Cardiologist is the field of activity of a doctor. When should you contact him? Pediatric and adult cardiologist

Initial appointment with a cardiologist - 1500 rubles.

An expert in matters of the heart, Honore de Balzac wrote: “The heart is a treasure. If you spend it right away, you’ll be a beggar.” Life is very difficult for such a “beggar”. To avoid becoming one, it is important to visit a specialist on time. When the first symptoms of cardiovascular disease appear, you need to see a cardiologist.

How is the reception going?

The first meeting with the doctor is an introduction between you and the cardiologist about your medical history. Damages to the heart and blood vessels directly affect the functioning of all organs. During the consultation, the doctor will try to determine the extent of this influence. It is necessary to tell about the symptoms that bother you and the time of their onset. Many heart diseases are genetically determined. Therefore, if your relatives have heart and vascular diseases, a specialist should find out about it. Tell us about chronic diseases other systems and organs. Perhaps they may be relevant to your current condition.

During initial consultation held full inspection sick. For diagnosis, the color and condition of the skin, size are important thyroid gland and lymph nodes. The chest and abdomen are palpated and assessed. The doctor listens to the heart, measures blood pressure and pulse. Based on the examination data, a presumptive diagnosis is made.

If you come for an initial appointment with a cardiologist, you will be given directions for tests. The basic test that is prescribed to all patients is an ECG. Ultrasound of the heart, blood vessels, blood tests for sugar and cholesterol, and others may also be indicated. diagnostic procedures to clarify the picture.

Heart disease: risk factors

In a world where disease cordially- vascular system- the cause of death of every 3 out of 10 people; the main factors provoking these pathologies are considered to be:

  • Smoking,
  • High cholesterol
  • High blood pressure,
  • Overweight,
  • Alcohol abuse
  • Sedentary lifestyle,
  • Stress,
  • Diabetes,
  • Use large quantity salt.

Many of these reasons are removable, but require a lot of attention. When you come to see a cardiologist at the Medic center, you can count on A complex approach to treatment. The doctor’s task is to help the patient eliminate the cause of the disease. Collaboration between the cardiologist and the patient - The best way achieve a good therapeutic result.

Make an appointment with a cardiologist would not hurt many, since cardiovascular diseases are very common among the population of our country and significantly affect the quality and life expectancy. Preventing a disease is easier than treating it, so consultation a good cardiologist- guarantee that pathological changes will be identified on early stage and serious complications can be avoided.

Complaints from cardiac patients

At an appointment with a cardiologist it all starts with discussing complaints. The main group consists of shortness of breath, chest pain, interruptions in heart function, frequent and palpitations, swelling in the legs, cough. Patients suffering from dizziness and headaches in the back of the head, tinnitus, flashing “spots” before the eyes, patients with weakness, dizziness, patients with chest pain, etc.

Good cardiologist will discuss complaints with you in detail: if this pain syndrome, then what kind of pain is in nature (stabbing, pressing, squeezing, burning) and where it is localized. All complaints relate to such characteristics as duration, circumstances of occurrence ( physical activity, emotional stress, at rest) and cessation (on your own or with the help of medications), how often do they bother you. It is advisable that you be prepared in advance for such questions and think through your answers, remember your feelings, and find the names of the medications you took.

These complaints do not necessarily indicate problems in the cardiovascular system: chest pain may occur due to osteochondrosis in the thoracic region spine or with pleurisy, palpitations - due to increased function thyroid gland. This is why it is important to find in Moscow such cardiologist, who is not limited by the narrow framework of his specialization, but thinks more broadly in order to suspect the pathology of organs other than the heart.

The importance of medical history for a cardiologist

At an appointment with a cardiologist It is important to collect two anamnesis: illness and life. In the history of the disease, it is important to find out the following points:

  • How did the disease begin?
  • How the symptoms changed over time.
  • How often do exacerbations occur and under what conditions (with severe physical activity, under stress, due to alcohol consumption)
  • Have you previously undergone examination and treatment and what are its results?

When collecting a life history, attention is paid to heredity, previous diseases, especially acute rheumatic fever, streptococcal infections. In addition, it is important to find out the patient’s lifestyle and diet, the presence bad habits, professional history.

Examination and diagnosis at an appointment with a cardiologist

When examining the patient, pay attention to the color of the skin and the presence of edema. The area of ​​the heart is palpated and tapped (this is how the boundaries of the heart are determined). Further one of the most important points– auscultation. With its help, the sonority of tones, the correctness of the rhythm are determined, and heart murmurs are detected. Then the doctor determines the pulse, not only in the hands, but also measures blood pressure. Good cardiologist knows and always warns the patient that before this procedure you need to rest for at least 5 minutes, and 2 hours before it - not to smoke or drink coffee.

After examination, the doctor prescribes necessary examinations: biochemical analysis blood, blood sugar test, ECG, Holter monitoring, cardiac ultrasound, stress tests, radiography chest. When the results become known, we can talk about the diagnosis and treatment regimen.

Do not delay your appointment if you suspect heart problems. hearts, hypertonic disease, diabetes significantly younger, because the sooner doctors can diagnose them, the greater the chance of a good prognosis. In our medical center in Moscow accepts cardiologist Georgy Karapetovich Antanyan is a highly qualified doctor with extensive experience. At our clinic you can undergo an examination, and at an appointment with a cardiologist Receive an individual treatment plan and recommendations regarding diet and lifestyle.

Preparing the patient for a visit to a cardiologist greatly facilitates the diagnosis process. So, when planning to come to see a doctor, you need to draw up full list complaints that caused concern and prompted an appointment with a cardiologist. It is important not to miss anything, because any change in well-being, even the most short-term, can be a symptomatic manifestation of a serious pathology of the cardiovascular system. Before consulting you, you must try to remember under what circumstances the deterioration occurred (for no reason, after a strong emotional stress, during physical activity, etc.), for how long did they last alarming symptoms(a couple of seconds, more than a minute, during the day), exactly how the improvement occurred (after taking any drug, after tracking, on its own), with what frequency the deterioration occurred.

When preparing to go to a cardiologist, it is advisable to check with your closest relatives about whether they have any problems with the cardiovascular system. Cardiologists explain the significance of such information by the fact that hereditary factor quite often plays a key role in the development of heart pathologies, which is important to consider when developing a treatment strategy. People who have previously undergone examination of the heart and/or blood vessels, were observed by another cardiologist, or have undergone a course of treatment aimed at eliminating a particular disease circulatory system, it is recommended to take all your medical documentation information they have on this issue. Yes, you should prepare medical card, certificates, extracts, results laboratory tests, old cardiograms, ultrasound reports, etc. Of particular diagnostic value for a cardiologist will be the results of examinations completed during Last year. If the patient has taken or continues to take any medical supplies, for a consultation with a cardiologist, he should take a pre-compiled list of these medications, preferably with doses indicated.

In preparation for visiting a cardiologist, at least 2 hours before the scheduled consultation time, it is strongly recommended to stop smoking and drinking caffeine-containing drinks, because otherwise the doctor will not be able to correctly assess functional ability of cardio-vascular system. Cardiologists emphasize that ignoring such restrictions can significantly distort the real picture of the condition of the heart and blood vessels, which can lead to errors when making a diagnosis.

As a rule, the initial appointment with a cardiologist begins with collecting the patient’s life history and discussing the complaints that led to the need to seek treatment. medical care. This is usually followed by a physical examination, during which the cardiologist evaluates the color of the skin, checks for swelling, palpates the heart area, taps the chest, performs auscultation, measures blood pressure and carefully examines the pulse in both arms. Based on the data obtained during the examination, the cardiologist makes a preliminary diagnosis and determines a list additional research, which will help confirm or refute the primary conclusion.

By the nature of his activity, he is engaged in the diagnosis and treatment of cardiovascular diseases. He is developing preventive methods, and also conducts rehabilitation measures in order to restore the health of people who have suffered acute heart disease.

What does a cardiologist treat?

The following diseases fall under the doctor’s competence:

  • Hypertension. Condition leading to increased blood pressure in vessels.
  • Heart failure. It is expressed in the weak ability of the heart muscle to contract, due to which the tissues surrounding it do not receive enough oxygen.
  • Coronary heart disease (CHD) - oxygen starvation heart muscle.
  • Angina pectoris. Pain occurs due to oxygen deficiency and spasm blood vessels. Chronic form IHD.
  • Cardiomyopathy. A disease in which the heart muscle becomes sluggish and weakened.
  • Heart defects, acquired or congenital(stenosis mitral valve, septal defect).
  • Inflammatory processes(carditis) in one of the areas of the heart muscle (endocarditis, myocarditis).
  • Arrhythmias. Failure of rhythms and heart rate.
  • Heart attack pre-infarction state. Acute form IHD, as a result of which cell death occurs in the affected area of ​​the myocardium.
  • Aortic aneurysm- thinning of the vessel wall, which can result in vessel rupture and bleeding.
  • Thrombosis, thrombophlebitis.
  • Atherosclerosis.

When to go to the doctor?

Diseases of the cardiovascular system do not forgive delay, so if suspicious symptoms occur, you should visit a doctor immediately. Warning signs can be:

  • pain radiating to and behind the sternum, to the shoulder blade, arm, shoulder, and jaw, but most often in the heart area (depending on whether symptoms occur during physical activity or at rest, a different diagnosis may be made);
  • too fast (> 105 beats per minute) or very slow (< 50) пульс;
  • shortness of breath and cough when lying down;
  • persistent increase in blood pressure numbers greater than 140/90;
  • swelling in the legs;
  • heart rhythm disturbances.

There are also other factors:

  • overweight, cholesterol levels are too high;
  • fainting, dizziness;
  • frequent headaches;
  • fast fatiguability;
  • age after 40 years.

Cardiologist appointment

What does a doctor do during an appointment at a clinic? If this is the first visit, the doctor will listen to existing complaints and look medical card patient, learns about the patient’s lifestyle, and finds out hereditary predispositions.

Then the cardiologist conducts an examination using palpation (palpation), auscultation (listening to sounds with a phonendoscope), and percussion (tapping method). In addition, it measures weight, height, determines the body mass index, and makes a conclusion about the tendency to obesity. Measures pulse and blood pressure. Directs to additional examination if necessary.

What examinations may be needed?

  • clinical and biochemical blood test;
  • general urine analysis;
  • chest x-ray;
  • ECG (electrocardiogram);
  • ECG with exercise (bicycle ergometer, treadmill test);
  • ECHO-CG (echocardiography);
  • coagulogram;
  • spirometry;
  • coronary angiography;
  • blood test for lipid spectrum;
  • scintigraphy;
  • computed tomography, MRI;
  • peripheral vascular Doppler;
  • daily blood pressure monitoring;
  • Holter ECG monitoring (during the day).

Some people are puzzled why there is such a separate specialty as cardiologist. The answer is simple: because rheumatism is a disease connective tissue inflammatory nature, main pathological process which develops in the membranes of the heart.

The fact is that rheumatic fever occurs in most cases against the background of infection with streptococcus. And its antigenic structure is similar to heart tissue, so rheumatism leads not only to joint damage, but also to heart disease. In view of the above, it is advisable for this group of diseases to be treated by the same specialist.

Pediatric cardiologist-

As for pediatric cardiology, they deal with heart problems from birth to 18 years of age. Childhood diseases can be divided into congenital and acquired. For example, heart disease develops at a very early stage - at the beginning of pregnancy and it can only be cured during the newborn period: the first months, or even weeks of life.

Children's provides diagnostics and treatment of joints and connective tissue diseases: arthrosis, arthritis, collagenosis.

When should I show my baby to the doctor?

Be sure to make an appointment with a cardiologist if you have small child the following symptoms are observed:

  • too rapid heartbeat (in infants the norm is about 130 beats per minute, in children after one year - from 80 to 120);
  • after feeding, a blue triangle appears in the area of ​​the nose and lips;
  • gets tired quickly while feeding;
  • fainting;
  • joints swell.

When to go to the doctor with a preschool child?

In children aged 3 to 9 years, heart disease is most often associated with complications after suffering from streptococcal sore throat or acute respiratory viral infection. Call your doctor for help if your child:

  • complains of tingling in the heart;
  • feels short of breath and has shortness of breath;
  • has difficulty with physical activity;
  • acceleration or deceleration of heart rhythms are observed;
  • chronic form of tonsillitis;
  • fainting and pre-fainting state;
  • there is swelling of the joints.

When to see a cardiologist?

IN adolescence pediatric cardiologist mainly treats patients with complaints of pain in the sternum, which is often associated with rapid growth and changes characteristic of puberty. Take your teenager to a cardiologist if he:

  • is seriously involved in any sport;
  • cannot withstand standard loads during physical education lessons;
  • moves little (sits a lot at the computer, TV, textbooks);
  • complains of pain in the left hypochondrium or in the joints;
  • goes through puberty faster than peers.

Examination by a cardiologist is an important component in the monitoring and treatment of therapeutic, cardiological and surgical patients. Dynamic observation by a cardiologist allows you to diagnose existing diseases at the initial stages of development, which significantly reduces the risk of complications and improves the prognosis.

Examination by a cardiologist can be carried out in the clinic or at home. Thanks to modern diagnostic equipment, the availability of portable devices, calling a cardiologist at home is not inferior in effectiveness and significance to an examination in medical institution. A visit to a cardiologist is necessary for most of the population of our planet, since cardiovascular diseases are detected in 80% of patients over 50 years of age.

What complaints should you contact a cardiologist for?

A cardiologist is a specialist therapeutic profile specializing in diseases of the cardiovascular system. Therefore, you should start a conversation with him with complaints concerning your heart. Do you have any other complaints that bother you? this moment, there is no need to hide it, but the emphasis should be on complaints from the cardiology section.

TO last group include:

  • complaints about discomfort behind the sternum
  • sensation of palpitations and interruptions in heart function
  • periodic
  • shortness of breath during exercise or emotional stress
  • swelling of the lower extremities
  • cough, painful behind the sternum

For patients suffering arterial hypertension, it is worth adding to this group:

  • pain in the back of the head when blood pressure rises
  • flickering "flies" before the eyes
  • loss of visual fields or dark spots in the observed visual image.

Questions from a doctor when examining a cardiologist

A qualified person will listen to your complaints and then ask questions to clarify some points regarding your complaints and general condition.

You need to clearly understand that the doctor is asking questions not out of idle curiosity, but in order to make a differential diagnosis among diseases that manifest a similar clinical picture.

Be ready:

  • specify the nature of pain during attacks and in the interictal period
  • indicate the irradiation (where does it go?) of pain
  • remember what came before pain attack(stress, physical activity).
  • name the medications you take at home. It is better, of course, to write out the medications and dosage schedule on paper so that you don’t forget anything during the examination.

How is the examination procedure performed by a cardiologist?

During the examination, the cardiologist asks the patient to undress to the waist, after which he examines skin, color of mucous membranes. In the region of the heart, a cardiac impulse is palpated, which is formed when the apex of the heart hits the chest.

Percussion

Then percussion is performed - determining the boundaries of the heart by tapping the doctor’s finger on the finger of the left hand, applied to the surface of the chest. Determining the boundaries is necessary for a preliminary assessment of the size of the heart.

Auscultation

The examination method allows us to determine heartbeat, identify the presence of extrasystoles or other variants of arrhythmia. During auscultation, the doctor evaluates heart sounds, paying attention to noises that are heralds of pathology of the valves or walls of the heart.

Currently, patients have the opportunity to call a cardiologist at home. This option for examination by a cardiologist is acceptable for many patients. This form of examination is ideal for older people, as well as patients in subcompensated and decompensated states.

The minimum examination should include:

  • Examination by a cardiologist with detailed collection of complaints and physical examination (auscultation, percussion)
  • ECG (12-lead ECG, long strip ECG, cardiotopography, ECTG-60, ECG with isometric stress)
  • Ultrasound ( ultrasonography) heart, dopplerography of blood vessels, transesophageal ultrasound (often necessary for rhythm disturbances to exclude the presence of blood clots in the cavities of the heart), ultrasound of the kidneys, adrenal glands, thyroid gland
  • 24-hour blood pressure and ECG monitoring (Holter monitoring)
  • Load tests (velergometric test, treadmill test, informational and pharmacological tests)
  • Consultations related specialists(endocrinologist, gynecologist, ophthalmologist, gastroenterologist, neurologist, nephrologist, etc.)
  • Laboratory tests: biochemical blood test (glucose, electrolytes, lipid spectrum, cholesterol, etc., cardiac enzymes), determination of the level of certain hormones (thyroid gland, brain natriuretic peptide).

Heartache

The most common reasons:

  • Coronary heart disease (CHD)
  • Heart valve defects
  • Neurocirculatory dystonia (NCD)

Rhythm disturbances, interruptions in heart function

Electrocardiogram (ECG) data play a key role in diagnosis. To find out the causes of arrhythmia, it is necessary to exclude organic reasons(damage to the valvular apparatus of the heart) - for this, an ultrasound of the heart is performed - and coronary heart disease. Some arrhythmias may be congenital. A common cause of arrhythmia may be dysfunction of the thyroid gland, which requires a full endocrinological examination (consultation with an endocrinologist, determination of hormone levels in the blood). When establishing the cause and determining the nature of the rhythm disturbance, an electrophysiological study (EPS) of the heart may be necessary.

If complaints arise, it is unacceptable to self-medicate. Only a medical specialist can determine the required scope of examination for staging accurate diagnosis, which will become the basis for proper treatment.