Cardiologist

[Roster17]

What is the difference between an interventional cardiologist and a regular cardiologist.  If one had a stent put in by an interventional cardio, should one stay under the care of that one or under the care of a regular cardio.  

Thank you

[ed34]

I believe an intervention cardiologist has done a lot more training in angioplasty procedures, whereas a cardiologist is more involved in the functioning of the heart and symptoms. My intervention cardiologist said "I'm just a plumber" which says it all really, and I leave the main decisions to my main cardiologist. However, there are times when she says nothing can be done, so I send a sneaky letter to the plumber to see if that's true. The problem is the cardiologist doesn't always realise the expertise of the interventionalist.
In many cases, if a cardiologist feels strongly that intervention is required, but the interventionalist doesn't have the confidence, then they will try and seek one who does. If they don't then it's time to change cardiologists.

[tiggercat513]

this is not in defense of the dr but looking at what you said "abnormal, but not ichemic" would mean that your ST showed no lack of blood flow to your heart. There is a percentage of blockage where a cath is called for but you may have been close to that amount of blockage but not quite there yet. My cardio told me that cholesterol was 90% genetically determined, and only 10% affected by diet. If you were hospitalized at any time they might have done a cholesterol test on you. just my 2 cents

[kenkeith]

Its difficult to second quess your doctor's treatment as (s)he has your health history, symptoms, etc.  It may be wise to get a second opinion for any intervention when there is a possibility of successful therapy with medication.  To say "let me know if I want a cath done" doesn't sound very professional especially as the doctor is being paid to make medical decisions.

[Roster17]

Sorry, ( he always said to him know if I want a cath done)  should read, He alway said to let him know if I want to have a cath done.
Roster

[Roster17]

Thank you for answering my question.  The reason I asked is because my interventional cardio never does any blood work and never asks about my chorlesteral (spell?). I have been going to him 9 yrs. My stess tests every year he said were abnormal, but not ichemic. Never said I should have a cath. He always said to him know if I want to have a cath done. I don't know any better,  He's the doc, he should know. In all this time the only meds he had me on was atenolol and aspirin. In Jan 2006 was my first normal stress test.  In June of the same year I start complaining that I was getting bad chest pains.  Ekg's always normal. Finally He decided to give me another stress test. Well, 2 days later he calls to tell me to come into the office. He told me I had to go to the hospital immediately because the test was horribly abnormal.  Yet he waited 2 days to call me. (I addressed that with him later on). I had the cath & had a 90% blockage in the LAD,so it was stented with DES. I am now on plavix along with the aspirin and atenolol.
He still never questioned my chorlesteral or put me on a statin.  It was my primary who put me on Zocor.
Now I see the interventional cardio every 6 mos for an EKG and once a year for a ST. I have passed all of ST after the stent.
I cannot compare him with a regular cardiologist because I never went to a reg one.  But when I think back, I wonder if he should have put me on meds after the abnormal stress tests. Maybe it would not have come to a  stent if taken the proper meds. I'm really not sure if I should change to a non interventional or stay with interventional. Do all or any off you think  it's wise at this point to go to a non interventional or should I stick with the inventional cardio since I have been going to him for a long time. This is long, I know. Hope you can understand it and thanks for listening. Hope I get some feedback.  

Roster 17

[kenkeith]

QUOTE: "What is the difference between an interventional cardiologist and a regular cardiologist".

My experience 6 years ago with the interventional cardiologist wasn't a doctor I would recommend.  He was waiting in emergency, and because I was told I had had a heart attack and no medical consultation nor a doctor prior I turned to him.  He sold me on an angiogram and the result was a stent in the RCA vessel; report indicated I also had a 72% blockage of the ICX (didn't do anything with it) and 100% occlusion of the LAD.

I was on medication for a few months, felt energized, no chest pain, etc. and he then wanted to do a stent implant on the ICX....I questioned why now, and why not at the time of the other stent implant? He didn't speak English very well and mumbled something and just before he left he put the stethoscope to the middle of my chest for about 3 seconds, and shook his head and walked out the door.  A few weeks later he moved out-of-state.

My now non-interventional doctor has never in the past 6 years ever suggested I have a stent implant. I have had no medical problems since, whatsoever, and he takes all the time necessary to answer questions, etc.

[Yvette BG]

In my mother's case, she was seeing a regular cardiologist, who referred her to an interventional cardiologist within the same cardiology practice/group to do her heart catherization. (Apparently, this regular cardiologist doesn't do interventional procedures like catherizations, or prefers someone that does them more often to do them for her patients.) The plan was for the interventional cardiologist to put a stent or two in, but when he was doing the heart catherization, he found more blockage than originally thought--and due to where the blockages were located, he told her she needed bypass surgery. He does not do this type of surgery, so he suggested several possible cardiothoracic surgeons from which to choose. For continued cardiac care after the bypass surgery, Mom went back to her original regular cardiologist.

Now when my Dad's heart problems starting getting worse about 6 months after my Mom's issues, since we liked the interventional cardiologist that cared for my Mom better than we liked her regular cardiologist (personality-wise, bedside manner, and more timely responsiveness to questions and problems), we called to see if he would see my father as a regular cardiology patient, which he did.  

I think that the situation with interventional cardiologists and regular cardiologists varies-- like with regular neurologists and neurosurgeons. Some specialists (interventionalists, neurosurgeons, etc.) only want to do the specific procedures or surgeries; then if they do the procedure, maybe handle the initial follow up office appointment afterwards and then they refer them back to the other physician for ongoing care. Other interventionalists seem willing to serve general cardiology and procedural aspects (catherization, stent, etc.) of the patient's care--provided they start with the patient.

I agree with Flycaster305--If you have a choice, stay with the person you trust the most and who treats you and your family the best.

Good luck,
Yvette  

[Flycaster305]

My Cardiologist put in my first three stents, but retired from the Cath Lab because he developed heart trouble of his own.  Subsequent stents were inserted by an Interventional Cardiologist.  I stayed with my initial doctor as that is who I have the greatest trust on my overall cardiac health.  I have a Pacemaker, enlarged heart as well as the stents and feel he has a better overall picture, including my diet/exercise/medications.  I would say it is who you trust the most.