Following the diagnosis of
coronary artery disease (CAD), you should visit your
primary care physician every few months to track your condition and ensure that
your treatment is going as planned. If you have complications or need
special procedures (such as cardiac catheterization or open-heart surgery), you
may need treatment from a variety of specialists.
Depending on how severe your CAD is and whether you already
have complications, you may need a team of health professionals to help
treat your disease and manage your treatment plan.
The following table outlines the types of health professionals who
may be involved in the treatment of CAD and related complications.
Who are they?
What is their role?
When would you see them?
Provide specialty medical care
Cardiac rehabilitation team
Doctor, nurse specialist, dietitian, exercise therapist, and physical therapist
Help you recover from an event or procedure and make healthy lifestyle changes
During the rehab program
Although you may not need help from all of these providers,
it is good to be aware of the full range of professionals you may encounter
at some point during the course of your treatment. If you need the help
of other health professionals, you should keep in constant contact with your
primary care doctor and report any changes in the way you feel or any
medicine-related side effects. Each individual's experience with CAD and with its
complications is different. Your health professionals will help tailor your
treatment to best suit your needs.
In some cases, your primary care physician (PCP)—usually an
internist or family medicine physician—will serve as your care coordinator and
be responsible for the day-to-day medical management of your coronary artery
disease. In these cases, your PCP will be the one who evaluates your
risk factors, does diagnostic tests, and looks for evidence of other
After you are diagnosed with CAD, your PCP will help you build a
treatment plan and will also decide whether you need to start taking
medicines or whether you need certain procedures to diagnose the severity of
your CAD. For this reason, it is important that you are open with your doctor
and make sure that he or she knows of any changes in your symptoms.
In general, you should visit your PCP once every few months to make
sure that you are on track with your CAD treatment and to continue with your
general medical care. In addition to a physical exam at each visit, you and
your doctor should review your progress with lifestyle modifications and, if
applicable, experiences with your prescribed medicines. If you have
new or changing symptoms, your PCP may do or request tests to check your heart.
Most primary care physicians are qualified to develop and manage
treatment plans for chronic diseases such as CAD. But if you develop
complications or have more severe CAD that needs a procedure or surgery as
treatment, your primary care physician may refer you to a specialist.
In some cases, a cardiologist will serve as your primary point of
contact in treating and managing your CAD. Whether you work more closely with a
primary care physician (PCP) or a cardiologist depends on a number of factors,
including the nature of your condition and the relationship you may already
have with either physician. Whether you see your cardiologist to treat mild
atherosclerosis or to provide follow-up care after a major surgery, this
specialist will add heart-specific expertise to your treatment plan.
interventional cardiologist can do a cardiac catheterization, an invasive
procedure used to take X-rays of your arteries and diagnose any narrowed areas
in your coronary arteries. An interventional cardiologist can also do an
angioplasty and place stents during a cardiac
catheterization to open narrowed or blocked arteries.
In some people, an open-chest surgery, called bypass surgery, may be recommended to bypass the blocked vessel and allow blood to
reach the heart.
A cardiothoracic surgeon (also called a cardiovascular surgeon or a
cardiac surgeon) is a specialist trained to do this surgery.
If you develop certain CAD-related complications, you may need to see
a number of other specialists to treat your specific conditions. For example,
you may need to see a nephrologist (kidney specialist) if you develop kidney
problems or a neurologist (brain and nervous system specialist) if CAD leads to
a stroke. Your primary care physician will direct you to the specialists who
are skilled in treating your specific condition. You may be referred to the
While primary care physicians serve as central coordinators of care
for many people with CAD, nurse educators are valuable resources as well.
addition to serving as a care coordinator, your nurse educator will serve other
important functions. For example, a professional educator may be the first one
to help you understand CAD, begin your treatment plan, teach you about the
effects of various medicines on your condition, and help you with lifestyle
One of the nurse educator's most important roles is to provide you
with the information you need about your disease as you are ready to handle it.
You will have CAD for the rest of your life, and your nurse educator can be
there with the information that you need to adapt to changes in your condition.
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. A cardiac rehab 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.
Because what you eat has a big effect on your coronary artery
disease, you may seek the aid of a dietitian or nutritionist to help you
develop a heart-healthy diet. If you also have high blood pressure
(hypertension) or diabetes, it may be important to limit salt and sugar intake
Dietitians are trained in nutrition and are experienced in helping
individuals make lifestyle changes. They understand that adjustments to your
eating habits can be the hardest changes to make. And they can help you take
small steps toward the larger goal of a balanced diet.
Many people with serious conditions such as CAD experience
depression, either independently or as a result of their physical condition.
Psychiatrists, psychologists, and clinical social workers can help you deal
with the mental challenges associated with any CAD-related complications that
you may have. Also, they can help you learn to manage the stress in your
life, which can have a direct bearing on the success of your treatment plan.
April 6, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& John A. McPherson, MD, FACC, FSCAI - Cardiology
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