Coronary Artery Disease: Roles of Different Doctors

Topic Overview

What health professionals are involved in taking care of people with coronary artery disease?

Following the diagnosis of coronary artery disease (CAD), you should visit your primary care physician every few months to track your condition and ensure that your treatment is going as planned. If you have complications or need special procedures (such as cardiac catheterization or open-heart surgery), you may need treatment from a variety of specialists.

Understanding your health professionals' roles

Depending on how severe your CAD is and whether you already have complications, you may need a team of health professionals to help treat your disease and manage your treatment plan.

The following table outlines the types of health professionals who may be involved in the treatment of CAD and related complications.

Health professionals for CAD

Health professional

Who are they?

What is their role?

When would you see them?

Primary care physician Internist, family physician Manage medical care Regular visits (about 2 to 4 per year)
Cardiologist Heart specialist

Provide specialty medical care

Sometimes for regular visits or when CAD gets worse
Other physicians Nephrologist (kidney specialist), cardiovascular surgeon (heart surgeon), neurologist (brain/nerve specialist) Provide specialty medical care for complications of CAD When complications arise or when special procedures need to be done
Nurse educator Specific type of nurse Educate you and help you take control Whenever medicines, diet, or self-management needs to be explained

Cardiac rehabilitation team

Doctor, nurse specialist, dietitian, exercise therapist, and physical therapist

Help you recover from an event or procedure and make healthy lifestyle changes

During the rehab program

Psychiatrist, psychologist, or social worker Mental health professional Help you cope with psychological aspects of disease Regularly (perhaps weekly), for as long as you need
Dietitian Nutritional expert Help you with heart-healthy diet Initially, and whenever diet needs to be changed

Although you may not need help from all of these providers, it is good to be aware of the full range of professionals you may encounter at some point during the course of your treatment. If you need the help of other health professionals, you should keep in constant contact with your primary care doctor and report any changes in the way you feel or any medicine-related side effects. Each individual's experience with CAD and with its complications is different. Your health professionals will help tailor your treatment to best suit your needs.

What is the role of a primary care physician in caring for people with coronary artery disease?

In some cases, your primary care physician (PCP)—usually an internist or family medicine physician—will serve as your care coordinator and be responsible for the day-to-day medical management of your coronary artery disease. In these cases, your PCP will be the one who evaluates your risk factors, does diagnostic tests, and looks for evidence of other diseases.

After you are diagnosed with CAD, your PCP will help you build a treatment plan and will also decide whether you need to start taking medicines or whether you need certain procedures to diagnose the severity of your CAD. For this reason, it is important that you are open with your doctor and make sure that he or she knows of any changes in your symptoms.

In general, you should visit your PCP once every few months to make sure that you are on track with your CAD treatment and to continue with your general medical care. In addition to a physical exam at each visit, you and your doctor should review your progress with lifestyle modifications and, if applicable, experiences with your prescribed medicines. If you have new or changing symptoms, your PCP may do or request tests to check your heart.

Most primary care physicians are qualified to develop and manage treatment plans for chronic diseases such as CAD. But if you develop complications or have more severe CAD that needs a procedure or surgery as treatment, your primary care physician may refer you to a specialist.

What are the roles of specialists in caring for people with coronary artery disease?

In some cases, a cardiologist will serve as your primary point of contact in treating and managing your CAD. Whether you work more closely with a primary care physician (PCP) or a cardiologist depends on a number of factors, including the nature of your condition and the relationship you may already have with either physician. Whether you see your cardiologist to treat mild atherosclerosis or to provide follow-up care after a major surgery, this specialist will add heart-specific expertise to your treatment plan.

What is the role of an interventional cardiologist?

An interventional cardiologist can do a cardiac catheterization, an invasive procedure used to take X-rays of your arteries and diagnose any narrowed areas in your coronary arteries. An interventional cardiologist can also do an angioplasty and place stents during a cardiac catheterization to open narrowed or blocked arteries.

What is the role of a cardiac surgeon?

In some people, an open-chest surgery, called bypass surgery, may be recommended to bypass the blocked vessel and allow blood to reach the heart.

A cardiothoracic surgeon (also called a cardiovascular surgeon or a cardiac surgeon) is a specialist trained to do this surgery.

What are the roles of other specialists?

If you develop certain CAD-related complications, you may need to see a number of other specialists to treat your specific conditions. For example, you may need to see a nephrologist (kidney specialist) if you develop kidney problems or a neurologist (brain and nervous system specialist) if CAD leads to a stroke. Your primary care physician will direct you to the specialists who are skilled in treating your specific condition. You may be referred to the following specialists:

Nurse educator

While primary care physicians serve as central coordinators of care for many people with CAD, nurse educators are valuable resources as well.

In addition to serving as a care coordinator, your nurse educator will serve other important functions. For example, a professional educator may be the first one to help you understand CAD, begin your treatment plan, teach you about the effects of various medicines on your condition, and help you with lifestyle changes.

One of the nurse educator's most important roles is to provide you with the information you need about your disease as you are ready to handle it. You will have CAD for the rest of your life, and your nurse educator can be there with the information that you need to adapt to changes in your condition.

Cardiac rehabilitation team

A cardiac rehabilitation (rehab) program teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. A cardiac rehab team often includes a doctor, a nurse specialist, a dietitian, an exercise therapist, and a physical therapist. The team designs a program just for you, based on your health and goals. Then they give you support to help you succeed.

Dietitian

Because what you eat has a big effect on your coronary artery disease, you may seek the aid of a dietitian or nutritionist to help you develop a heart-healthy diet. If you also have high blood pressure (hypertension) or diabetes, it may be important to limit salt and sugar intake as well.

Dietitians are trained in nutrition and are experienced in helping individuals make lifestyle changes. They understand that adjustments to your eating habits can be the hardest changes to make. And they can help you take small steps toward the larger goal of a balanced diet.

Mental health professional

Many people with serious conditions such as CAD experience depression, either independently or as a result of their physical condition. Psychiatrists, psychologists, and clinical social workers can help you deal with the mental challenges associated with any CAD-related complications that you may have. Also, they can help you learn to manage the stress in your life, which can have a direct bearing on the success of your treatment plan.

Credits

By Healthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer John A. McPherson, MD, FACC, FSCAI - Cardiology
Last Revised April 6, 2012

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