testing for heart disease
What can I do to prepare for a visit to the cardiologist?
Health Pro December 18, 2006
It is understandable that people who have never seen a cardiologist before may be scared about the problem that they are having as well as what the cardiologist will think about it.
Just remember that the doctor is part of your health care team. His or her only goal is to make your health better. In order to do this, the cardiologist must know what your health care worries are.
You can help by organizing your thoughts and records, and by being prepared for the questions that you will be asked.
Prepared patients are more able to get all of their concerns answered on the first visit, while unprepared patients often leave with many more questions than they came in with.
In my experience as a consultant, most often little information has been communicated by the referring physician before the consultation visit (often in a hospital hallway, or rushed telephone conversation, and in general terms with no name given).
Often a patient will perceive the reason for the consultation as for a different purpose than the original reason of the referring physician.
A critical question will relate to the reason for which you made the appointment. Focus on this problem will permit the cardiologist to answer the questions properly. Often, patients blurt out a partial history, but don’t tell me that their underlying concerns relate to worry about a stroke or cancer rather than the left shoulder pain for which the patient originally made the appointment.
If I am unaware of the patient's concern, I may focus on the shoulder and not understand that the concerns are elsewhere and the patient misses out at a chance to have the concern answered.
With respect to the chief reason for the visit you will be asked to describe the problem.
- If it is a rapid heart beat (as an example), how fast does it go (how many beats per minute), is it regular (like a metronome) or irregular, is it associated with anything else that happens at the same time (dizziness, sweatiness, feeling like you are going to pass out, passing out, chest pain, shortness of breath, headache, nausea, vomiting, etc)?
- How long does the event last?
- How often does this occur?
- How long have these episodes been occurring?
- What triggers the episodes or relieves them (examples: always when I drink coffee or smoke, when I run or vacuum, when I take cold medications, etc)?
- Have any investigations or tests previously been done to look into this problem?
- Has it ever happened before in your life?
- Do you have any problems that would make a heart problem more likely to occur (history of heart murmur, rheumatic fever, family history of heart disease, diabetes, hypertension, high cholesterol, smoking history, recreational drug use such as cocaine or amphetamines, radiation therapy to the chest, chemotherapy, thyroid disease)?
Certainly a list of medications and their doses (including over the counter remedies that you use) will be helpful to your doctors, as will be a list of medications that you haven’t tolerated for one reason or another.
Being prepared with all of the answers to the doctor’s questions, you will be able to obtain more of the answers to questions that you might otherwise forget to ask.
Don’t be afraid to write them down and bring them with you. Some of these questions might be:
1. What is the diagnosis, what does it mean?
2. How much will this alter my life?
3. How often does it require follow-up, and by whom?
4. What is the long-term prognosis?
5. Is there anything that I can do to reduce my own symptoms or problems?
6. Will these results be communicated to my primary care physician?
7. What signs or symptoms should I be concerned enough to call about?
8. Are there any reliable sources for me to get more information about this problem?
Often the cardiologist has a form that you can obtain before the visit to help identify the questions that you will be asked.
No one has all the answers at the beginning, so it is useful to involve your spouse, family or friends to help you remember things like your previous surgeries, and illnesses that may influence your health.