When to Start Seeing a Cardiologist

Think you’re too young to be seeing a cardiologist? Ask a cardiologist what they think. “The earlier you start, the better,” says Patrick Azcarate, M.D., with Baptist Health Miami Cardiac & Vascular Institute. “Even if you’re young and you have a healthy lifestyle, you could still be at risk for cardiovascular disease, or CVD.”

A study from 2000-2016 has shown that heart attacks are occurring in young patients as early as those in their 20s. Dr. Azcarate, who specializes in general cardiology including coronary artery disease, prevention cardiology, heart failure, echocardiography and nuclear imaging, and cardio-oncology, says that while CVD tends to affect older adults, people of all ages can be at risk.

Patrick Azcarate, M.D., a cardiologist with Baptist Health Miami Cardiac & Vascular Institute

“As a clinical cardiologist, I manage patients with CVD, which can include hypertension, high cholesterol, coronary artery disease, arrhythmias and heart failure,” Dr. Azcarate says. “A number of my patients are what you might consider ‘too young’ to be seeing a cardiologist yet here they are, being treated or followed for something heart related.”

Some young patients can be born with congenital heart problems that have gone undiagnosed for years, says Dr. Azcarate. “Young patients can also present differently from older patients with different and more subtle symptoms,” he says. “It requires a detailed clinical history and thorough exam to identify those at most risk for cardiac disease.”

According to the American Heart Association (AHA), heart disease is the leading cause of death in the United States, especially for those aged 60 and older. And once a person reaches age 40, those risks start to increase exponentially.

Statistics from the AHA reflect the scope of cardiovascular disease, or CVD, in the U.S.:

·       Between 2015 and 2018, nearly 127 million adults had some form of CVD.

·       CVD, listed as the underlying cause of death, accounted for 874,613 deaths in 2019.

·       CVD remains the number one cause of death in the U.S., claiming more lives each year than all forms of cancer and Chronic Lower Respiratory Disease (CLRD) combined.

·       In 2019, coronary heart disease (CHD) was the leading cause (41.3%) of deaths attributable to CVD, followed by other CVD (17.3%), stroke (17.2%), high blood pressure (11.7%), heart   failure (9.9%) and arterial diseases (2.8%).

·       Approximately every 40 seconds, someone in the U.S. will have a myocardial infarction, or heart attack.

·       Average age at the first heart attack is 65.6 years for males and 72.0 years for females.

Knowing your risks and symptoms                                                                                                              

“By middle age, it’s a good idea to begin annual cardiology checkups,” advises Dr. Azcarate. “But even if you’re in your 30s, it’s important to consider your risk factors and know the symptoms.”Chest pressure, palpitations, dizziness, shortness of breath or fainting are all symptoms that warrant a visit to your doctor or cardiologist, he says – or to the nearest emergency room if your symptoms are severe or continue to worsen.

Women may experience symptoms of CVD differently than men, according to Dr. Azcarate. For example, he says, instead of the typical chest pressure radiating to the left arm which many men experience with a heart attack, women may feel pain in their jaw or in the upper middle area of their abdomen, and even nausea. Many women mistake these symptoms for indigestion or heartburn, or just choose to ignore them and soldier on, he says.

Dr. Azcarate emphasizes that anyone with a family history of heart disease or a personal history of risk factors such as hypertension or high cholesterol should consider a cardiac evaluation, regardless of their age. “That way, we can address any issues early on and make sure you’re on the right treatment plan for you, whether that be lifestyle modifications, medications or surgery,” he says.

What to expect at your cardiologist appointment

Your cardiologist will check your blood pressure to test how much difficulty your heart undergoes when pumping blood. Dr. Azcarate says that blood tests are also useful as they measure the levels of minerals in your blood. “Your lab work may point to high cholesterol, organ dysfunction or even heart failure,” he says.

If any signs present themselves during your checkup, your cardiologist can determine the best course of action, from diagnostic testing to prescribing the appropriate medications that will help reduce stress on your heart.

A heart-healthy lifestyle

It’s never too late to adopt heart-healthy strategies that can mitigate your risk of heart disease, assures Dr. Azcarate, who says that abstaining from smoking is one of the first and primary forms of prevention you can practice, followed by diet and exercise.

“The link between smoking and CVD has been well-established for decades and fewer people are smoking tobacco today than a decade ago,” says Dr. Azcarate. With diet, he says it’s important to find a heart-healthy diet that works for you and avoids processed foods and saturated fats. And exercise? “Think of exercise as a prescription that costs nothing yet offers a multitude of benefits,” he says, adding that the American College of Cardiology recommends 150 minutes of moderate-intensity exercise per week.

Starting these lifestyle habits while you’re young can promote healthier aging and a healthier heart, Dr. Azcarate says, as they will help lower your blood pressure and cholesterol levels, and also your risk of developing cardiovascular issues later in life. “Even if you ultimately require medications to help lower your blood pressure or cholesterol, regular exercise will still help improve any symptoms, increase your quality of life and improve your longevity.”