of the eyes, examining the health of the tiny blood vessels present there. These blood vessels are particularly vulnerable to damage or disease if the patient has diabetes.
As part of a cardiovascular exam, an electrocardiogram (EKG) may be performed to painlessly record the heart's electrical activity. Additional tests that may be performed, which are also painless, include a chest x-ray and an echocardiogram. If an exercise stress test or nuclear stress test was scheduled in advance, then this test will also be performed.
Feedback from your cardiologist
Based on the information obtained from the first visit to the cardiologist, you or your loved one will then receive feedback from the cardiologist. The cardiologist will then do one of the following:
Either diagnose a condition that requires no treatment (e.g., minor premature ventricular contractions) or conclude that no serious medical condition is present. In this case, the cardiologist may recommend another follow-up appointment just to be safe or may determine that additional visits are unnecessary.
Diagnose a condition that may be managed with medication. The cardiologist will prescribe the appropriate medication and recommend periodic follow-up.
Recommend additional testing (e.g., a Holter monitor or a cardiac catheterization) to confirm a diagnosis and/or to gain additional information about an existing condition.
Diagnose a condition that requires more treatment than medication, such as catheter ablation or bypass surgery. The cardiologist may refer you or your loved one to a specialist (e.g., an electrophysiologist or a cardiothoracic surgeon) for additional treatment.
Make sure you take this opportunity to ask any questions that have not yet been answered. This is particularly important if you have been given printouts of electrocardiogram (EKG) results or other lab work and any terms are unfamiliar to you.
After the first visit to your cardiologist
In addition to keeping any follow-up or referral appointments that are scheduled at the end of the first cardiologist visit, there are a number of things that you or your loved one can do after leaving the cardiologist’s office.
Research any diagnosis that was given (search for the term on this site)
If a test was recommended, research that as well
If a medication was prescribed, learn about the potential side effects of the specific medication prescribed as well as General Drug Recommendations
If a procedure was recommended, search for the term on this site to learn how to prepare for the procedure, what to expect during and after the procedure and what the potential outcome means for your overall heart health
In addition to learning more about your treatment plan, a trip to the cardiologist is a wake-up call for many people to start taking better care of their cardiovascular health. Maybe you were told that your blood pressure was a little high, or you needed to lose weight, or you should quit smoking, or you should pay more attention to your cholesterol level.
Questions for your doctor
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to their first visit to the cardiologist:
What school did you receive your medical degree from? Where did you perform your residency?
Are you board-certified? How long have you been practicing?
Which local hospitals are you affiliated with?
What types of routine tests do you perform during an office visit?
Have you found anything wrong with my heart? Can you diagnose a condition?
Can this diagnosis explain my symptoms?
What other non-heart related conditions may be causing my symptoms?
Can you recommend any medications or procedures for the treatment of my condition?
How long will I be taking these medications?
Can you recommend a nutritionist or fitness trainer to help me improve my overall cardiovascular health?
