TürkçeCardiology is a specialty that includes the diagnosis, treatment, and follow-up of cardiovascular diseases. Hypertension, coronary artery disease, heart failure, rhythm disorders, and heart valve diseases are the most commonly encountered conditions. The treatment process is personalized according to each patient’s age, lifestyle, and heart function.
1. Application and Medical History
During the first examination, the patient explains complaints such as chest pain, shortness of breath, palpitations, fainting, fatigue, or swelling in the legs. Family history of heart disease, smoking, blood pressure, diabetes, cholesterol levels, and stress level are evaluated. This stage is the most critical step in identifying risk factors.
2. Physical Examination
Heart rate, pulse, blood pressure, heart sounds, and lung auscultation findings are evaluated. Edema, fullness in the neck veins, skin discoloration, or rhythm irregularities are noted if present. This information shows the overall condition of the cardiovascular system.
3. Planning Diagnostic Tests
Basic tests are planned for the accurate diagnosis of cardiological diseases:
- ECG (Electrocardiography): Shows the heart rhythm, conduction disorders, and possible signs of a heart attack.
- Echocardiography (ECHO): The structure of the heart, muscle strength, valve functions, and the presence of clots are evaluated by ultrasound.
- Exercise test: Measures the response of heart vessels during exercise.
- Holter ECG: Hidden arrhythmias are detected with a 24–48 hour rhythm recording.
- Blood tests: Indicators of heart muscle damage (troponin), cholesterol, glucose, and kidney functions are examined.
- CT coronary angiography or conventional angiography: The degree of vascular occlusions is determined.
4. Diagnosis and Risk Classification
After evaluating all test results, the type of disease is determined:
- Coronary artery disease (vascular blockage)
- Hypertension
- Heart failure
- Rhythm disorder (arrhythmia, atrial fibrillation, tachycardia, etc.)
- Heart valve disease
- Cardiomyopathy (heart muscle disease)
In addition, the patient’s overall risk is classified as “low, medium, or high cardiovascular risk.”
5. Creating the Treatment Plan
The treatment plan is determined according to the type and severity of the disease:
- Medication treatment: Blood thinners, cholesterol-lowering drugs (statins), blood pressure medications, and drugs that regulate heart rate.
- Interventional treatment: Opening blocked vessels with balloon (angioplasty) or stent procedures.
- Surgical treatment: Coronary bypass, valve repair/replacement, or pacemaker implantation.
- Heart failure management: In addition to medication, salt restriction, fluid balance, and special device support (CRT, ICD).
- Arrhythmia treatments: Ablation, permanent pacemaker, or defibrillator applications.
6. Preparation Before Treatment
Before invasive (interventional) procedures, blood tests are performed and medications used are reviewed. Temporary discontinuation or dose adjustment may be required for patients using blood thinners. The fasting period before the procedure and precautions to follow afterward are explained.
7. Procedure and Application Process
Angiography, stent, or ablation procedures are performed under sterile conditions, usually through the groin or arm. The patient is generally awake during the procedure and does not feel pain. After the intervention, the patient is kept under observation for a few hours and is discharged the same day or the following day.
8. Post-Procedure and Recovery
Pressure is applied to the procedure site and rest is recommended for the first 24 hours. Medications should be taken regularly and water intake should be increased. If pain, bleeding, or bruising occurs, the physician should be informed.
9. Follow-up and Control
Regular follow-ups are very important after treatment. In the first month and then at intervals of 3–6 or 12 months depending on the patient and the severity of the disease, heart functions are monitored with ECG and ECHO. Blood lipid levels and blood pressure are also monitored. Medication doses are adjusted when necessary.
10. Lifestyle Adjustments
Patient education is an integral part of treatment to protect heart health:
- Reducing salt and fat intake,
- Following a Mediterranean-type diet,
- Walking regularly,
- Avoiding smoking and alcohol,
- Managing stress,
- Maintaining regular sleep.
11. Rehabilitation and Long-Term Follow-up
After a heart attack or surgery, cardiac rehabilitation programs increase the patient’s physical capacity. Long-term success is achieved through exercise planning, nutritional counseling, and psychological support.
12. Multidisciplinary Approach
The cardiology process is carried out together with teams from dietetics, pulmonology, endocrinology, physical therapy, and psychiatry. When necessary, patients are referred to cardiac surgery or electrophysiology specialists.