Topic Overview
What health professionals are involved in taking care of people who have coronary artery disease?
After a diagnosis ofcoronary artery disease (CAD), you should visit yourprimary care physician every few months. Your doctor can help track your condition and make sure thatyour treatment is going as planned. If you have complications or needspecial procedures (such as cardiac catheterization or open-heart surgery), youmay need treatment from a range of specialists.
Understanding your health professionals' roles
Depending on how severe your CAD is and whether you alreadyhave complications, you may need a team of health professionals to helptreat your disease and manage your treatment plan.
This table outlines the types of health professionals whomay be involved in the treatment of CAD and its complications.
Health professional | Who are they? | What is their role? | When would you see them? |
|---|---|---|---|
| Primary care physician | Internist, family physician | They manage your medical care. | Regular visits (about 2 to 4 per year) |
| Cardiologist | Heart specialist | This doctor provides specialty medical care. | Sometimes for regular visits or when CADgets worse |
| Other physicians | Nephrologist (kidney specialist), cardiovascularsurgeon (heart surgeon), neurologist (brain/nerve specialist) | They provide specialty medical care for complications ofCAD. | When complications arise or when special proceduresneed to be done |
| Nurse educator | Specific type of nurse | This nurse can educate you and help you take control. | Whenever medicines, diet, or self-management needsto be explained |
| Cardiac rehabilitation team | Doctor, nurse specialist, dietitian, exercise therapist, and physical therapist | Your team will 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 | They help you cope with psychological aspects ofdisease. | Regularly (perhaps weekly), for as long as youneed |
| Registered dietitian | Nutritional expert | He or she can help you with heart-healthy diet. | Initially, and whenever diet needs to bechanged |
Although you may not need help from all of these providers,it is good to be aware of them. You may encounterthem at some point during the course of your treatment. If you need the helpof other health professionals, you should keep in close contact with yourprimary care doctor. Make sure to report any changes in the way you feel or anymedicine-related side effects. Each person's experience with CAD and with itscomplications is different. Your health professionals will help tailor yourtreatment to best suit your needs.
What is the role of a primary care physician in caring for people who have coronary artery disease?
In some cases, your primary care physician (PCP)-usually aninternist or family medicine physician-will coordinate your care. He or she may be responsible for the day-to-day medical management of your coronary arterydisease. In these cases, your PCP will be the one who evaluates yourrisk factors, does tests, and looks for signs of otherdiseases.
After you are diagnosed with CAD, your PCP will help you build atreatment plan. He or she will also decide if you need to start takingmedicines or if you need certain procedures to diagnose how severe your CAD is. For this reason, it is important that you are open with your doctor. Make sure that he or she knows of any changes in your symptoms.
In general, you should visit your PCP once every few months. This is a good chance to makesure that you are on track with your CAD treatment and to continue with yourgeneral medical care. Along with a physical exam at each visit, you andyour doctor should review how you're doing with lifestyle changes and with your prescribed medicines. If you havenew or changing symptoms, your PCP may do or request tests to check your heart.
Most primary care physicians are qualified to develop and managetreatment plans for chronic diseases such as CAD. But if you developcomplications or have more severe CAD that needs a procedure or surgery astreatment, your primary care physician may refer you to a specialist.
What are the roles of specialists in caring for people who have coronary artery disease?
In some cases, a cardiologist will be your main point ofcontact in treating and managing your CAD. Whether you work more closely with aprimary care physician (PCP) or a cardiologist depends on many things,including the nature of your condition and the relationship you may alreadyhave with either doctor. Whether you see your cardiologist to treat mildatherosclerosis or to provide follow-up care after a major surgery, thisspecialist will add heart-specific expertise to your treatment plan.
What is the role of an interventional cardiologist?
Aninterventional cardiologist can do a cardiac catheterization. This is an invasiveprocedure used to take X-rays of your arteries and diagnose any narrowed areasin your coronary arteries. An interventional cardiologist can also do anangioplasty and place stents during a cardiaccatheterization 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 a narrowed or blocked vessel and allow blood toreach the heart.
A cardiothoracic surgeon is a specialist trained to do this surgery. This type of surgeon may also be called a cardiovascular surgeon or acardiac surgeon.
What are the roles of other specialists?
If you develop certain CAD-related complications, you may need to seea number of other specialists. For example,you may need to see a nephrologist (kidney specialist) if you develop kidneyproblems. You may need to see a neurologist (brain and nervous system specialist) if CAD leads toa stroke. Your primary care physician will direct you to the specialists whoare skilled in treating your specific condition. You may be referred to thefollowing specialists.
Nurse educator
While primary care physicians serve as central coordinators of carefor many people with CAD, nurse educators are valuable resources as well.
Along with serving as a care coordinator, your nurse educator will serve otherimportant functions. For example, he or she may be the first oneto help you understand CAD and start your treatment plan. He or she may teach you about theeffects of various medicines on your condition and help you with lifestylechanges.
One of the nurse educator's most important roles is to provide youwith the information you need about your disease as you are ready to handle it.You will have CAD for the rest of your life. Your nurse educator can bethere 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. This 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
What you eat has a big effect on your coronary arterydisease. You may seek the aid of a registered dietitian to help youplan a heart-healthy diet. If you also have high blood pressure(hypertension) or diabetes, it may be important to limit salt and sugar intakeas well.
Registered dietitians are trained in nutrition. They are experienced in helping people make lifestyle changes. They understand that adjustments to youreating habits can be the hardest changes to make. And they can help you takesmall steps toward the larger goal of a balanced diet.
Mental health professional
Many people with serious conditions such as CAD havedepression. Psychiatrists, psychologists, and clinical social workers can help you dealwith the mental challenges that come with any CAD-related complications thatyou may have. Also, they can help you learn to manage the stress in yourlife. This can affect the success of your treatment plan.
