Transcription:
When is it Time to See a Cardiologist?

Helen: Welcome back to The Well Within Reach podcast. I'm your host, Helen Danderan and today I'm going to be joined by Dr. Amit Zachariah, an interventional cardiologist at the Riverside Heart and Vascular Institute to learn more about when it's time to see a cardiologist. And we're back with Dr. Zachariah thank you for being here today.

Dr. Amit Zachariah: Thank you for having me.

Helen: Yes, we're glad to have you. So, to get started, can you go ahead and tell us a little bit about your background?

Dr. Amit Zachariah: Yeah. I actually grew up in town in Kakiki and I did my training in Cincinnati Houston and Chicago. And then I came back to practice in town again. And now I'm doing interventional cardiology at Riverside Hospital.

Helen: Awesome. What, kind of drew you to coming back here to this area?

Dr. Amit Zachariah: It just sort of worked out that way in in a way. I was looking for jobs out of training and I finished up in Chicago, so this was actually a good place to end up.

Helen: Yeah, that's amazing. So, getting into the topic at hand, when should someone see a cardiologist?

Dr. Amit Zachariah: Yeah, there's a couple of different reasons why you might want to. The first one is if you already have a history of heart disease, then I think that's always a good reason to, for example, if you've not seen a cardiologist in several years it's a good time to kind of reestablish care with a cardiologist. A second reason might be you were referred by your primary care provider. They know your heart history and they know your medical problems and they might realize that you are someone that needs to see a cardiologist. So if they put that referral in and suggest it, then I think it's always a good idea to listen to their advice and see a cardiologist.

Helen: Got it. So if you haven't been in a while, or if you're being referred by your primary care those are good reasons. And so what cardiac symptoms should someone look out for? That could mean maybe I should take this to my primary care to figure out what's going on?

Dr. Amit Zachariah: Yeah. So there's three ones that I'll kind of focus on during this podcast. One is chest pain. So one of the things that we worry about with chest pain is could it be related to blockages in the artery, resupplying blood to the heart? And we call that Angelo chest pain. And the heart is a muscle and it needs a blood supply. And if there's arteries that supply blood to the heart, muscle that have narrowings or blockages, then that can cause symptoms. And that would be things like chest pain. You might know this as heart disease or coronary artery disease, but that can cause chest pain.

A second symptom might be shortness of breath. This could also be related to things like heart disease but it could also be related to things like heart valve disease where if you have a narrowing in one of the heart valves where it's not opening that well, or a leaking of one of the other heart valves where it's leaking too much it can cause shortness of breath. And then also if your heart is not pumping well or not relaxing well, it can cause things like heart failure and that can cause shortness of breath.

The final major symptom to look out for would be things like palpitations or dizziness. This could be related to an electrical problem of. And these are things that we call arrhythmias, where situations like atrial fibrillation, for example, can cause these symptoms and might be a reason to see a cardiologist.

Helen: Got it. So chest pain, you said palpitations and then shortness of breath. Those are the three to kind of look out for. And then maybe consider seeing a cardiologist if you have those. But are there times when you might have no symptoms but maybe need to be seen?

Dr. Amit Zachariah: Yes. And there are certain conditions. You sort of increase your risk of having heart disease where you have other medical problems. And some of those other medical problems would be things like diabetes chronic kidney disease high blood pressure, high cholesterol. If you're a current or former smoker, and we'll kind of dive into that a little bit deeper now. For example, if you have diabetes or chronic kidney disease, you are two to four times a higher risk to have heart disease than people that don't have diabetes.

And the similar risk apply with chronic kidney disease. We now have medications that can help treat actually diabetes, chronic kidney disease, and decrease cardiovascular risk all at once. And so these are new medicines that have that have come out right now actually, and that might be something that your cardiologist might put you on. Other things that I mentioned. Things like high blood pressure, which is hypertension that can also lead to increased risk of heart disease, stroke, kidney disease, or heart failure.

And we can sort of give you advice in terms of diet, exercise, and some medications that can lower your risk. The other thing I mentioned was the high cholesterol levels and cholesterol deposits in your arteries, and it can form plaques, and that's how you get blockages in your heart arteries. And by decreasing your cholesterol levels, you prevent that from happening. Some of the things that you can do for that would be, of course, the lifestyle changes like diet and exercise, but your cardiologist might also put you on medications to lower your cholesterol.

There are some medications people have been on for many years. Things like statins that you might know about already. Some people don't tolerate statins, and there are some newer medicines that have come out. For example, injectable medicines. And some of them are actually quite well tolerated. There's a new one that's come out that where you can take it maybe once every six months as an injection in the office. It's very convenient to take and it decreases your cardiovascular risk. And then we mentioned smoking, very important risk factor to have heart disease.

And it also increases your risk to have things like peripheral artery disease, which are blockages and other arteries that are not in your heart or on your heart, but perhaps in your legs. And so, if you have pain when you walk or if you have pain, when you exercise, particularly in your calves, it's a good reason to get checked out to see if you might have blockages in those arteri. and it's a good reason to see a cardiologist.

Helen: So if you have other health issues, a lot of them can lead to heart issues. So just getting checked out, making sure you're, good to go is always a good thing. we're going to take a quick break to talk about heart care at Riverside. The Riverside Heart Team is a skilled group of experts specializing in treatments that heal hearts throughout the region, working together the riverside heart. Team is committed to preventing heart disease by bringing the latest, most effective treatments to Kaikiki and their surrounding communities.

For more information about Riverside Heart and Vascular Institute, visit riverside healthcare.org/heart at Riverside. Your hearts in the right place. And jumping back in another question for you. Why should someone not delay if they fall into one of the categories that you mentioned before?

Dr. Amit Zachariah: Yeah, that's a good question. There are complications that can result if you delay the care that we talked about. And so that would be things like, for example, if you have heart disease that you sort of leave alone and let progress over time, that can get worse and you might get a heart attack. Other things that can happen would be things like heart failure, where the heart gets weaker and then if you have abnormal heart rhythms, for example.

It can cause structural changes to the heart or it can make you have these symptoms that keep coming back, these palpitations that we talked about. Also, things like high blood pressure, if you don't control that, it can increase your risk of stroke and kidney failure. And diabetes can also result in, heart disease and heart attacks as well as peripheral artery disease.

Helen: Got it. So, with many things, it's better to catch it early, know what you're dealing with and manage that. And so if someone wants to do that and they want to go see a cardiologist, but they haven't, they might be nervous. What should they expect at their first time seeing a cardiologist?

Dr. Amit Zachariah: Yeah, so usually you'll. Get a sort of similar visit as when you see your primary care doctor or primary care provider. And what'll happen is the cardiologist will ask you some questions to get a sense of your clinical history as to what symptoms you might have or what risk factors you might have. They'll do an exam where they listen to your heart, see if they hear anything that's abnormal and then they'll also. Perhaps do an EKG where they look at the electrical system of the heart, and then based on your risk factors and your symptoms, they may order a cardiac test.

Helen: Got it. Well, that's great. How can I or somebody interested, schedule an appointment with a Riverside cardiologist? Do we need a referral from primary care? How does that work?

Dr. Amit Zachariah: So the simplest way is to go to the Riverside Cardiology website. There's actually a link right on the website where you can click to schedule an appointment. I think it's always good to discuss this with your primary care provider. But you don't necessarily absolutely need a referral. And you can actually schedule it yourself through the website or you can even call the number and call the office and they can schedule you that way too.

Helen: Well, I think that's all I had for today. Did you have anything else you wanted to add?

Dr. Amit Zachariah: No. I just wanted to thank you for allowing me to be here.

Helen: Of course. Thank you for joining us and thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org/heart.