1. 2 8 21 cardiology

Cardiology
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Cardiology
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This article is about the medical specialty. For the album, see Cardiology (album). For
the medical journal, see Cardiology (journal).
Cardiology
Heart diagram blood flow en.svg
Blood flow diagram of the human heart. Blue components indicate de-oxygenated blood
pathways and red components indicate oxygenated blood pathways.
System Cardiovascular
Subdivisions Interventional, Nuclear
Significant diseases Heart disease, Cardiovascular disease, Atherosclerosis,
earning websites that make the most money
Cardiomyopathy, Hypertension (High Blood Pressure)

Significant tests Blood tests, electrophysiology study, cardiac imaging, ECG,
echocardiograms, stress test
Specialist Cardiologist
Glossary Glossary of medicine
Cardiologist
Occupation
Names
Physician
Surgeon
Occupation type Specialty
Activity sectors Medicine, Surgery
Description
Education required
Doctor of Medicine (M.D.)
Doctor of Osteopathic medicine (D.O.)
Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)
Bachelor of Medicine, Bachelor of Surgery (MBChB)
Fields of
employment Hospitals, Clinics
Cardiology (from Greek καρδίᾱ kardiā, "heart" and -λογία -logia, "study") is a branch of
medicine that deals with the disorders of the heart as well as some parts of the
circulatory system. The field includes medical diagnosis and treatment of congenital
heart defects, coronary artery disease, heart failure, valvular heart disease and
electrophysiology. Physicians who specialize in this field of medicine are called
cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians
who specialize in cardiology. Physicians who specialize in cardiac surgery are called
cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.
https://youtu.be/jVvQaqFOJpY
Contents
1 Specializations
1.1 Adult cardiology
1.1.1 Cardiac electrophysiology
1.1.1.1 Clinical cardiac electrophysiology
1.1.2 Cardiogeriatrics
1.1.3 Echocardiography
1.1.4 Interventional cardiology
1.2 Preventive cardiology and cardiac rehabilitation
1.3 Pediatric cardiology
1.3.1 Tetralogy of Fallot
1.3.2 Pulmonary atresia
1.3.3 Double outlet right ventricle

1.3.4 Transposition of great arteries
1.3.5 Persistent truncus arteriosus
1.3.6 Ebstein anomaly
2 The Heart
2.1 Coronary circulation
2.2 Cardiac examination
3 Heart disorders
3.1 Hypertension
3.1.1 Essential vs Secondary hypertension
3.1.2 Complications of hypertension
3.2 Coronary artery disease
3.3 Cardiac arrest
3.4 Congenital heart defects
4 Diagnostic tests in cardiology
5 Cardiology community
5.1 Associations
5.2 Journals
5.3 Cardiologists
6 See also
7 References
8 Sources
9 External links
Specializations
All cardiologists study the disorders of the heart, but the study of adult and child heart disorders
are through different training pathways. Therefore, an adult cardiologist (often simply called
"cardiologist") is inadequately trained to take care of children, and pediatric cardiologists are not
trained to take care of adult heart disease. The surgical aspects are not included in cardiology
and are in the domain of cardiothoracic surgery. For example, coronary artery bypass surgery
(CABG), cardiopulmonary bypass and valve replacement are surgical procedures performed by
surgeons, not cardiologists. However, the insertion of stents and pacemakers is performed by
cardiologists.[citation needed]
Adult cardiology
Cardiology is a specialty of internal medicine. To be a cardiologist in the United States, a
three-year residency in internal medicine is followed by a three-year fellowship in cardiology. It is
possible to specialize further in a sub-specialty. Recognized sub-specialties in the United States
by the ACGME are cardiac electrophysiology, echocardiography, interventional cardiology, and
nuclear cardiology. Recognized subspecialties in the United States by the American Osteopathic
Association Bureau of Osteopathic Specialists (AOABOS) include clinical cardiac
electrophysiology and interventional cardiology.[1][2] While in India, a person needs to undergo
three years of residency in General Medicine or Pediatrics after M.B.B.S and then three years of
residency in Cardiology to be a D.M/Diplomate of National Board (DNB) in Cardiology.[citation
needed]

Per Doximity, adult cardiologists make an average of $436,849 in the United States.[3]
Cardiac electrophysiology
Main article: Cardiac electrophysiology
Cardiac electrophysiology is the science of elucidating, diagnosing, and treating the electrical
activities of the heart. The term is usually used to describe studies of such phenomena by
invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac
responses to programmed electrical stimulation (PES). These studies are performed to assess
complex arrhythmias, elucidate symptoms, evaluate abnormal electrocardiograms, assess risk
of developing arrhythmias in the future, and design treatment. These procedures increasingly
include therapeutic methods (typically radiofrequency ablation, or cryoablation) in addition to
diagnostic and prognostic procedures. Other therapeutic modalities employed in this field
include antiarrhythmic drug therapy and implantation of pacemakers and automatic implantable
cardioverter-defibrillators (AICD).[4][5]
The cardiac electrophysiology study (EPS)
typically measures the response of the injured or cardiomyopathic myocardium to PES on
specific pharmacological regimens in order to assess the likelihood that the regimen will
successfully prevent potentially fatal sustained ventricular tachycardia (VT) or ventricular
fibrillation (VF) in the future. Sometimes a series of EPS drug trials must be conducted to enable
the cardiologist to select the one regimen for long-term treatment that best prevents or slows the
development of VT or VF following PES. Such studies may also be conducted in the presence
of a newly implanted or newly replaced cardiac pacemaker or AICD.[4]
Clinical cardiac electrophysiology
Main article: Clinical cardiac electrophysiology
Clinical cardiac electrophysiology is a branch of the medical specialty of cardiology and is
concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with
expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are
trained in the mechanism, function, and performance of the electrical activities of the heart.
Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or
guide therapy for heart rhythm disturbances (arrhythmias). They are trained to perform
interventional and surgical procedures to treat cardiac arrhythmia.[citation needed]
The training required to become an electrophysiologist is long and requires 7 to 8 years after
medical school (within the U.S.). Three years of internal medicine residency, three years of
Clinical Cardiology fellowship, and one to two (in most instances) years of clinical cardiac
electrophysiology.[6]
Cardiogeriatrics
Main article: Cardiogeriatrics

Cardiogeriatrics, or geriatric cardiology, is the branch of cardiology and geriatric medicine that
deals with the cardiovascular disorders in elderly people.
Cardiac disorders such as coronary heart disease, including myocardial infarction, heart failure,
cardiomyopathy, and arrhythmias such as atrial fibrillation, are common and are a major cause
of mortality in elderly people.[7][8] Vascular disorders such as atherosclerosis and peripheral
arterial disease cause significant morbidity and mortality in aged people.[9][10]
Echocardiography
Main article: Echocardiography
Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound
to create images of the heart.
Echocardiography has become routinely used in the diagnosis, management, and follow-up of
patients with any suspected or known heart diseases. It is one of the most widely used
diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size
and shape of the heart (internal chamber size quantification), pumping capacity, and the location
and extent of any tissue damage. An echocardiogram can also give physicians other estimates
of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic
function (how well the heart relaxes).
Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy,
dilated cardiomyopathy, and many others. The use of stress echocardiography may also help
determine whether any chest pain or associated symptoms are related to heart disease. The
biggest advantage to echocardiography is that it is not invasive (does not involve breaking the
skin or entering body cavities) and has no known risks or side effects.
Interventional cardiology
Main article: Interventional cardiology
Interventional cardiology is a branch of cardiology that deals specifically with the catheter based
treatment of structural heart diseases.[11] A large number of procedures can be performed on
the heart by catheterization. This most commonly involves the insertion of a sheath into the
femoral artery (but, in practice, any large peripheral artery or vein) and cannulating the heart
under X-ray visualization (most commonly Fluoroscopy).
The main advantages of using the interventional cardiology or radiology approach are the
avoidance of the scars and pain, and long post-operative recovery. Additionally, interventional
cardiology procedure of primary angioplasty is now the gold standard of care for an acute
Myocardial infarction. This procedure can also be done proactively, when areas of the vascular
system become occluded from Atherosclerosis. The Cardiologist will thread this sheath through
the vascular system to access the heart. This sheath has a balloon and a tiny wire mesh tube
wrapped around it, and if the cardiologist finds a blockage or Stenosis, they can inflate the
balloon at the occlusion site in the vascular system to flatten or compress the plaque against the

vascular wall. Once that is complete a Stent is placed as a type of scaffold to hold the
vasculature open permanently.
Preventive cardiology and cardiac rehabilitation
In recent times, the focus is gradually shifting to Preventive cardiology due to increased
Cardiovascular Disease burden at an early age. As per WHO, 37% of all premature deaths are
due to cardiovascular diseases and out of this, 82% are in low and middle income countries.[12]
Clinical cardiology is the sub specialty of Cardiology which looks after preventive cardiology and
cardiac rehabilitation. Preventive cardiology also deals with routine preventive checkup though
non invasive tests specifically Electrocardiography, Stress Tests, Lipid Profile and General
Physical examination to detect any cardiovascular diseases at an early age while cardiac
rehabilitation is the upcoming branch of cardiology which helps a person regain his overall
strength and live a normal life after a cardiovascular event. A subspecialty of preventive
cardiology is sports cardiology.
Pediatric cardiology
Helen B. Taussig is known as the founder of pediatric cardiology. She became famous through
her work with Tetralogy of Fallot, a congenital heart defect in which oxygenated and
deoxygenated blood enters the circulatory system resulting from a ventricular septal defect
(VSD) right beneath the aorta. This condition causes newborns to have a bluish-tint, cyanosis,
and have a deficiency of oxygen to their tissues, hypoxemia. She worked with Alfred Blalock
and Vivien Thomas at the Johns Hopkins Hospital where they experimented with dogs to look at
how they would attempt to surgically cure these "blue babies." They eventually figured out how
to do just that by the anastomosis of the systemic artery to the pulmonary artery and called this
the Blalock-Taussig Shunt.[13]
Tetralogy of Fallot, pulmonary atresia, double outlet right ventricle, transposition of the great
arteries, persistent truncus arteriosus, and Ebstein's anomaly are various congenital cyanotic
heart diseases, in which the blood of the newborn is not oxygenated efficiently, due to the heart
defect.

Tetralogy of Fallot
Tetralogy of Fallot
Tetralogy of Fallot is the most common congenital heart disease arising in 1–3 cases per 1,000
births. The cause of this defect is a ventricular septal defect (VSD) and an overriding aorta.
These two defects combined causes deoxygenated blood to bypass the lungs and going right
back into the circulatory system. The modified Blalock-Taussig shunt is usually used to fix the
circulation. This procedure is done by placing a graft between the subclavian artery and the
ipsilateral pulmonary artery to restore the correct blood flow.
Pulmonary atresia
Pulmonary atresia happens in 7–8 per 100,000 births and is characterized by the aorta
branching out of the right ventricle. This causes the deoxygenated blood to bypass the lungs
and enter the circulatory system. Surgeries can fix this by redirecting the aorta and fixing the
right ventricle and pulmonary artery connection.
There are two types of pulmonary atresia, classified by whether or not the baby also has a
ventricular septal defect.[14][15]
Pulmonary atresia with an intact ventricular septum: This type of pulmonary atresia is
associated with complete and intact septum between the ventricles.[15]
Pulmonary atresia with a ventricular septal defect: This type of pulmonary atresia happens when
a ventricular septal defect allows blood to flow into and out of the right ventricle.[15]
Double outlet right ventricle
Double outlet right ventricle (DORV) is when both great arteries, the pulmonary artery and the
aorta, are connected to the right ventricle. There is usually a VSD in different particular places
depending on the variations of DORV, typically 50% are subaortic and 30%. The surgeries that
can be done to fix this defect can vary due to the different physiology and blood flow in the
defected heart. One way it can be cured is by a VSD closure and placing conduits to restart the
blood flow between the left ventricle and the aorta and between the right ventricle and the
pulmonary artery. Another way is systemic-to-pulmonary artery shunt in cases associated with
pulmonary stenosis. Also, a balloon atrial septostomy can be done to fix DORV with the
Taussig-Bing anomaly.[citation needed]

Transposition of great arteries
Dextro-transposition of the Great Arteries
There are two different types of transposition of the great arteries, Dextro-transposition of the
great arteries and Levo-transposition of the great arteries, depending on where the chambers
and vessels connect. Dextro-transposition happens in about 1 in 4,000 newborns and is when
the right ventricle pumps blood into the aorta and deoxygenated blood enters the bloodstream.
The temporary procedure is to create an atrial septal defect (ASD). A permanent fix is more
complicated and involves redirecting the pulmonary return to the right atrium and the systemic
return to the left atrium, which is known as the Senning procedure. The Rastelli procedure can
also be done by rerouting the left ventricular outflow, dividing the pulmonary trunk, and placing a
conduit in between the right ventricle and pulmonary trunk. Levo-transposition happens in about
1 in 13,000 newborns and is characterized by the left ventricle pumping blood into the lungs and
the right ventricle pumping the blood into the aorta. This may not produce problems at the
beginning, but will eventually due to the different pressures each ventricle uses to pump blood.
Switching the left ventricle to be the systemic ventricle and the right ventricle to pump blood into
the pulmonary artery can repair levo-transposition.[citation needed]
Persistent truncus arteriosus
Persistent truncus arteriosus is when the truncus arteriosus fails to split into the aorta and
pulmonary trunk. This occurs in about 1 in 11,000 live births and allows both oxygenated and
deoxygenated blood into the body. The repair consists of a VSD closure and the Rastelli
procedure.[citation needed]
Ebstein anomaly

Ebstein's anomaly is characterized by a right atrium that is significantly enlarged and a heart
that is shaped like a box. This is very rare and happens in less than 1% of congenital heart
disease cases. The surgical repair varies depending on the severity of the disease.[16]
Pediatric cardiology is a sub-specialty of pediatrics. To become a pediatric cardiologist in the
United States, one must complete a three-year residency in pediatrics, followed by a three-year
fellowship in pediatric cardiology. Per doximity, pediatric cardiologists make an average of
$303,917 in the United States.[3]
The Heart
Blood flow through the valves
Main article: Heart
As the center focus of cardiology, the heart has numerous anatomical features (e.g., atria,
ventricles, heart valves) and numerous physiological features (e.g., systole, heart sounds,
afterload) that have been encyclopedically documented for many centuries.
Disorders of the heart lead to heart disease and cardiovascular disease and can lead to a
significant number of deaths: cardiovascular disease is the leading cause of death in the United
States and caused 24.95% of total deaths in 2008.[17]
The primary responsibility of the heart is to pump blood throughout the body. It pumps blood
from the body — called the systemic circulation — through the lungs — called the pulmonary
circulation — and then back out to the body. This means that the heart is connected to and
affects the entirety of the body. Simplified, the heart is a circuit of the Circulation.[citation
needed] While plenty is known about the healthy heart, the bulk of study in cardiology is in
disorders of the heart and restoration, and where possible, of function.
The heart is a muscle that squeezes blood and functions like a pump. Each part of the heart is
susceptible to failure or dysfunction and the heart can be divided into the mechanical and the
electrical parts.

The electrical part of the heart is centered on the periodic contraction (squeezing) of the muscle
cells that is caused by the cardiac pacemaker located in the sinoatrial node. The study of the
electrical aspects is a sub-field of electrophysiology called cardiac electrophysiology and is
epitomized with the electrocardiogram (ECG/EKG). The action potentials generated in the
pacemaker propagate throughout the heart in a specific pattern. The system that carries this
potential is called the electrical conduction system. Dysfunction of the electrical system
manifests in many ways and may include Wolff–Parkinson–White syndrome, ventricular
fibrillation, and heart block.[18]
The mechanical part of the heart is centered on the fluidic movement of blood and the
functionality of the heart as a pump. The mechanical part is ultimately the purpose of the heart
and many of the disorders of the heart disrupt the ability to move blood. Failure to move
sufficient blood can result in failure in other organs and may result in death if severe. Heart
failure is one condition in which the mechanical properties of the heart have failed or are failing,
which means insufficient blood is being circulated.[19]
Coronary circulation
Main article: Coronary circulation
Coronary circulation is the circulation of blood in the blood vessels of the heart muscle
(myocardium). The vessels that deliver oxygen-rich blood to the myocardium are known as
coronary arteries. The vessels that remove the deoxygenated blood from the heart muscle are
known as cardiac veins. These include the great cardiac vein, the middle cardiac vein, the small
cardiac vein and the anterior cardiac veins.[citation needed]
As the left and right coronary arteries run on the surface of the heart, they can be called
epicardial coronary arteries. These arteries, when healthy, are capable of autoregulation to
maintain coronary blood flow at levels appropriate to the needs of the heart muscle. These
relatively narrow vessels are commonly affected by atherosclerosis and can become blocked,
causing angina or a heart attack. (See also: circulatory system.) The coronary arteries that run
deep within the myocardium are referred to as subendocardial.[citation needed]
The coronary arteries are classified as "end circulation", since they represent the only source of
blood supply to the myocardium; there is very little redundant blood supply, which is why
blockage of these vessels can be so critical.[citation needed]
Cardiac examination
Main article: Cardiac examination
The cardiac examination (also called the "precordial exam"), is performed as part of a physical
examination, or when a patient presents with chest pain suggestive of a cardiovascular
pathology. It would typically be modified depending on the indication and integrated with other
examinations especially the respiratory examination.[citation needed]

Like all medical examinations, the cardiac examination follows the standard structure of
inspection, palpation and auscultation.[citation needed]
Heart disorders
Main article: List of heart disorders
Cardiology is concerned with the normal functionality of the heart and the deviation from a
healthy heart. Many disorders involve the heart itself but some are outside of the heart and in
the vascular system. Collectively, the two together are termed the cardiovascular system and
diseases of one part tend to affect the other.
[20]
Hypertension
Main article: Hypertension
Hypertension, also known as "high blood pressure"", is a long term medical condition in which
the blood pressure in the arteries is persistently elevated.[21] High blood pressure usually does
not cause symptoms.[22] Long term high blood pressure, however, is a major risk factor for
coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and
chronic kidney disease.[23][24]
Lifestyle factors can increase the risk of hypertension. These include excess salt in the diet,
excess body weight, smoking, and alcohol.[22][25] Hypertension can also be caused by other
diseases, or as a side-effect of drugs.[citation needed]
Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which
are the maximum and minimum pressures, respectively.[22] Normal blood pressure at rest is
within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg
diastolic.[26] High blood pressure is present if the resting blood pressure is persistently at or
above 140/90 mmHg for most adults.[25] Different numbers apply to children.[27] Ambulatory
blood pressure monitoring over a 24-hour period appears more accurate than office best blood
pressure measurement.[21][25]
Lifestyle changes and medications can lower blood pressure and decrease the risk of health
complications.[28] Lifestyle changes include weight loss, decreased salt intake, physical
exercise, and a healthy diet.[25] If lifestyle changes are not sufficient then blood pressure
medications are used.[28] Up to three medications can control blood pressure in 90% of
people.[25] The treatment of moderate to severe high arterial blood pressure (defined as
>160/100 mmHg) with medications is associated with an improved life expectancy and reduced
morbidity.[29] The effect of treatment of blood pressure between 140/90 mmHg and 160/100
mmHg is less clear, with some reviews finding benefit[30][31] and others finding a lack of
evidence for benefit.[32] High blood pressure affects between 16 and 37% of the population
globally.[25] In 2010 hypertension was believed to have been a factor in 18% (9.4 million)
deaths.[33]

Essential vs Secondary hypertension
Main articles: Essential hypertension and Secondary hypertension
Essential hypertension is the form of hypertension that by definition has no identifiable cause. It
is the most common type of hypertension, affecting 95% of hypertensive
patients,[34][35][36][37] it tends to be familial and is likely to be the consequence of an
interaction between environmental and genetic factors. Prevalence of essential hypertension
increases with age, and individuals with relatively high blood pressure at younger ages are at
increased risk for the subsequent development of hypertension. Hypertension can increase the
risk of cerebral, cardiac, and renal events.[38]
Secondary hypertension is a type of hypertension which is caused by an identifiable underlying
secondary cause. It is much less common than essential hypertension, affecting only 5% of
hypertensive patients. It has many different causes including endocrine diseases, kidney
diseases, and tumors. It also can be a side effect of many medications.[citation needed]
Complications of hypertension
Main complications of persistent high blood pressure
Main article: Complications of hypertension
Complications of hypertension are clinical outcomes that result from persistent elevation of
blood pressure.[39] Hypertension is a risk factor for all clinical manifestations of atherosclerosis
since it is a risk factor for atherosclerosis itself.[40][41][42][43][44] It is an independent
predisposing factor for heart failure,[45][46] coronary artery disease,[47][48] stroke,[39] renal
disease,[49][50][51] and peripheral arterial disease.[52][53] It is the most important risk factor for
cardiovascular morbidity and mortality, in industrialized countries.[54]
Cardiac arrhythmia

Main article: Cardiac arrhythmia
Cardiac arrhythmia, also known as "cardiac dysrhythmia" or "irregular heartbeat", is a group of
conditions in which the heartbeat is irregular, too fast, or too slow. A heart rate that is too fast –
above 100 beats per minute in adults – is called tachycardia and a heart rate that is too slow –
below 60 beats per minute – is called bradycardia.[55] Many types of arrhythmia have no
symptoms. When symptoms are present these may include palpitations or feeling a pause
between heartbeats. More seriously there may be lightheadedness, passing out, shortness of
breath, or chest pain.[56] While most types of arrhythmia are not serious, some predispose a
person to complications such as stroke or heart failure.[55][57] Others may result in cardiac
arrest.[57]
There are four main types of arrhythmia: extra beats, supraventricular tachycardias, ventricular
arrhythmias, and bradyarrhythmias. Extra beats include premature atrial contractions, premature
ventricular contractions, and premature junctional contractions. Supraventricular tachycardias
include atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. Ventricular
arrhythmias include ventricular fibrillation and ventricular tachycardia.[57][58] Arrhythmias are
due to problems with the electrical conduction system of the heart.[55] Arrhythmias may occur in
children; however, the normal range for the heart rate is different and depends on age.[57] A
number of tests can help with diagnosis including an electrocardiogram (ECG) and Holter
monitor.[59]
Most arrhythmias can be effectively treated.[55] Treatments may include medications, medical
procedures such as a pacemaker, and surgery. Medications for a fast heart rate may include
beta blockers or agents that attempt to restore a normal heart rhythm such as procainamide.
This later group may have more significant side effects especially if taken for a long period of
time. Pacemakers are often used for slow heart rates. Those with an irregular heartbeat are
often treated with blood thinners to reduce the risk of complications. Those who have severe
symptoms from an arrhythmia may receive urgent treatment with a jolt of electricity in the form
of cardioversion or defibrillation.[60]
Arrhythmia affects millions of people.[61] In Europe and North America, as of 2014, atrial
fibrillation affects about 2% to 3% of the population.[62] Atrial fibrillation and atrial flutter resulted
in 112,000 deaths in 2013, up from 29,000 in 1990.[63] Sudden cardiac death is the cause of
about half of deaths due to cardiovascular disease or about 15% of all deaths globally.[64]
About 80% of sudden cardiac death is the result of ventricular arrhythmias.[64] Arrhythmias may
occur at any age but are more common among older people.[61]
Coronary artery disease
Main article: Coronary artery disease
Coronary artery disease, also known as "ischemic heart disease",[65] is a group of diseases
that includes: stable angina, unstable angina, myocardial infarction, and is one of the causes of
sudden cardiac death.[66] It is within the group of cardiovascular diseases of which it is the
most common type.[67] A common symptom is chest pain or discomfort which may travel into
the shoulder, arm, back, neck, or jaw.[68] Occasionally it may feel like heartburn. Usually

symptoms occur with exercise or emotional stress, last less than a few minutes, and get better
with rest.[68] Shortness of breath may also occur and sometimes no symptoms are present.[68]
The first sign is occasionally a heart attack.[69] Other complications include heart failure or an
irregular heartbeat.[69]
Risk factors include: high blood pressure, smoking, diabetes, lack of exercise, obesity, high
blood cholesterol, poor diet, and excessive alcohol, among others.[70][71] Other risks include
depression.[72] The underlying mechanism involves atherosclerosis of the arteries of the heart.
A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing,
coronary computed tomographic angiography, and coronary angiogram, among others.[73]
Prevention is by eating a healthy diet, regular exercise, maintaining a healthy weight and not
smoking.[74] Sometimes medication for diabetes, high cholesterol, or high blood pressure are
also used.[74] There is limited evidence for screening people who are at low risk and do not
have symptoms.[75] Treatment involves the same measures as prevention.[76][77] Additional
medications such as antiplatelets including aspirin, beta blockers, or nitroglycerin may be
recommended.[77] Procedures such as percutaneous coronary intervention (PCI) or coronary
artery bypass surgery (CABG) may be used in severe disease.[77][78] In those with stable CAD
it is unclear if PCI or CABG in addition to the other treatments improve life expectancy or
decreases heart attack risk.[79]
In 2013 CAD was the most common cause of death globally, resulting in 8.14 million deaths
(16.8%) up from 5.74 million deaths (12%) in 1990.[67] The risk of death from CAD for a given
age has decreased between 1980 and 2010 especially in developed countries.[80] The number
of cases of CAD for a given age has also decreased between 1990 and 2010.[81] In the United
States in 2010 about 20% of those over 65 had CAD, while it was present in 7% of those 45 to
64, and 1.3% of those 18 to 45.[82] Rates are higher among men than women of a given
age.[82]
Cardiac arrest
Main article: Cardiac arrest
Cardiac arrest is a sudden stop in effective blood flow due to the failure of the heart to contract
effectively.[83] Symptoms include loss of consciousness and abnormal or absent
breathing.[84][85] Some people may have chest pain, shortness of breath, or nausea before this
occurs.[85] If not treated within minutes, death usually occurs.[83]
The most common cause of cardiac arrest is coronary artery disease. Less common causes
include major blood loss, lack of oxygen, very low potassium, heart failure, and intense physical
exercise. A number of inherited disorders may also increase the risk including long QT
syndrome. The initial heart rhythm is most often ventricular fibrillation.[86] The diagnosis is
confirmed by finding no pulse.[84] While a cardiac arrest may be caused by heart attack or heart
failure these are not the same.[83]

Prevention includes not smoking, physical activity, and maintaining a healthy weight.[87]
Treatment for cardiac arrest is immediate cardiopulmonary resuscitation (CPR) and, if a
shockable rhythm is present, defibrillation.[88] Among those who survive targeted temperature
management may improve outcomes.[89] An implantable cardiac defibrillator may be placed to
reduce the chance of death from recurrence.[87]
In the United States, cardiac arrest outside of hospital occurs in about 13 per 10,000 people per
year (326,000 cases). In hospital cardiac arrest occurs in an additional 209,000[90] Cardiac
arrest becomes more common with age. It affects males more often than females.[91] The
percentage of people who survive with treatment is about 8%. Many who survive have
significant disability. Many U.S. television shows, however, have portrayed unrealistically high
survival rates of 67%.[92]
Congenital heart defects
Main article: Congenital heart defect
A congenital heart defect, also known as a "congenital heart anomaly" or "congenital heart
disease", is a problem in the structure of the heart that is present at birth.[93] Signs and
symptoms depend on the specific type of problem.[94] Symptoms can vary from none to
life-threatening.[93] When present they may include rapid breathing, bluish skin, poor weight
gain, and feeling tired.[95] It does not cause chest pain.[95] Most congenital heart problems do
not occur with other diseases.[94] Complications that can result from heart defects include heart
failure.[95]
The cause of a congenital heart defect is often unknown.[96] Certain cases may be due to
infections during pregnancy such as rubella, use of certain medications or drugs such as alcohol
or tobacco, parents being closely related, or poor nutritional status or obesity in the
mother.[94][97] Having a parent with a congenital heart defect is also a risk factor.[98] A number
of genetic conditions are associated with heart defects including Down syndrome, Turner
syndrome, and Marfan syndrome.[94] Congenital heart defects are divided into two main
groups: cyanotic heart defects and non-cyanotic heart defects, depending on whether the child
has the potential to turn bluish in color.[94] The problems may involve the interior walls of the
heart, the heart valves, or the large blood vessels that lead to and from the heart.[93]
Congenital heart defects are partly preventable through rubella vaccination, the adding of iodine
to salt, and the adding of folic acid to certain food products.[94] Some defects do not need
treatment.[93] Other may be effectively treated with catheter based procedures or heart
surgery.[99] Occasionally a number of operations may be needed.[99] Occasionally heart
transplantation is required.[99] With appropriate treatment outcomes, even with complex
problems, are generally good.[93]
Heart defects are the most common birth defect.[94][100] In 2013 they were present in 34.3
million people globally.[100] They affect between 4 and 75 per 1,000 live births depending upon
how they are diagnosed.[94][98] About 6 to 19 per 1,000 cause a moderate to severe degree of

problems.[98] Congenital heart defects are the leading cause of birth defect-related deaths.[94]
In 2013 they resulted in 323,000 deaths down from 366,000 deaths in 1990.[101]
Diagnostic tests in cardiology
Main article: Diagnostic tests in cardiology
Diagnostic tests in cardiology are the methods of identifying heart conditions associated with
healthy vs. unhealthy, pathologic heart function. The starting point is obtaining a medical history,
followed by Auscultation. Then blood tests, electrophysiological procedures, and cardiac
imaging can be ordered for further analysis. Electrophysiological procedures include
electrocardiogram, cardiac monitoring, cardiac stress testing, and the electrophysiology
study.[citation needed]
Cardiology community
Associations
American College of Cardiology
American Heart Association
European Society of Cardiology
Heart Rhythm Society
Canadian Cardiovascular Society
Indian Heart Association
National Heart Foundation of Australia
Cardiology Society of India
Journals
Main category: Cardiology journals
Acta Cardiologica
American Journal of Cardiology
Annals of Cardiac Anaesthesia
Current Research: Cardiology
Cardiology in Review
Circulation
Circulation Research
Clinical and Experimental Hypertension
Clinical Cardiology
EP – Europace
European Heart Journal
Heart
Heart Rhythm
International Journal of Cardiology
Journal of the American College of Cardiology
Pacing and Clinical Electrophysiology
Indian Heart Journal
Cardiologists

Cardiologist
Occupation
NamesDoctor, Medical Specialist
Occupation type Specialty
Activity sectors Medicine
Description
Education required
Doctor of Medicine (M.D.)
Doctor of Osteopathic Medicine (D.O.)
Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)
Fields of
employment Hospitals, Clinics
Main article: List of cardiologists
Robert Atkins (1930–2003), known for the Atkins diet
Eugene Braunwald (born 1929), editor of Braunwald's Heart Disease and 1000+ publications
Wallace Brigden (1916–2008), identified cardiomyopathy

Willem Einthoven (1860–1927), a physiologist who built the first practical ECG and won the
1924 Nobel Prize in Physiology or Medicine ("for the discovery of the mechanism of the
electrocardiogram")
Werner Forssmann (1904–1979), who infamously performed the first human catheterization on
himself that led to him being let go from Berliner Charité Hospital, quitting cardiology as a
speciality, and then winning the 1956 Nobel Prize in Physiology or Medicine ("for their
discoveries concerning heart catheterization and pathological changes in the circulatory
system")
Andreas Gruentzig (1939–1985), first developed balloon angioplasty
William Harvey (1578–1657), wrote Exercitatio Anatomica de Motu Cordis et Sanguinis in
Animalibus that first described the closed circulatory system and whom Forssmann described as
founding cardiology in his Nobel lecture
Murray S. Hoffman (born 1924) As president of the Colorado Heart Association, he initiated one
of the first jogging programs promoting cardiac health
Max Holzmann (1899–1994), co-founder of the Swiss Society of Cardiology, president from
1952–1955
Samuel A. Levine (1891–1966), recognized the sign known as Levine's sign as well as the
current grading of the intensity of heart murmurs, known as the Levine scale
Henry Joseph Llewellyn "Barney" Marriott (1917–2007), ECG interpretation and Practical
Electrocardiography[102]
Bernard Lown (born 1921), original developer of the defibrillator
Woldemar Mobitz (1889–1951), described and classified the two types of second-degree
atrioventricular block often called "Mobitz Type I" and "Mobitz Type II"
Jacqueline Noonan (born 1928), discoverer of Noonan syndrome that is the top syndromic
cause of congenital heart disease
John Parkinson (1885–1976), known for Wolff–Parkinson–White syndrome
Helen B. Taussig (1898–1986), founder of pediatric cardiology and extensively worked on blue
baby syndrome
Paul Dudley White (1886–1973), known for Wolff–Parkinson–White syndrome
Louis Wolff (1898–1972), known for Wolff–Parkinson–White syndrome
Karel Frederik Wenckebach (1864–1940), first described what is now called type I
second-degree atrioventricular block in 1898
See also
icon medicine portal
Outline of cardiology
List of cardiac pharmaceutical agents
Glossary of medicine
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Ramrakha, Punit; Hill, Jonathan, eds. (2012). Oxford Handbook of Cardiology (2nd ed.). Oxford
University Press. ISBN 978-0-19-964321-9.
External links
Look up cardiology in Wiktionary, the free dictionary.
American Heart Association
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Arteries and veins
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Categories: Cardiology
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