A Trip to the Cardiologist

I see a lot of anxiety associated with a first time visit to the cardiologist.  Chest pain, palpitations, fainting, and shortness of breath can all be scary symptoms related to heart disease.

Or they may not be.

I may surprise you when I say this:  More often than not, for patients who come in for an initial consultation for one of these symptoms, the cause is not cardiac.

Chest pain can be due to many things other than the heart -- a pulled muscle, esophageal reflux, anxiety or stress.  While palpitations may be an arrhythmia, they may be due to anxiety and stress.  And the most common cause of fainting is a vasovagal event, which is completely benign and improved with lifestyle changes.

A common scenario is a patient who comes in with symptoms that after a thorough evaluation I determine is not related to his heart, but that same patient has multiple uncontrolled cardiac risk factors.  A typical patient would be a middle-aged man with chest pain that is burning in nature and worse with eating spicy food and worse at night.  We determine that his pain is due to esophageal reflux and is not due to his heart.  HOWEVER.... he has uncontrolled diabetes and high blood pressure, smokes, doesn't exercise, and eats poorly.  So, once I reassure him that his chest pain is not coming from his heart, we discuss the uncontrolled risk factors that are the true threats to his heart health.

That said, I see some pretty serious stuff.  I'm sending one recent new patient for urgent heart valve surgery.  Another in all likelihood has pretty severe coronary artery disease, so we're getting him tested very quickly before we proceed to more invasive exams.

My point is this:  Being referred to a cardiologist can be scary, but doesn't necessarily mean you have a life-threatening heart ailment.