According to the Centers for Disease Control (CDC), heart disease is the leading cause of death for "men, women, and people of most racial and ethnic groups in the United States." However, heart disease can be present with no symptoms until a significant event happens, like a stroke or heart attack.
Initial Screening & Treatment
Because it's known as a "silent killer," physicians are acutely aware of the importance of early detection, diagnosis and preventative treatment. In many cases, heart health management begins with a primary care physician (PCP).
Typically, a PCP is responsible for screening and initial treatments for high blood pressure, high cholesterol, diabetes, weight management and smoking. Left unchecked, these are all contributing factors to heart disease.
Primary care physicians will refer patients to a cardiologist if they have heightened risk factors for heart disease, heart failure or if their heart condition becomes more nuanced. "The relationship between a PCP and a cardiologist is a partnership for managing the most effective treatment for a patient," said Dr. Bradley Witbrodt, BJC Medical Group cardiologist.
In St. Louis and surrounding areas, most PCPs and specialists utilize an electronic medical record for documentation and test results. This digital record allows PCPs and specialists to share notes and data for mutual patients. Physicians also communicate through chat messages and phone calls to discuss specific patient issues.
The cardiology group at Missouri Baptist Medical Center meets weekly with the cardiothoracic surgery group to discuss difficult and complex cases in a "heart team approach." As many as a dozen cardiologists and surgeons may review complex and high-risk patient cases to discuss the best possible outcome.
Specialized Heart Care
Visiting a cardiologist for the first time for heart issues can be an intimidating and overwhelming experience for many patients, Dr. Witbrodt acknowledged. "We see many patient referrals because they have some type of cardiac complaint. It's also common for patients to get a cardiology consult for preventative reasons such as a family history of heart attack or heart failure or if they smoke, have diabetes or are overweight."
Dr. Witbrodt takes time to put patients at ease by answering their questions when assessing their heart health and disease risk.
When seeing new patients, he talks about their symptoms and family history of cardiac problems. "Many times, patients bring a list of heart-related issues they noticed like chest pain or shortness of breath, when the episode happened, and what they were doing," Dr. Witbrodt added. "We also look at current medication, past medical history and previous cardiac testing results."
While almost all new patients get an electrocardiogram (EKG) and cholesterol bloodwork in the clinic, other testing like an echocardiogram evaluate why they are short of breath, or a stress test to assess the heart's blood flow, are scheduled based on the patient's symptoms.
Addressing the concerns that many first-time patients have, Dr. Witbrodt added that not every patient who sees a cardiologist will need an invasive heart procedure. "Some patients may need their medication adjusted, while others may need help changing their habits to accommodate a healthier lifestyle. Surgery is usually reserved for patients with abnormal test results and who are at the highest risk."