What to expect at your first appointment with a cardiologist

Heart Health

by Helen Hashemi, MD

Feb 17, 2023

Keeping your heart healthy is critical to living your best life. And if you have a family history of cardiac problems or risk factors for heart disease, you or your primary care doctor may want your heart to get some extra care.

That’s when you make an appointment with a general cardiologist like me. Like your primary care doctor, I’ll ask you questions, check your vital signs and probably run some tests. But the questions, tests and procedures are a little different than what you may expect since I focus on your heart health. Let me walk you through what a typical first visit with me and my staff might look like.

Before you see a cardiologist

Most people come to general cardiologists like me because they:

  • Have symptoms of heart disease, such as chest pain, shortness of breath or heart palpitations.
  • Want to take steps to prevent heart disease. These people often have a family history of heart disease and want to make sure they’re healthy. Or they have a risk factor such as high blood pressure, high cholesterol or diabetes, and their primary care physician has asked for some help in controlling these factors.
  • Already have diagnosed cardiac issues and need someone to help them on their journey with heart disease. They may have had a heart attack, had a stent implanted, had atrial fibrillation or been diagnosed with vascular disease.

We may do different procedures or ask different questions depending on the reason you’re in my office. First, let’s look at what we’ll do if you’re having symptoms.

Assessing cardiac symptoms and planning your care

Before you come in, I’ll get your medical records from your primary care doctor and any other healthcare professionals you’ve seen. We’ll study those records and talk with your primary care physician or their staff to find out what’s going on with you.  

When you come into the office, you’ll first meet with a medical assistant who will go over your medical history, including:

  • Any surgeries you’ve had
  • Medications you’re taking
  • Habits like drinking, smoking or drugs
  • Your family history

The assistant takes your vital signs, like your blood pressure, heart rate and oxygen level. Most of the time, we get an EKG so we can assess your heart’s activity.

After that, we talk about why you came to see me. I ask questions about your symptoms and any previous cardiac workups. We also go over your family, medical and surgical histories once more before I do a physical exam.  

After all of that is done, I go over all your data from your visit with me and from other physicians and hospitals you’ve visited. That helps me make decisions like whether a medication needs to be changed or whether you may need an angiogram, a CAT scan or other tests.

Finally, using all the information I’ve gathered, my staff and I work with you to come up with a plan to help manage your symptoms. These can include medications, changes to your diet, exercise or stress-relieving practices, or sometimes surgery.

Preventing heart problems

If you’re coming to me for help with preventing cardiac disease, your visit focuses on the best ways to keep your heart healthy. After I look at your medical records and the results of your tests and exams, you and I talk about what we can start doing immediately.

For example, if you have a family history of high cholesterol but yours is currently normal, I might recommend that you have it checked more frequently. I can recommend diet changes that can help keep your cholesterol level low. If your level is higher than it should be, we can talk about using medications to bring it down.

Rehabbing your heart

If you’ve been diagnosed with cardiac disease, my goals are to keep you from having another event and help you get back to living a full life. We make certain any medications that you’re on are working as they should and teach you how to monitor your symptoms so we can catch and treat any future problems early.

I may also recommend cardiac rehabilitation. Cardiac rehab is a specialized exercise program overseen by a physical therapist. The exercises aren’t difficult and are designed to help you and your heart build strength gradually and safely.

If, for example, you had a heart attack, your therapist might start you out with a short walk, then over time increase the distance. Eventually, your therapist may have you jog or run. You and your heart are monitored during your workout. After each session, your therapist sends me a report on your progress.

The importance of family in heart health

I spend quite a bit of time during someone’s initial visit talking about their family history. That is so important because family and genetics play a very prominent role in whether you develop cardiac disease.

Risk factors for heart disease like high blood pressure, high cholesterol and diabetes all are influenced by your genetics. Heart disease itself can be hereditary. Some people have types of vascular diseases that are 100% genetic. Premature coronary artery disease—a buildup of plaque in the arteries—also can be inherited from family members.

Family members also tend to pass on social habits that affect heart health. For example, if one person in a home is a smoker, everyone there is exposed to smoke. If everyone in the family eats the same salty foods, they’re all predisposed to hypertension. Or maybe they all follow a not-so-healthy diet, so they all develop high cholesterol.

Because having a complete picture of your family health is so vital to treating and preventing cardiac conditions, another common recommendation is genetic testing.

Heart health of the future

I love being a cardiologist. It’s a privilege to take care of everyone who comes to see me. I love that I can do something to help them live life to the fullest.

Still, cardiac disease is one of the most common causes of death in America. Most people I see already have a heart condition. That’s why it’s important to come to us early on, when you first see signs, before you develop heart disease. Then we can focus more on prevention.

Looking for a cardiologist? Find a cardiologist near you.

About the Author

Dr. Hashemi is a cardiologist with Baylor Scott & White Heart and Vascular Hospital – Dallas specializing in acute and chronic cardiac issues. She is passionate about preventive cardiology and helps patients focus on diet, lifestyle and risk factor modification.

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