The cardiovascular consultation is your introduction to the cardiologist, who will elicit a detailed history of your problem and perform a thorough examination of your heart and vascular system. The history of your problem will also include eliciting information about other diseases and symptoms, a medical history of your close relatives, and information about the risk factors that lead to coronary disease (hardening of the arteries), elevated cholesterol and other fats in your blood, high blood pressure, diabetes, and smoking. The cardiologist will also want an exact list of your medications and the dose and frequency that they are taken, as well as any history of medication, allergies or intolerances. It is helpful if you bring a list of your medications with you, or bring the medicine containers themselves. Pertinent information, especially test results, from other doctors should be secured, if possible, for review.
The cardiovascular consultation is one of the most important "tests" your cardiologist will "perform". At its completion your cardiolgist will usually have a reasonable impression about the nature of the problem and what additional tests will likely be required to further clarify the diagnosis. You can help your cardiologist by being thorough, but also concise in supplying the above information in response to his queries.
Congenital heart disease (CHD) is heart disease in the newborn, and includes structural defects, congenital arrythmias, and cardiomyopathies. CHD is a defect of the heart that exists primarily at birth, and can describe a wide variety of different abnormalities affecting the heart. CHD occurs when the heart or blood vessels near the heart does not develop properly before birth. Therefore, the heart does not pump because it is not completely developed. Also the blood flow is obstructed in the heart of the vessels nearby, causing an abnormal flow of blood through the heart. Blood flow obstructions put a strain on the heart muscle causing the heart to work harder and beat faster. Abnormal blood flow usually occurs when there is a hole in the walls of the heart and may be an abnormal connection between two arteries outside the heart.
Coronary artery disease means narrowing of the coronary arteries (arteries that supply blood to the heart). This narrowing is due to a buildup in the walls of the arteries of plaque (deposits made up of cholesterol, other fats, and calcium)—a process called atherosclerosis (hardening of the arteries). If a plaque becomes delicate and breaks, a blood clot will quickly form that can block blood flow in the artery and may lead to a myocardial infarction (death of the heart muscle area supplied by the blocked artery), often referred to as a heart attack. Several tests can be performed in an emergency department to determine if a heart attack is occurring. Blood tests can detect certain substances in the blood that are released during a heart attack. An electrocardiogram (ECG, EKG) can reveal heart attacks and heart rhythm problems.
An electrophysiology (EP) study is a test that can precisely record the electrical activity inside the heart. It is often used to determine whether there is an extra electrical pathway inside the heart and, if so, where it is located.
During an EP test, one or more thin, flexible wires are inserted into veins in the arm, groin, or neck and threaded into the heart. Small electrical conductors called electrodes are positioned inside the heart to measure electrical signals. The wires transmit information about the electrical activity to a machine that measures and records the activity. The information can be displayed on a screen or printed onto a paper tracing for a more detailed picture of how electrical signals flow inside the heart.
Electrical currents can also be sent through the wires into the heart (pacing). This is done during the procedure to determine whether abnormal rhythms can be triggered in the heart. This allows the doctor to determine the type of heart rhythm abnormality and the best way to treat it.
A disease of blood vessels outside the heart is called Peripheral vascular disease (PVD) which affects the peripheral circulation, as opposed to the cardiac circulation. PVD comprises diseases of both peripheral arteries and peripheral veins. PVD is sometimes incorrectly used as a synonym for peripheral artery disease (PAD). Intermittent claudication due to inadequate blood flow to the leg is an example of peripheral artery disease (PAD) while varicose veins and spider veins are examples of peripheral vein disease.
