There are many different reasons to see a specialist for atherosclerotic cardiovascular disease (ASCVD). You may want to find ways to improve your health, such as by lowering your LDL, or “bad” cholesterol levels. Your primary care doctor may want you to follow up on some test results from your physical. Maybe you already have a diagnosis of ASCVD. Or you’ve already had a heart attack. Whatever the reason for this first visit, you can expect the specialist to have certain goals in mind.
They’ll seek to:
- Figure out whether the symptoms you’re having are linked to ASCVD, then assess your overall risk for various medical conditions.
- Find out if you have a high risk of having a cardiac event such as a heart attack.
- Discuss your treatment and counsel you on your options.
When You Arrive for Your ASCVD Appointment
At the start of your visit, a medical assistant will take you to an exam room to collect data and do some simple tests. They’ll ask you for key health info such as:
- Your personal medical history
- Your family medical history, especially family members who’ve had similar conditions to yours
- Your symptoms
- Medications you take
- Any allergies you have
It can help to gather all your medical info and any notes in a folder for easy access so you don’t have to remember everything off the top of your head.
Checking Your Vital Signs
The assistant will then take your “vitals”: your blood pressure, heart rate, oxygen levels, height, and weight. They’ll likely also give you an electrocardiogram, also known as an EKG or ECG. This will check electrical signals in your heart and flag any problems. The specialist will get a lot of key information from these stats.
Your doctor might have asked you to have some bloodwork done before this initial visit. These are lab tests on small blood samples you give that measure cholesterol; the status of conditions like diabetes; and other things specific to your health.
Meeting Your ASCVD Specialist
Your specialist will review the information your tests have gathered. They’ll then come in to meet you and start the interview. They’ll put together what they call a focused history to zero in on the reason for your visit. To do this, they’ll:
- Look at your symptoms.
- Collect information from you that will help show your chances of having certain health problems.
- Go over your personal history with you, then describe any tests and imaging you might need.
- Ask about your lifestyle, such as a history of smoking.
Imaging and Testing for ASCVD
Your specialist also will review prior imaging and other tests you’ve had up until now. Data from tests like CT scans can show signs of ASCVD and other conditions. This is key in helping your doctor pinpoint your risk status.
A specialist such as a cardiologist will likely order further tests, including:
An echocardiogram. This scan of your heart made by sound waves shows how well your heart works and points out anything abnormal.
A stress test. This uses physical exercise to raise your heart rate. It helps assess how well your heart pumps blood and can flag issues such as blockages in your arteries. It also can show whether your symptoms are related to ASCVD.
Your Physical Exam for ASCVD
After the initial exam, your specialist will want to check out how well other parts of your body work. They’ll listen to your heart to identify murmurs or anything abnormal in your heart rhythm. They can also detect high cardiac pressure, which can point to heart failure or fluid buildup in your body. They’ll also listen to your lungs for anything unusual.
Discussing Your Treatment Plan for ASCVD
You’ll likely spend the last part of your appointment deciding on or talking about a treatment plan. Your specialist may suggest treatments, including a coronary angiogram, surgery, a pacemaker, or something else, and explain the possible side effects of each. They can also suggest ideas for changing your lifestyle to improve your condition and lessen chances of it getting worse. They should take time to answer your questions and make sure that you understand your options so you can advocate for your own health.
If you both decide more info is needed, your doctor will order more tests.
Your doctor might not have all the answers on the spot. From this first visit, though, they can identify the most likely major issues you have and get started on treatment if needed.
Show Sources
Photo Credit: Wat'hna Racha / EyeEm / Getty Images
SOURCES:
Salim Hayek MD, cardiologist and medical director, University of Michigan Frankel Cardiovascular Center Clinics, Ann Arbor, MI.
University of Michigan Health: “Cholesterol (Lipid Management).”
Dignity Health: “Cardiologist Appointment: What You Need and What to Expect.”
Mayo Clinic: “Electrocardiogram (ECG or EKG),” “Echocardiogram,” “Stress Test.”
MedlinePlus: “What You Need to Know About Blood Testing.”
