Your Heart and the Doctors Who Care For It

By Joy Pape, RN, BSN, CDE, WOCN

When Bill, who has diabetes and a family history of heart disease, had chest pain, he was told to see a special type of heart doctor—an “interventional cardiologist.” Like other heart doctors, he treats problems of the heart and blood vessels. Bill wondered what this specialty is and what an interventional cardiologist does. You, like Bill, might have seen these terms and wondered the same thing.

Some examples of interventional cardiology are:

Angioplasty

Angioplasty opens blocked arteries to restore normal blood flow to your heart muscle. A special balloon is inserted in your blocked artery and inflated; this opens up the blockage once the balloon is removed. Sometimes a tiny wire-mesh tube is inserted to help keep the artery open; this is called a “stent.”

Arrhythmia (irregular heartbeat) control

Treating abnormal areas of the heart with freezing temperatures and radio-frequency energy can restore normal heart rhythm.

Diabetes, Heart Disease, and Specialists

Because diabetes is considered a hormonal disease, most people who have diabetes see an endocrinologist, a physician who specializes in diagnosing and treating hormonal diseases. People with diabetes are at twice the risk for developing heart disease, so many people with diabetes have a cardiologist, too. In the fields of both endocrinology and cardiology, there are sub-specialties. Two cardiology subspecialties are preventive cardiology and interventional cardiology.

Preventive Cardiology

Preventive cardiology is dedicated to the prevention and management of cardiovascular disease. The same things you do to manage your diabetes are part of what you do to prevent heart disease. Preventive cardiology includes both informal and formal programs.

Informal programs can be as simple as your health care provider (HCP) assessing your risks for heart disease and teaching you ways to decrease these risks. For example, your HCP teaches you the importance of making healthy lifestyle choices to help you obtain and maintain a healthy weight. These lifestyle choices usually include healthy eating, physical activity and stress management. You may also be treated with medications to reach your recommended targets.

Formal programs involve a team of health care providers with programs to help you reach your targets and prevent heart disease. These programs can consist of meeting with a cardiologist, then regularly participating in an exercise program, better known as a cardiac rehab program, These programs may also have exercise physiologists, formal dietary education programs taught by dietitians, diabetes education classes taught by Certified Diabetes Educators, stress management classes run by psychologists, and more. Many times, besides meeting one-to-one with your cardiologist, these other programs are group programs.

Interventional Cardiology

Interventional cardiology deals specifically with the treatment of heart diseases once you have a problem. An interventional cardiologist is specially trained to perform these procedures. These types of procedures are considered minimally invasive because only a catheter is inserted in your body. Surgical procedures such as a cardiac bypass are considered invasive because the chest area needs to be opened.  In these minimally invasive procedures, the cardiologist numbs a spot on your groin or arm and then threads a catheter (plastic tube) into an artery, and then a wire is inserted through the catheter so it can travel to the heart via the artery.. Once there, the procedure needed can be performed. Once the procedure is performed, the catheter is removed. These are relatively painless procedures. You will need to lie still for a few hours after the procedure to prevent any bleeding at the catheter site. If you are taking any form of metformin, you may need to stop it before and after the procedure. Be sure to tell your health care team before you have any procedures done and ask about their policy on metformin.

Whether you have heart disease or you don’t, diabetes does increase your risk. Remember, when it comes to diabetes and any of its complications, prevention is the best medicine.