Cardiology

Cardiology is the medical speciality dedicated to the heart and blood vessels, as well as to related diseases. The cardiologist is the medical specialist in diseases that affect the cardiovascular system. They intervene to understand symptoms, make a diagnosis and adapt treatment where necessary. To do so, several tests may be carried out by the cardiologist during your consultation or will be scheduled after this consultation.

The most common tests are:

- Electrocardiogram (ECG): allows the heart rate to be monitored at a specific moment in time and heart rate abnormalities or coronary diseases to be detected. Its analysis helps to adjust immediate treatment in the event of an emergency or care at a specialised centre. This occurs to treat diseased arteries (for example, in the event of myocardial infarction) or to treat heart rate abnormalities (for example, in the event of arrhythmia). The test is painless.

- Echocardiography: this ultrasound examination allows for all the heart’s anatomical structures to be seen, as well as cavities like the atria and ventricles, valves, and cardiac muscle. Echocardiography is combined with Doppler technology so as to see the blood flow from the heart to large vessels such as the aorta or the pulmonary artery.

- Stress test: this test aims to put strain on the heart during physical exercise and record the electrocardiogram (ECG). The exercise is calibrated to increase the heart rate by 2- to 3-minute increments and detect coronary diseases. It may be carried out on a treadmill or on a bike and lasts for between 20 and 30 minutes.

- ECG Holter monitor: allows for cardiac activity to be recorded over a 24-hour period or longer thanks to a portable device and electrodes that are constantly attached to the chest. It records patients’ heart rates during their everyday lives. Abnormalities may result in ailments or palpitations. The occurrence of symptoms may be intermittent and undetectable during a consultation. This analysis provides evidence of any cardiac dysrhythmia and indications regarding its gravity.

- BP (blood pressure) Holter monitor: allows for blood pressure to be recorded over a 24-hour period or longer thanks to a portable device and a blood pressure cuff on the arm. This automatically takes blood pressure readings at regular intervals scheduled by the cardiologist. Continuous recording enables pressure abnormalities to be detected, whether they are too high or too low. This analysis provides evidence of any abnormalities and allows the doctor to decide upon and implement an adequate treatment plan.

The main diseases diagnosed and treated in cardiology are:

  • Atherosclerosis: narrowing of the coronary arteries (following the accumulation of fat that may calcify), as well as related complications (myocardial infarction, arteritis, aneurysm).
  • Cardiac valve diseases (e.g., aortic or mitral insufficiency, aortic or mitral stenosis).
  • Arrhythmia: cardiac dysrhythmia.
  • Heart failure: the heart’s inability to ensure the necessary blood flow to the organs.
  • Arterial hypertension: pressure is abnormally high.
  • Venous thromboses: located mainly in the lower limbs, a blood clot forms in the vein and obstructs the blood flow.

The main symptoms encountered are:

  • Pain in the chest with a feeling of tightness, together with pain in the left arm and jaw, pallor, sweating, and general weakness. These symptoms are those most often described in myocardial infarction. If in doubt, dial 144.
  • Pain in the chest with shortness of breath on exertion may reveal angina (or angina pectoris). If in doubt, dial 144.
  • Increased heart rate with a feeling of discomfort but without any specific events (stress, strong emotions) may result in you dialling 144 or consulting your general practitioner.
  • Discomfort and/or a loss of consciousness may indicate a heart rate abnormality and should be investigated medically. If in doubt, dial 144 or consult your general practitioner.
  • Shortness of breath on exertion that may also occur in a lying position, rapid and significant weight gain together with oedema of lower limbs (swollen legs and feet), significant fatigue (that limits daily activities and is of recent emergence). These symptoms may indicate heart failure and result in you consulting your general practitioner.