Cardiovascular diseases are a major focus in internal medicine. This is hardly surprising: heart-related diseases are the leading cause of death worldwide.
Cardiology is the branch of medicine that deals with the heart. Cardiologists are responsible for diagnosing and treating congenital or acquired diseases of the heart, the blood vessels near the heart, and the circulatory system.
Along with the brain, the heart is the most important organ. For this reason, cardiovascular diseases—such as a heart attack—can quickly become life-threatening.
There are many conditions that fall within the scope of an internist specializing in cardiology: heart failure, arrhythmias, and heart valve defects are among them. Coronary artery disease (CAD), a condition affecting the coronary arteries, is also common, as is myocarditis, an inflammation of the heart muscle.
Diagnostic methods for cardiological conditions include: measurements of heart activity (electrocardiogram, or ECG), cardiac catheterization, echocardiography, and computed tomography (CT) scans of the heart.
Heart diseases often require intensive care. The placement of stents and pacemakers are treatments necessary when the heart’s blood vessels are narrowed. It is therefore obvious that cardiologists work closely with cardiac surgeons.
What is cardiology?
Cardiology is a branch of internal medicine. It deals with the diagnosis and treatment of congenital and acquired diseases of:
- the heart
- Circulatory
- vessels near the heart, as well as the
- the pericardium
Pediatric cardiology is not part of internal medicine but is affiliated with pediatrics and adolescent medicine.
In addition to the ECG, echocardiography plays an important role in diagnostic imaging.
Treatment involves both conservative and interventional (surgical) therapies.
Surgical procedures on the heart are usually performed at a cardiology clinic. Cardiology clinics offer a wide range of services.
It ranges from the diagnosis of high blood pressure and simple catheter procedures to complex heart transplants. The focus of conservative therapy is on medication.
Cardiology treats patients with heart and circulatory diseases @ Charlie's /AdobeStock
Therapeutic Services Offered by Cardiology
The treatment and management of congenital and acquired cardiovascular diseases are best handled by a cardiologist. Depending on the severity of the condition, a cardiac center specializing in heart disease is the best facility.
Depending on the cause and severity of the condition, cardiology specialists have both conservative and surgical treatment options at their disposal.
The main focuses of conservative therapy are:
- Medication: The most important classes of medications include nitrates and molsidomine, beta-blockers, calcium channel blockers, ACE inhibitors, and diuretics.
- Treatment of any underlying condition
- Eliminating and changing harmful lifestyle habits
- Electrocardioversion (electrical treatment, “electroshock”) for certain types of arrhythmias
- Exercise therapy to improve cardiac output
Surgical procedures are generally performed at hospitals. These facilities have all the necessary equipment and experienced staff available in case of an emergency.
Most cardiology clinics also have a catheterization lab where not only cardiac catheterization procedures (coronary angiography) but also surgical catheter treatments are performed.
Surgical options for the treatment of cardiovascular diseases include, for example:
- Balloon angioplasty (also known as PTCA)
- Stent implantation in the coronary arteries
- Rotary ablation to remove very hard and calcified narrowings in the coronary arteries in cases of coronary artery disease
- Catheter ablation (ablation therapy) for cardiac arrhythmias
- Implantation of an artificial heart valve
- Implantation of a valve clip
- Dilation of a narrowed heart valve (valve dilation) in cases of heart valve defects
- Catheter-guided closure of a persistent foramen ovale and an atrial septal defect (congenital heart defect)
- Implantation of pacemakers, defibrillators, and cardiac resynchronization pacemakers for heart failure
- Heart transplantation for heart failure
- Basic intensive care, such as for heart attacks
A stent is a metal medical implant that doctors place in the heart’s blood vessels @ peterschreiber.media /AdobeStockDiagnostic Procedures in Cardiology
Every examination begins with a medical history (review of the patient’s medical history) and a clinical examination.
Various technical procedures are used to determine the cause or extent of the disease.
These include recording the heart’s electrical signals. This is done as a standard ECG or, over a longer period, as a Holter monitor.
This provides evidence of various heart diseases, circulatory disorders, and cardiac arrhythmias.
Since some abnormalities only become apparent during physical exertion, a stress ECG may also be necessary. This is particularly important in cases of coronary heart disease.
A chest X-ray can be used to evaluate the following areas:
- Heart chambers
- Aorta
- Condition of the lungs
The heart chambers and heart valves can also be clearly visualized using echocardiography (ultrasound examination).
A stress ECG measures the heart’s performance @ Yistocking /AdobeStock
Other important tests include:
- Myocardial scintigraphy to visualize the heart muscle
- Radionuclide ventriculography to visualize the contraction of the ventricle
- Cardiac catheterization to measure pressure in the heart chambers and at the heart valves, as well as to assess heart function
- Performing and interpreting angiocardiograms and coronary angiograms to visualize the coronary arteries
- Intravascular ultrasound (IVUS)
Qualifications of Cardiology Specialists
Cardiology specialists are generally designated as board-certified physicians in internal medicine and cardiology (so-called cardiologists).
Prospective cardiologists must complete at least 6 years of advanced training in internal medicine and general practice, as well as in cardiology.
A model training regulation issued by the German Medical Association specifies which diagnostic and therapeutic procedures must be performed and how frequently.
For example, future cardiologists must have performed at least 500 echocardiograms and at least 300 left heart catheterizations.
How do I find the “best hospital” for cardiology?
It is not possible to designate a hospital as the “best hospital” or “top hospital” for cardiology. However, there are doctors and hospitals that specialize in the treatment of cardiovascular diseases. They therefore have extensive experience. You can find these cardiology experts in the Leading Medicine Guide.
What makes our doctors specialists in cardiology?
The Leading Medicine Guide features only select, highly qualified medical experts and specialists.
All listed doctors possess a high level of professional expertise and have extensive experience in the field of cardiology. They therefore meet the Leading Medicine Guide’s strict admission criteria.
