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A cardiologist is a doctor who specializes in the cardiovascular system - which includes the heart and blood vessels. Cardiologists are experts in the anatomy and health of the heart, the cardiovascular system, and a wide range of heart diseases. They are sometimes referred to as heart doctors.

Heart disease is the leading cause of death in the US, and cardiologists are on the frontlines of the fight against this condition. They treat heart disease as well as many other related issues, like high blood pressure, blocked arteries, heart attacks, heart valve disease, arrhythmia, and heart failure. They also promote heart-healthy habits with their patients.

Board-certified cardiologists must complete undergraduate training, medical school, a residency in internal medicine, and a cardiology fellowship. Once they have completed their education (which takes about 15 years!), cardiologists earn certification from the American Board of Internal Medicine (ABIM).

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Cardiologists treat a spectrum of heart diseases, including:

- Heart attack: A blockage of fat, cholesterol, and other substances in the arteries that can be fatal. Signs of a heart attack include pressure, pain or aching in your chest and arms, nausea, cold sweat, fatigue, shortness of breath, sudden dizziness, and/or feeling lightheaded. If you think you are having a heart attack you need to act immediately.

- Heart failure: A gradual weakening of the heart muscle that can get worse over time and can lead to a heart attack.

- Arrhythmia: When the electrical impulses that regulate heart rhythm don’t work properly, this is called arrhythmia. It can feel like a racing heart, or a fluttering and can happen along with palpitations. Heart palpitations: Skipping heartbeats, pounding, rapid heartbeats, or beating too fast.

- Atrial fibrillation: An irregular heartbeat that may increase your chances of getting a stroke.

- Coronary artery disease: When the blood vessels that supply blood, oxygen, and nutrients to your heart become damaged or diseased. Stroke: A blockage of blood supply to the brain that can cause major bodily damage and may result in death.

Cardiologists can perform a wide range of procedures, including:

- Ablation: A heart that beats too quickly, palpitates, or has arrhythmia can benefit from ablation. This procedure involves ablating the troubled area, causing scar tissue to develop which helps prevent short-circuiting. If you suffer from tachycardia, a condition that causes your heart to beat around 100 beats per minute or higher, you may also benefit from ablation.

- Electrocardiogram (EKG): An EKG machine records the electrical signals in your heart. It may be used to check for abnormal heart rhythms, detect heart attack, or check up on heart disease treatments including pacemakers and stents.

- Echocardiogram (ECG): A machine that uses sound waves to create an image of your heart.

- Angioplasty: A procedure that threads a thin tube through a blood vessel in the groin or arm to restore blood flow to an artery.

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Cardiologists treat a wide spectrum of heart diseases and vascular diseases, which include:

- Heart and blood vessel disease (Cardiovascular disease): The term "heart disease" encompasses several conditions that include heart attack, stroke, heart failure, arrhythmia, and heart valve problems.

- Heart attack: Heart attacks occur when fat, cholesterol and other substances block arteries. Heart attacks can be fatal. Signs of a heart attack include pressure, pain or aching in your chest and arms, nausea, cold sweat, fatigue, shortness of breath, sudden dizziness, and/or feeling lightheaded. If you think you are having a heart attack you need to act immediately.

- Stroke: A blockage of blood supply to the brain that can cause major bodily damage and may result in death.

- Congestive heart failure: A gradual weakening of the heart muscle that can get worse over time and may lead to a heart attack.

- Arrhythmia: When the electrical impulses that regulate heart rhythm don’t work properly. It can feel like a racing heart, or a fluttering and can happen in addition to palpitations.

- Heart palpitations: Skipping heartbeats, pounding, rapid heartbeats, or beating too fast.

- Coronary artery disease: When the blood vessels that supply blood, oxygen, and nutrients to your heart become damaged or diseased.

- Hypertension: High blood pressure.

- Atrial fibrillation: An irregular heartbeat that may increase your chances of getting a stroke.

Symptoms of heart conditions can vary depending on the condition. However, there are several signs that you should speak to a doctor or cardiologist right away. These symptoms include:

- Pain or discomfort in the chest: Tightness in the chest or chest pain can be an early indicator of a blocked artery, heart infections, or arrhythmias. Pain in the chest can also be a warning sign that you are having a heart attack.

- Dizziness or lightheadedness: Dizziness or lightheadedness can indicate arrhythmia, cardiomyopathy, or heart valve disease. If your blood pressure has dropped significantly, this can also produce lightheadedness.

- Fatigue: Fatigue or shortness of breath can be an indicator of cardiomyopathy (diseased heart muscle), coronary artery disease, congenital heart defects, arrhythmias, and more. Fatigue and shortness of breath while performing daily activities is one of the most common signs of heart disease.

- Swelling or coldness in legs, feet, ankles: Swelling or coldness in the lower extremities is a common sign that the heart is not pumping blood effectively. This can be a sign of heart valve disease, atherosclerosis (buildup of plaque in arteries), cardiomyopathy, and more.

- Irregular heartbeat: Fast (“fluttering”) or slow heartbeats are common signs of arrhythmia, weakened heart pumping, and heart valve problems.

If you have had any of these symptoms in the past, or are experiencing them, talk to a doctor right away. These sensations can be signs of life-threatening heart disease. In the United States, 1 in 4 deaths a year is caused by heart disease or complications from heart disease. Images taken of your heart muscle can help detect these conditions early, and help prevent severe problems down the road.

There are several different types of echocardiograms that are used by cardiologists; they all use sound waves to create pictures of your heart but are applied in slightly different ways. The most common types of echocardiograms are:

- Transthoracic echocardiograms (TTE):

This is the most common form of echocardiogram test used by cardiologists. The sonographer (the person who operates the imaging machine) places a transducer on the chest over the heart. The transducer sends high-frequency sound waves (ultrasound beam) through the chest to the heart. As the sound waves bounce off the heart, the transducer records these echoes. A computer then interprets the sound waves into a moving image that can be seen on a monitor. This image shows the heart beating, and blood vessels flowing through the heart.

- Transesophageal echocardiogram:

If doctors need a more detailed image of the heart, they may ask to do this type of test. During the test, the throat will be numbed, and the patient will be given sedation drugs to help relaxation. A tiny transducer will be guided through the mouth and down the throat to the stomach via the esophagus (the tube that connects the throat to the stomach). By doing this, the transducer is put behind the heart. The transducer then records sound wave echoes from the heart. These sound waves are interpreted by a computer into a moving image of the heart which can be seen on a monitor. This helps the sonographer get a better look at some of the heart’s chambers that are hard to see in a TTE test.

- Stress echocardiogram:

This test is the same as a TTE test (transducer placed on the chest over the heart) but is performed after a cardiac stress test. This stress is usually created by running or walking on a treadmill, or with medication that makes blood pump as if the body is exercising. By creating ultrasound images after activity, doctors can see how well the blood is pumping blood to the body. This helps detect narrowing of the arteries, a condition that can lead to heart failure and heart attack.

- Doppler echocardiography: This is done with TTE and Transesophageal tests using the Doppler effect. The pitch of sound waves change as they echo off blood cells moving through blood vessels and the heart muscle, and these signals are used to determine the speed and direction of blood flow. This helps doctors measure blockage in the arteries, and check for leakage in the heart valves. Doppler ultrasounds are useful in catching coronary artery disease and heart disease in children.

Echocardiograms are noninvasive diagnostic tests that use high-frequency sound waves to create images of the heart, the heart’s structures, and blood flow through the heart.

Doctors use these images to help monitor and diagnose heart conditions such as:

• Arrhythmias (abnormal heart rate)
  
• Heart disease (like congenital heart defects)
  
• Heart failure (weak or abnormal pumping of the heart muscle)
  
• Cardiomyopathy (thickened heart muscle)
  
• Heart attack
  
• Coronary artery disease (plaque build-up on the arterial walls leading to the heart)
  
• Pulmonary hypertension (high blood pressure in the arteries leading to the lungs)
  
• Narrowing or blockage of the heart valves
  
• Leaky heart valves
  
• Endocarditis (infection in the heart valves)
  
• Blood clots and tumors
  

Echocardiograms are painless, effective procedures that can help detect the risk or effects of heart disease and conditions of the heart. According to the CDC, heart disease is the leading cause of death in the United States. If you are experiencing symptoms related to heart disease or a heart condition, talk to a doctor right away.

No special preparation is needed before most echocardiogram exams. Unlike other forms of diagnostic imaging, you do not need to fast or forego medication in the hours before your appointment.

If you are undergoing a transesophageal echocardiogram, your doctor may ask that you refrain from eating for several hours before the exam. Additionally, transesophageal echocardiograms utilize sedative medicine to reduce discomfort during the test. Because of this, it is recommended that you organize a ride home after your appointment. You will be unable to operate motor vehicles for a few hours after these tests.

Echocardiograms are risk-free. Sonographers use ultrasound echoes to create moving images of the heart, so tests are free of X-ray beams and radiation.

Stress tests have a small risk of irregular heartbeat or heart attack, but this is rare. Stress tests are done under the watch of an experienced doctor who will monitor oxygen levels and heart rate, ensuring that the test is safe and controlled.

If a transesophageal test is needed for a more detailed image, the transducer is guided through the esophagus to the stomach. This can cause very mild soreness in the throat after the test, but this result is rare.