image

First Cardiologist Appointment: What to Expect

This story originally appeared on massgeneralbrigham.org

If you’ve been told to see a cardiologist, you probably have a lot of questions and concerns. What happens when you get referred to a cardiologist? How can you prepare for the appointment? Will you have any tests that day? What can you expect?

What are the signs you need to see a cardiologist? Maybe your primary care physician (PCP) has referred you to a heart doctor. Perhaps you have symptoms of a cardiac issue, such as occasional chest pain or shortness of breath. Maybe your family has a history of heart problems and you want to better understand your personal risk.

It’s important to talk to a specialist who can address your concerns and recommend next steps. “My goals for the first appointment are to get to know my patient as a person—who they are, what is important to them, their concerns and worries. And then I focus on getting the health information I need to help them with whatever problem brought them in to see me,” says Fidencio Saldaña, MD, MPH, a Mass General Brigham cardiologist. Dr. Saldaña treats heart patients at Brigham and Women’s Hospital and Brigham and Women’s Faulkner Hospital.

How can I prepare for my first cardiologist appointment?

“A visit to any healthcare provider can be stressful,” says Dr. Saldaña. “But any time something is going on with the heart, there seems to be an added anxiety or worry about how serious the issue might be.”

He suggests several things you can do to make the first appointment less stressful and more productive:

  • Dress appropriately: Wear loose, comfortable clothing. You may have to remove your shirt, take off your socks and shoes, or change into a gown. The healthcare team may ask you to wear a gown. One common in-office heart test, an electrocardiogram (EKG), involves sticking sensors to your skin. So Dr. Saldaña recommends you avoid using lotions just before your appointment.
  • Bring a friend or family member: “Having someone with you is very helpful. They can be an extra pair of ears, listen, take notes, and remind you about a certain symptom or episode,” Dr. Saldaña says. “We’re not just taking care of one individual—we’re really taking into consideration the family, the patient’s support system. We want the patient and their family to feel supported and to have the information that they need.”
  • Arrive early: The average time of a first cardiology appointment is 40 minutes. Dr. Saldaña recommends arriving 15-20 minutes early. That way, you have time to complete important paperwork. You can also make sure the office has received previous test results and has your insurance information. Arriving early also gives you a buffer in case you get lost or have trouble finding a parking spot.

What questions will my cardiologist ask?

At the first appointment, your specialist will get to know you and start to understand your heart health. Dr. Saldaña suggests that you prepare to answer certain questions by writing the information down and bringing it to your appointment.

Symptoms

If you’re having any symptoms, your cardiologist will want to know:

  • What they are
  • How often they occur
  • Whether anything makes them better or worse

Personal medical history and family medical history

The healthcare team will want to know all about your health. This may include a wide range of things, including:

  • Other medical conditions you may have
  • Allergies
  • Medications you take
  • Previous surgeries or hospitalizations

“I often ask about things that may not seem heart-related, and some folks may be surprised and wonder: ‘Why are you asking me about this if I’m here for my heart?’” says Dr. Saldaña. “We want to get a sense of the entire person. Other illnesses could be involved in your particular issue with the heart.”

Your cardiologist will also want to know whether you or any close family members had certain health conditions, such as:

Medications

Bring a list of every medication you take to this appointment, including supplements and over-the-counter drugs. Better yet, Dr. Saldaña suggests, bring all medication containers with you. That will help your doctor review detailed information such as dosages.

Lifestyle

Your lifestyle is an important part of your heart health, so your cardiologist will ask about your lifestyle and habits, including:

  • Alcohol and drug use
  • Diet and nutrition
  • Exercise habits
  • Smoking history
  • Stress and how you manage it

Medical records and previous test results

f you’ve had previous appointments or tests, your cardiologist should review them. Ideally, that information should be sent to the cardiologist’s office in advance. But you can bring information with you. In addition, the front desk will ask for your PCP’s contact information, any other specialists you see, and your insurance information.

Your cardiologist is there to be a team member to make sure you receive the appropriate information on diagnosis and treatment if necessary. When you leave, you should feel listened to. You should have an understanding of what the visit was for, what the diagnosis is, and the plan moving forward.

FIDENCIO SALDAÑA, MD, MPHCardiologist
Brigham and Women’s Hospital and Brigham and Women’s Faulkner Hospital

What does a cardiologist do on your first visit?

Your first visit with a cardiologist will involve a physical exam and possibly some bloodwork and non-invasive tests. Non-invasive tests are generally pain-free. They don’t require any incisions (cuts) or the insertion of tools, except maybe a needle.

Physical exam

During your first appointment, the cardiology team will take measurements called “vitals.” This may include height, weight, blood pressure, breathing rate, resting heart rate, and body temperature.

Then your cardiologist will perform a head-to-toe examination of your body with a focus on your heart. They’ll listen to your heart and lungs by placing a stethoscope on your chest and back. They’ll examine and press on the blood vessels in your neck, arms, and legs. And they’ll look at your ankles and feet for any swelling.

In-office heart tests

Depending on the information your cardiologist needs, you may have a few simple, pain-free tests during the first appointment.

Blood tests: Your cardiologist’s team may draw blood to test cholesterol level, how well your kidneys are working, blood counts, and more. “Unless you’re instructed to do so, you can just eat normally and come on in,” Dr. Saldaña says. “If we need a blood test after you’ve been fasting, you can always return for that.”
Electrocardiogram: An EKG uses electrodes stuck to your skin to measure your heart’s electrical signals.
Chest X-ray: This test takes a picture of your heart’s structures.

If your cardiologist recommends more complex testing, that’s usually scheduled for a later date.

What questions can I ask my cardiologist?

Dr. Saldaña asks people to bring a list of questions to their first cardiology appointment. That way you don’t forget to ask anything that’s important to you.

Consider asking your cardiologist the following questions during your first appointment:

  • Is there a problem with my heart? If so, what is it called and what does it mean?
  • What caused the problem?
  • What are my next steps? Should I have tests or receive treatments?
  • Where can I learn more about this condition?
  • What can I do to improve my heart health and lessen my risk of complications?
  • What signs or symptoms should I call you about?
  • When should I seek emergency medical attention?

Dr. Saldaña also suggests that you or a loved one take notes throughout the appointment so you can review the information again later.

“Your cardiologist is there to be a team member to make sure you receive the appropriate information on diagnosis and treatment if necessary,” he says. “When you leave, you should feel listened to. You should have an understanding of what the visit was for, what the diagnosis is, and the plan moving forward.”

Contributor
Fidencio Saldaña, MD, MPH
Cardiologist
617-983-7420