Cardiology

From Wikipedia, the free encyclopedia

This article is about the medical specialty dealing with the heart. For the album by Good
Charlotte, see Cardiology (album). For the medical journal, see Cardiology (journal).
Cardiology

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,
Cardiomyopathy, Hypertension
(High Blood Pressure)

Significant
tests

Blood tests, Electrophysiology

study, Cardiac imaging, ECG,
Echocardiograms, Stress test

Specialist

Cardiologist

Cardiology (from Greek kardi, "heart" and - -logia, "study") is a branch of

medicine dealing with disorders of the heart be it human or animal. 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.

Contents

1 Specialization
o 1.1 Adult cardiology
o 1.2 Pediatric cardiology
2 The heart
3 Disorders
o 3.1 Disorders of the coronary circulation
o 3.2 Cardiac arrest
o 3.3 Disorders of the myocardium (muscle of the heart)
o 3.4 Disorders of the pericardium (outer lining of the heart)
o 3.5 Disorders of the heart valves
o 3.6 Congenital heart defect
o 3.7 Diseases of blood vessels (vascular diseases)
o 3.8 Procedures to counter coronary artery disease
o 3.9 Devices used in cardiology
o 3.10 Diagnostic tests and procedures
4 Cardiologists
5 Journals
6 Associations
7 See also
8 References
9 External links

Specialization
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
unqualified and called just "cardiologist") is inadequately trained to take care of children,
and pediatric cardiologists are inadequately trained to take care of adults. The surgical
aspects are not included in cardiology and are in the domain of cardiothoracic surgery.
For example, coronary artery bypass surgery (CABG) and cardiopulmonary bypass are
both surgical procedures performed by surgeons, not cardiologists.

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 subspecialties in the United States by the ACGME are:[citation needed]

Cardiac electrophysiology: Study of the electrical properties and conduction

diseases of the heart.
Echocardiography: The use of ultrasound to study the mechanical
function/physics of the heart.

Interventional cardiology: The use of catheters for the treatment of structural and
ischemic diseases of the heart.
Nuclear cardiology: The use of nuclear medicine to visualize the uptake of an
isotope by the heart using radioactive sources.

Recognized subspecialties in the United States by the American Osteopathic Association

Bureau of Osteopathic Specialists (AOABOS) include:[1]

Clinical cardiac electrophysiology

Interventional cardiology

Pediatric cardiology
Pediatric cardiology is a specialty of pediatrics. To be a pediatric cardiologist in the
United States, a three-year residency in pediatrics is followed by a three-year fellowship
in pediatric cardiology.

The heart

Blood flow through the valves

Main articles: heart and human 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 and
caused 29.34% of all deaths in 2002.[citation needed]
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. 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
ParkinsonWhite syndrome, ventricular fibrillation, and heart block.
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.

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.

Disorders of the coronary circulation

Coronary arteries labeled in red text and other landmarks in blue text.
Contrary to a basic understanding of the cardiovascular system, the heart cannot itself
receive enough oxygen and nutrients from the blood it pumps and it must be supplied

with blood as if it were any other organ in the body. Unlike the systemic organs the heart
receives perfusion in the phase of diastole rather than systole. This circulation of blood is
called the coronary circulation. The coronary circulation consists of coronary arteries and
coronary veins.
Disorders of the coronary circulation can have devastating effects to the heart since
damage to the heart can reduce coronary circulation which causes further damage. A few
examples are presented, as follows:
Acute coronary syndrome (ACS)
Acute coronary syndrome is a broad term encompassing many acute myocardial
infarction symptoms.
Angina pectoris
Angina pectoris literally means "chest pain" that refers to pain caused by ischemia
of the heart.
Atherosclerosis
Atherosclerosis is the condition in which an artery wall thickens as the result of a
build-up of fatty materials (e.g., cholesterol). Atherosclerosis of a coronary artery
leads to coronary heart disease.
Coronary heart disease
Coronary heart disease is a general term for any reduction in coronary circulation.
One such condition is atherosclerosis.
Myocardial infarction (a.k.a. heart attack)
A myocardial infarction is the death of a part of the heart which is typically
caused by a blockage of the coronary circulation or coronary heart disease.
Restenosis
Recurrence of stenosis which would refer to a narrowing of a coronary artery in
the context of the coronary circulation.

Cardiac arrest

A rhythm strip showing a couple beats of normal sinus rhythm followed by an atrial beat
and asystole ("flatline").
Cardiac arrest refers to the cessation of normal systemic circulation due to failure in
proper contraction of the heart. There are several conditions that can cause cardiac arrest.
Asystole ("flatline")

Asystole refers to the absence of electrical activity of the heart and is sometimes
referred to as a "flatline" because the electrocardiogram shows a solid line due to
the absence of electrical activity.
Pulseless electrical activity (PEA)
Pulseless electrical activity is when the electrocardiogram shows a rhythm that
should produce a pulse but it does not. PEA is commonly caused by the 6 H's and
6 T's (see PEA article).
Pulseless ventricular tachycardia
Pulseless ventricular tachycardia (VT) Is one classification of VT such that no
pulse is felt because of an ineffective cardiac output which causes cardiac arrest.
Sudden cardiac death
Sudden cardiac death is a concept of natural death rather than a specific medical
condition. There are several causes of sudden cardiac death and it is distinct from
cardiac arrest.
Ventricular fibrillation
Ventricular fibrillation is fibrillation of the ventricles of the heart. Rhythmic
contraction is necessary for efficient movement of blood, and fibrillation disrupts
this rhythm sufficiently to cause cardiac arrest.
Treatment of cardiac arrest includes cardiopulmonary resuscitation (CPR) and
defibrillation depending on the exact cause of cardiac arrest.

Disorders of the myocardium (muscle of the heart)

The diagram shows a healthy heart (left) and one suffering from right ventricular
hypertrophy (right).

A man with congestive heart failure and marked jugular venous distension. External
jugular vein marked by an arrow.
Cardiomyopathy
Cardiomyopathy is a deterioration of the myocardium.
Ischemic cardiomyopathy
Cardiomyopathy causing ischemia of the heart due to coronary artery disease.
Nonischemic cardiomyopathy
Cardiomyopathy not caused by ischemia of the heart.
Amyloid cardiomyopathy
Cardiomyopathy caused by amyloidosis.
Hypertrophic cardiomyopathy (HCM)
Cardiomyopathy caused by hypertrophy of the heart.
Hypertrophic obstructive cardiomyopathy (HOCM) (Idiopathic hypertrophic
subaortic stenosis (IHSS))