In recent weeks, we have seen an increase in the number of cardiology cases involving issues with pacemaker placement, premature patient discharge, and heart attacks. Cardiology cases present an array of unique challenges for an attorney, and a cardiology consultant can prove to be a valuable resource when working through the specificities of these cases.
Overview of Cardiologists
Cardiologists receive extensive education and training, including four years of medical school, three years of residency in general internal medicine, and three or more years in specialized fellowship training. In order to become certified, a cardiologist must complete a minimum of ten years of clinical and educational preparation and must pass a rigorous two-day exam given by the American Board of Internal Medicine. This exam tests not only their knowledge and judgment but also their ability to provide superior care.
Patients with symptoms cardiac-related conditions will often consult with a cardiologist for help in diagnosing and treatment plans. Symptoms like shortness of breath, chest pain, or syncopal episodes often require advanced testing that can only be properly interpreted by a board-certified cardiologist. Occasionally, heart murmurs or ECG changes also need the evaluation of a cardiologist.
Cardiologists are involved in the treatment of heart attacks, heart failure, and serious heart rhythm disturbances. Their skills and training are required whenever decisions are made about procedures such as cardiac catheterization, balloon angioplasty, or heart surgery. Cardiologists are also intimately involved in the follow-up care required for patients with serious heart disease or catastrophic cardiac events, such as myocardial infarction or coronary artery bypass surgery.
It is a common misconception that cardiologists are surgeons. Some cardiologists perform minor surgical procedures or tests such as cardiac catheterizations (which require small skin punctures or incisions) and some subspecialists are certified in placing pacemakers or internal cardiac defibrillators. However, most specialize in office diagnoses and interpretation of echocardiograms, ECGs, and exercise tests. Some physicians have specialized skill in cholesterol management or cardiac rehabilitation and fitness, yet all cardiologists know how and when these crucial tests are medically indicated in regards to managing cardiac emergencies.
Routine Cardiology Procedures
A cardiologist skill set is essentially centered around the performance and interpretation of the following tests or procedures:
Electrocardiogram (EKG or ECG)
An electrocardiogram (EKG or ECG) is a device that records the electrical activity of a patient’s heart detecting any subtle or overt electrical abnormalities of the heart muscle.
An echocardiogram (also called an Echo) is a type of ultrasound that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of a patient’s heart. These signals are turned into moving pictures of the heart that can be seen on a visual display making it easier for a cardiologist to diagnosis and detect abnormalities in valvular structures.
Cardiac catheterization is a minor surgical procedure in which a cardiologist feeds a tiny catheter into the great vessels of the heart through access from a small incision in the groin area. Cardiac catheterization has great diagnostic value as it allows physicians to check blood flow in the coronary arteries, blood pressure in the chambers of the heart, valvular integrity, and helps to investigate any wall motion disturbances.
If a patient is found to have significant plaque buildup (atherosclerosis), then a coronary angiogram may be employed to pinpoint the size and location of fat and calcium deposits (plaque) that are narrowing the vessels.
Percutaneous Coronary Intervention (PCI)
Very similar to the coronary angiogram, but it’s used to open up narrowed coronary arteries with special tools. The two common types of PCI are angioplasty with or without coronary stents or atherectomy (removal of plaque). The results from a coronary angiogram help cardiologists determine if treatment with medicine, percutaneous coronary intervention (PCI), or bypass surgery (CABG) may be the most efficacious for beneficial outcomes.
Overview and Benefits of Cardiology Consultants
Employing a consultant, as opposed to an expert witness, provides many of the same benefits of the attorney-client privilege in that the findings are not subject to discovery. The attorney and the consultant are free to engage in frank discussions without having any concerns. For cardiology consultants, this proves to be extremely beneficial. Given the myriad of issues that can arise during a cardiology case, it is imperative that the attorney understands all elements, and a cardiology consultant is one of the best ways to do so. As a consultant, the cardiologist is free to:
- · Interview the client to address different elements of the case
· Research medical literature
· Examine and produce chronologies
· Review medical records
· Assist attorney understand the case facts