What Is an Invasive Cardiologist?

Medically Reviewed by Carmelita Swiner, MD on July 07, 2023
Written by WebMD Editorial Contributors
5 min read

You need a strong, healthy heart to live a long life. Eating a varied diet, exercising, and not smoking can help keep your heart strong. Unfortunately, genetics, lifestyle habits, or accidents can lead to heart problems. In the United States, heart disease is a leading cause of death. Heart disease or problems with the heart can affect anyone, including children. There are many types of heart conditions. The most common heart condition is coronary artery disease, which involves a blockage in the arteries that can lead to a heart attack.

The heart is a complex organ. This is why invasive cardiologists exist. These doctors specialize in using minimally or marginally invasive procedures to diagnose and treat cardiovascular disease or anomalies of the heart. Invasive cardiologists must have a thorough understanding of the heart and blood vessels. Seeing a cardiologist can help you diagnose, manage, and treat complex cardiac conditions and diseases of the heart and blood vessels.

Invasive cardiologists are a subspeciality of cardiology similar to interventional cardiologists. Invasive cardiologists are qualified to diagnose and treat conditions like coronary artery disease, vascular disease, acquired structural heart disease, congestive heart failure, valvular heart disease, and congenital heart disease. 

To understand your overall heart health and any problems, the invasive cardiologist will review your medical records, medical history, and symptoms. They may run tests like X-rays, blood tests, or electrocardiogram (ECG) if these tests have not already been done before your visit. These types of tests help determine the problem. 

Additionally, an invasive cardiologist is qualified to perform minimally invasive tests to further identify or treat structural or electrical abnormalities in the heart’s structure or arteries that other cardiologists may not be able to perform. Performing these minimally invasive tests helps the invasive cardiologist diagnose and treat their patients appropriately. Invasive cardiologists have to be prepared to respond to emergencies immediately, since their services may be needed quickly to stop a patient from having a heart attack. 

Invasive cardiologists are medical doctors who have specifically trained in the tools and techniques to diagnose or treat cardiovascular diseases or defects. Like most physicians, these doctors typically first go through medical school. After completing medical school, they will spend about seven to eight additional years of training to specialize in invasive cardiology. They will also need to complete a certification in internal medicine if they want to eventually be board-certified as a cardiologist. 

This process involves completing:

  • An average of four years in medical school
  • A three-year residency in internal medicine or in pediatrics if wanting to specialize in working with children
  • A three-year fellowship in cardiology where they work with physicians and gain additional advanced training in cardiology, prevention, diagnosis, and patient care
  • A one to two-year invasive (interventional) cardiology fellowship to gain additional specialized training

Patients may see an invasive cardiologist in an emergency if they are having a heart attack. They will also see people to diagnose and treat problems before it becomes an emergency, such as coronary artery disease, heart valve disease, and peripheral vascular disease. 

Since invasive cardiologists are cardiology specialists, your doctor or a cardiologist will likely refer you when there are concerns about: 

Too Much Arterial Plaque that Can’t Be Treated by Medication Alone

If you have atherosclerosis, or a buildup of fatty plaques in your blood vessels, you likely are taking medications to reduce your risk of blocked arteries. If arteries become blocked, you’re at increased risk of a heart attack. However, medication may not be enough. You may need a minimally invasive treatment to help unclog blocked arteries.  

New or Worsening Symptoms of Coronary Artery Disease 

If you have coronary artery disease, your arteries become narrower, often due to plaque buildup. This narrowing of the arteries can reduce the flow of blood and oxygen to your heart muscles. Your doctor or cardiologist may send you to see an invasive cardiologist if you’re experiencing new or worsening symptoms to rule out whether additional minimally invasive treatments are needed. 

Signs or Symptoms of Peripheral Vascular Disease

You can also experience new or worsening symptoms of clogging, narrowing, or hardening of arteries in other parts of your body. As a result, you may be referred to an invasive cardiologist for further diagnosis and potential treatment. Peripheral vascular disease can also cause problems with your heart’s functioning.

Concerns about Heart Valve Disease

The heart’s valves help control the blood flow to the chambers of your heart. Problems with your valves’ functioning can lead to significant health and heart issues. Your doctor or cardiologist might refer you to an invasive cardiologist for further diagnosis if they suspect valve problems.

You may see an invasive cardiologist in different settings. If you’re experiencing an emergency like a heart attack or stroke, you’ll be seen immediately through a hospital’s emergency department. If you’re referred to an invasive cardiologist, you can see them either through a private practice or through a hospital system. 

When you go to the invasive cardiologist, they'll talk with you to learn more about your symptoms, and they will review your medical records and any testing you’ve had at that point, such as an ECG, blood test, or X-ray. Their goal is to help provide additional diagnosis and the least invasive treatment solutions to help you.  

If you have clogged arteries or structural abnormalities, an invasive cardiologist may recommend and can perform:

  • Cardiac catheterization, which lets the doctor see and evaluate how well your blood vessels are supplying your heart
  • Angioplasty, which involves the doctor inserting a tiny balloon into your clogged vein to push plaque against your artery walls so your blood flow will increase and help your heart return to normal capacity 
  • Stenting, which is inserting a tiny plastic or metal tube (stent) that will permanently hold a clogged vein open

Typically, these procedures are performed in a hospital. The doctor will discuss the advantages and disadvantages of any procedures with you to determine the right course of action. 

The exception is if you’re in an emergency, like having a heart attack or stroke. The medical team, including the invasive cardiologist, may need to make decisions quickly. Angioplasty and stenting are effective in emergency situations in treating heart attacks and strokes.