Signs You Need to See a Cardiologist

The expression “better late than never” applies to a lot of things in life. Your heart health, however, is not one of them. When it comes to caring for your heart, early awareness of heart disease symptoms and risk can save your life.

Lola Ojutalayo, MD, a Mass General Brigham interventional cardiologist and medical director of the Cardiac Rehabilitation Program at Salem Hospital, offers insight into when you should see a heart doctor and why.

“Heart disease is the leading cause of death in the U.S.,” states Dr. Ojutalayo. “It’s very important that you understand what can make your heart sick and know how to reduce your risk of heart disease as you age.”

What is a cardiologist?

A cardiologist is a doctor who specializes in diagnosing and treating heart problems. “Cardio” means heart, stemming from the Greek word kardía. Each cardiologist has a specialty, such as heart imaging, heart surgery or heart rehabilitation.

What does a cardiologist do?

“As cardiologists, we see the whole range of heart conditions,” says Dr. Ojutalayo. To explain potential heart problems, she compares the heart’s components to plumbing and electrical systems.

“I call myself a heart plumber,” jokes Dr. Ojutalayo. “The most common heart condition I see is coronary artery disease (CAD). As an interventional cardiologist, I open up the heart arteries (or pipes) when you have a heart attack. This relieves your chest pain and improves blood flow to the heart muscle.”

CAD is a buildup of cholesterol-filled plaque (various substances carried in the bloodstream) in the heart arteries. Plaque narrows the arteries and may entirely block blood flow to the heart as it builds up over time.

Learn about signs you need to see a cardiologist, including heart disease symptoms, heart attack symptoms, and irregular heartbeats. 

Heart disease symptoms

Changes to your tolerance for physical activity — whether it’s running, going up a flight of stairs or simply walking around your house — may be a sign of heart disease. Cardiologists assess your symptoms and any changes in your ability to perform previously doable activities.

Like other muscles in your body, the heart muscle works harder with any physical movement. More activity requires more oxygen to be pumped through the heart. So it makes sense that a blockage in the pipes would cause problems.

“The hallmark symptom of heart disease is when you have chest pain while you’re active in some way. Then suddenly it’s better when you’re sitting and rested,” highlights Dr. Ojutalayo. “That experience indicates you need to talk to your primary care provider (PCP) or see a cardiologist right away.”

In addition to chest pain with activity (also called angina), you may experience:

• Chest tightness, pressure, or discomfort
  
• Pain that starts near your chest and reaches your shoulder, arm, jaw, neck or back
  
• Shortness of breath
  
• Heart palpitations (less common)
  

Recognizing the symptoms of heart attack

“With a heart attack, you have a complete (100%) or near complete blockage of the heart artery,” says Dr. Ojutalayo. “Chest pain symptoms from a heart attack often have a sudden onset, aren’t caused by much (if any) activity and are persistent.”

If you think you had a heart attack, seek immediate medical attention and call 911. Symptoms of a heart attack may include:

• Chest pain
  
• Nausea
  
• Sweating
  
• Dizziness
  
• Neck, back or jaw pain
  
• Pain at the top of your belly (less common)
  

Arrhythmia and heart palpitations

Other heart doctors called electrophysiologists specialize in your heart’s electrical system, which regulates your heartbeat. These specialists treat irregular heartbeats (arrhythmias), such as a rapid heart rate or frequent heart palpitations. 

“Heart palpitations feel like your heart is skipping a beat, beating irregularly or racing. They’re definitely a reason to see a cardiologist or notify your primary care doctor,” says Dr. Ojutalayo.

Sources both in and outside of your heart can trigger palpitations. Cardiologists use a heart rhythm monitor to examine your heart and look for any abnormal heart rhythms.

Risk factors for heart disease

“Seeing a cardiologist isn’t just for people with symptoms or who’ve already been diagnosed with heart disease,” says Dr. Ojutalayo. “It’s also for anyone who has risk factors for heart disease.” 

Risk factors are things that make you more likely to develop heart problems in the future. Understanding your risk starts with seeing your primary care provider regularly (once a year). They will identify and monitor things that increase your risk for heart disease, including:

• Diabetes
  
• Chronic kidney disease
  
• High blood pressure or hypertension
  
• High cholesterol
  
• Obesity
  
• Smoking tobacco
  
• Family history of early heart disease
  

Even if you live a healthy lifestyle, a family history of early CAD significantly increases your risk for heart disease. A family history of early CAD means:

• Your mother developed CAD before age 65
  
• Your father developed CAD before age 55
  

Early awareness of risk helps you and your doctor most effectively prevent heart problems in the future. Your primary care doctor can refer you to a cardiologist if needed. You can also meet with a cardiologist to receive a more in-depth assessment of your risk and identify any heart disease symptoms.

Do I need a referral to see a cardiologist?

You don’t need a referral to make an appointment with most cardiologists. Nurse coordinators help match you with the right type of heart doctor given your symptoms. 

However, your insurance company might require a referral to cover medical costs. You should check with your insurance provider first to avoid ending up with a larger bill than expected. If your insurance wants a referral, talk with your primary care doctor about seeing a cardiologist.

Listen to your heart

It can be easy to minimize or ignore your symptoms, but Dr. Ojutalayo emphasizes the importance of early action and listening to your body. 

“The earlier you come in to see a cardiologist, the better your heart health will be,” she says. “Early treatment for your symptoms prevents the heart muscle and heart tissue from becoming irreversibly damaged.”