Your heart beats 100,000 times every day! Pumping blood and nutrients through the blood vessels to every organ in the body. When you realize that heart disease is the biggest killer in men and women you can appreciate why it is important to look after your heart! It is thought that 90% of heart attacks and strokes are completely preventable with the right care and attention to your health.  In this article we look at what a cardiologist does and the top 10 reasons you should visit a cardiologist in Singapore.

What is a cardiologist?

A cardiologist is a doctor who specializes in the management and prevention of diseases of the heart and the blood vessels. They are also experts at evaluating symptoms that could be caused by the heart, for example chest pain, palpitations,  shortness of breath and dizziness. 

What does a cardiologist do?

A cardiologist will discuss your symptoms or problems then arrange some tests to evaluate the heart like ECG, echocardiography, blood and stress tests.  Once they have all the information, they will give you a diagnosis and recommend treatment, if necessary.  Sometimes treatment will be medication, and other times it might be invasive like stenting of the arteries or pacemaker implantation or they may sometimes recommend treatment by a surgeon. 

Top 10 reasons to see a cardiologist:

1. High cholesterol – High cholesterol leads to fatty plaques in the arteries all over the body. In the heart arteries this can lead to heart attacks or chest pains (angina). In the brain/neck this can lead to strokes. Cardiologists are experts in the treatment of high cholesterol.  They can examine all the cholesterol components and then use tests like ultrasound and CT to look for evidence of blood vessel and heart disease. Lowering cholesterol early can prevent heart attacks and strokes. There are many treatments such as statins and PCSK9 inhibitors that can be used to lower cholesterol.
2. High blood pressure – Blood pressure is the measure of force being placed against the artery walls all over the body. If that pressure is too high it damages the blood vessels and organs causing heart attacks, heart failure, strokes, blindness and kidney failure. Ideally your blood pressure should be < 120/80. Your cardiologist is a specialist in the assessment and treatment of high blood pressure (hypertension).
3. Heart pain – Getting pains in the chest can be a sign of heart disease or heart attack. If you ever get chest pain, don’t ignore it! If concerned, call emergency services immediately! Your cardiologist will work out the cause of the pain and treat it.
4. Physician recommendation – If you go to your GP/family physician or see another specialist sometimes they will pick up things that need the specialist attention of a cardiologist. For example, if you attend your GP with pain in your chest, and they have concerns it could be heart pain they will refer you to a heart specialist.
5. Family history – Family history is incredibly important when it comes to heart problems. If your mother, father, brother, or sister had heart disease or a heart attack before the age of 65, this is a warning sign that you could be at risk of heart disease too. You should attend a cardiologist where they can work out if you are at risk.
6. Shortness of breath – Breathlessness can be a sign of heart problems. Common heart causes of breathlessness are arrhythmia, coronary artery disease, and heart failure. It is best to see a cardiologist for the assessment of shortness of breath using heart ultrasounds (echocardiography) and cardiac stress tests.
7. Kidney disease – Believe it or not, having kidney problems is a good reason to see a heart specialist! If you have problems with the kidney, it is often a sign that there are problems also in the heart and blood vessels. Best to visit a cardiologist and get checked out before it is too late.
8. Smoker – If you are a smoker or an ex-smoker, then you have an increased risk of heart attacks, strokes, and angina. When you visit your heart specialist they can easily assess your heart and arteries to see if you have caused any damage to them. If you catch the disease early, then often more serious consequences like heart attacks can be prevented.
9. Diabetes – Patients with diabetes are much more likely to get disease of the heart and blood vessels including high cholesterol and hypertension. They are at much higher risk of heart attack, heart failure and stroke. It is vitally important that diabetes patients are carefully managed to prevent these consequences. A cardiologist is the best person to manage a patient with diabetes often in tandem with their endocrinologist.
10. Starting to exercise – If you have been sedentary/inactive for a long time and plan to start exercising, then it is recommended by international guidelines that you are assessed by a cardiologist first. Inactive people can have asymptomatic heart disease. It can lead to sudden death if they start exercising too vigorously. Your cardiologist can assess your risk of this prior to initiating an exercise program and often help guide you in what exercise is best.

Related article: How Much Does It Cost To See A Cardiologist In Singapore?

What diseases do they treat?

Cardiologists treat disease of the heart and blood vessels.  A list of some of the more common ones are provided below:

• High blood pressure
• High cholesterol
• Heart attacks and angina – coronary artery disease
• Heart muscle diseases – cardiomyopathies
• Heart failure
• Palpitations – arrhythmia, atrial fibrillation
• Myocarditis and pericarditis
• Heart valve disease

What happens at a first visit to a cardiologist?

At your first visit, your heart specialist will start by taking a detailed history of all your symptoms and previous illnesses and treatment. This will then be followed by a physical examination that focuses on the heart and blood vessels. Depending on the problem that you have, your cardiologist will then perform a series of tests that may include: ECG, echocardiography (heart ultrasound), heart stress test, blood tests, cardiac CT, coronary angiography and cardiac MRI. 

Once they have all the results, your cardiologist will discuss your potential diagnosis and how to best treat it. This will most likely be using medication, but sometimes people may need angioplasty/stenting or pacemaker implantation. Very rarely your cardiologist may need to refer you to a heart surgeon for open heart surgery. You can view my video on this topic here.