Different Types of Cardiologists & What They Do

When it comes to heart health, knowing who to turn to can feel overwhelming. Cardiologists are often seen as the specialists you go to only when something serious is happening — chest pain, heart attacks, or other scary symptoms that send you straight to the ER.

But the truth is, cardiologists play a much broader role in keeping your heart healthy, and many of them focus on preventing heart disease before it ever starts.

Whether you've been referred to a cardiologist by your primary care doctor or you're simply curious about your risk factors, understanding the different types of cardiologists — and what each one does — can help you feel more confident and informed when seeking care.

Let's break it down.

What is a cardiologist?

"A cardiologist is a medical doctor who specializes in diagnosing and treating heart disease and or blood vessel disease," explains Dr. Joe Aoun, an interventional cardiologist at Houston Methodist. "Basically, that's what we call cardiovascular disease."

Cardiologists treat a wide range of conditions, including:

• High blood pressure (hypertension)
• Coronary artery disease (clogged arteries)
• Heart failure (a weakened heart)
• Irregular heart rhythms (like atrial fibrillation)
• Adult congenital heart disease (structural heart issues present at birth)
• Heart valve disease

 

But not all cardiologists treat every condition. That's where subspecialists come in.

Types of cardiologists you might see

Cardiology is a diverse field, and depending on your symptoms or diagnosis, you might be referred to one of these various types of cardiologists.

General cardiologists

General cardiologists are often the first type of cardiologist someone might see if they have symptoms of heart or blood vessel disease or have multiple risk factors.

What they do:

• Provide exams and heart tests to diagnose and manage heart conditions
• Recommend treatment plans, including medications and lifestyle changes, for heart disease prevention or management
• Connect patients with other heart specialists as needed for evaluation and procedures

 

When you may have to see one:

• You're having non-emergent symptoms such as chest pain, heart murmur or occasional shortness of breath
• You have heart disease risk factors, such as high blood pressure, high cholesterol levels, or a family history of heart disease

 

"Genetics play a role," says Dr. Aoun. "If you have a history in my family of heart disease, or heart failure, or heart attacks — especially at a younger age — seeking the care of a cardiologist is very important."

Other heart disease risk factors that may prompt you to see a general cardiologist include:

• Smoking
• Diabetes
• Being overweight
• Age

 

Interventional cardiologists

These specialists, Dr. Aoun says, are often referred to as the "plumbers" of the heart.

"We can open up clogged arteries and treat valves with transcatheter options — without opening the chest," says Dr. Aoun. "That means going through the groin or the wrist and fixing the valves."

What they do:

• Perform catheter-based procedures like angioplasty and stent placement
• Treat heart valve issues using minimally invasive techniques
• Help restore blood flow and prevent heart attacks

 

When you might see one:

• If you have coronary artery disease
• If you need a valve repair or replacement
• If you've had a heart attack or are at high risk for one

 

Electrophysiologists

These cardiologists specialize in the heart's electrical system — the part that controls your heartbeat.

"Electrophysiologists focus on rhythm problems in the heart, such as irregular heartbeats or dizziness related to heart issues," Dr. Aoun explains.

What they do:

• Diagnose and treat arrhythmias
• Implant pacemakers or defibrillators
• Perform ablation procedures

 

When you might see one:

• If you experience heart palpitations, dizziness, or fainting
• If you're diagnosed with atrial fibrillation (AFib)
• If your smartwatch alerts you to an irregular heartbeat

 

Heart failure specialists

When the heart becomes too weak to pump blood effectively, heart failure specialists step in with advanced therapies.

"Whenever the heart is very weak and needs advanced therapies such as heart transplants or LVADs — left ventricular assist devices — that's when heart failure specialists are involved," says Dr. Aoun.

What they do:

• Manage chronic heart failure
• Recommend treatments like medications, lifestyle changes or devices
• Coordinate care for heart transplants or mechanical support

 

When you might see one:

• If you've been diagnosed with heart failure
• If you have swelling in your legs, shortness of breath or fatigue
• If your heart function is declining despite treatment

 

Cardiac imaging specialists

These doctors are experts in interpreting heart imaging — like ultrasounds, computerized tomography scans (CT scans) and magnetic resonance imaging scans (MRIs) — to help diagnose and monitor heart conditions.

"Cardiac imagers are subspecialized in reading echocardiograms, CT scans, or cardiac MRIs," Dr. Aoun says.

What they do:

• Read echocardiograms (ultrasounds of the heart)
• Interpret cardiac CTs and MRIs
• Help detect structural abnormalities or damage

 

When you might see one:

• If your cardiologist orders advanced imaging
• If you have congenital heart disease or unexplained symptoms
• If you're being monitored for changes in heart structure or function

 

Adult congenital heart disease (ACHD) specialists

People born with congenital heart disease (structural issues of the heart) need ongoing, specialized heart care throughout their lives living as they live with the condition. ACHD specialists are highly trained in monitoring and treating the long-term issues that can arise in the decades after surgeries or catheterizations used to treat heart issues in childhood.

What they do:

• Diagnose and/or manage congenital heart conditions in adults
• Provide care plans, including medications, procedures or revisions for patients
• Help women with congenital heart conditions safely manage pregnancies

 

When you might see one:

• You were born with a congenital heart issue and need heart care
• You are a woman with a congenital heart issue either pregnant or considering pregnancy

 

Heart surgeons

Heart surgeons, or cardiac surgeons, focus solely on open or robotically assisted surgical treatments for heart conditions. Heart surgeons address or repair structural issues in the heart that can be present at birth or developed over time, including blocked arteries, heart valve repairs or replacements, or even heart transplants when hearts fail.

"Heart surgeons are usually not considered cardiologists," Dr. Aoun clarifies. "Interventional cardiologists and electrophysiologists do procedures, but they're usually not open-heart procedures. Cardiac surgeons are a different specialty."

While cardiologists may perform catheter-based procedures, open-heart surgeries are handled by heart surgeons.

What they do:

• Perform surgeries for serious heart conditions that are considered emergencies or can no longer be managed by noninvasive treatments
• Monitor recovery after heart surgery

 

When you might see one:

• You have coronary artery disease that requires surgery
• You need a heart valve repaired or replaced
• You have an aortic aneurysm that requires surgery
• You have heart failure and need a heart transplant

 

Cardio-oncologists

Cardio-oncologists care for patients with cancer or cancer survivors to detect, treat or monitor heart issues that may arise due to cancer treatments such as chemotherapy, radiation and other therapies.

What they do:

• Help direct heart care for cancer patients with current heart issues or monitor cancer survivors for heart late effects

 

When you might see one:

• You're undergoing cancer treatment and experiencing heart issues
• You're a cancer survivor who is experiencing heart issues years after treatment

 

Do you need a referral to see a cardiologist?

"It depends," says Dr. Aoun. "I would encourage any patient to review their health insurance plan and contact their insurer before they make an appointment with a cardiologist to understand their options."

He also recommends starting with your primary care doctor first, who can help direct you.

"Sometimes it's not necessarily the heart that is causing symptoms," Dr. Aoun says. "They may need to be referred to other medical specialties."

Symptoms that might signal it's time to see a cardiologist

Cardiologists treat and prevent heart disease — you don't need to wait for a crisis to see one. Here are some classic signs that might prompt you to see a cardiologist:

• Chest pain or pressure
• Shortness of breath during activity
• Heart fluttering or racing
• Swelling in the legs
• Dizziness, lightheadedness or fainting

 

Dr. Aoun emphasizes that some symptoms require immediate emergency care.

"If someone suddenly experiences shortness of breath or faints or is experiencing chest pain that lasts more than a few minutes, especially with sweating, nausea, or difficulty breathing — definitely call 911," Dr. Aoun advises. "If it feels like an elephant is sitting on their chest and that pain radiates or moves to either their back, their left shoulder, or their jaw, those are signs that are typical of a heart attack. It's not the pain that goes away within a second, it's the pain that lasts few minutes."