- Adult Congenital Heart Disease
- Cardiovascular Disease
- Advanced Heart Failure and Transplant Cardiology
- Interventional Cardiology
- Electrophysiology
The world of cardiology is a complex one. There are so many pieces that fit together to make the heart work the way that it should. Pressure, fluidity, flow, heart muscle operation, and electrical charges are just some of these components. These all go into the many parts of the cardiovascular system’s regular operation. As such, there is an entire world of cardiology specializations that are available.
These specializations are built around addressing each one of the components of cardiology. Each of these components are critical to heart health and function. Here are five of the great career and educational specializations of the cardiology discipline today.
1. Adult Congenital Heart Disease ![]()
Congenital heart issues are those that are inherited genetically at birth. Congenital heart disease is the most common form of birth defect. Congenital heart issues will quite often have a lifelong influence.
In the specialty area of cardiology referred to as Adult Congenital Heart Disease, the main area of concern is in helping those with these congenital heart conditions to lead uninterrupted, healthy lives as adults. Congenital heart disease issues are often repaired in childhood. In these cases, although treated as children, adults with congenital heart disease will still need continued care. Their care will include follow-up care and procedures.
Some of the most common follow-up procedures include repairing valves or conduits, and inserting a balloon or stent. This is done to repair obstructions that may develop over time. There are also some adults with congenital heart disease who were not treated as children. In these cases, the care would include more extensive surgical procedures and/or medical treatments. There are many cardiologists who lack training in this specific area.
The adult congenital heart disease population is growing. This means that the need for cardiologists who specialize in this unique area is growing, as well. It should be noted that although adulthood health is a key component here, there are also many cases in children. This is a fairly obvious fact, seeing as it is considered to be a genetic condition. Because of this, there is also a need for pediatric specialization when it comes to congenital heart issues.
2. Cardiovascular Disease ![]()
A cardiovascular disease is any disease or continued condition that affects the heart and/or circulatory system. It is a known fact that the need for qualified heart doctors is a global issue. But there is also a great need for cardiovascular physicians right here in the United States.
Per the American Board of Internal Medicine, someone working in this specialization is “an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions, such as heart attacks and life-threatening, abnormal heartbeat rhythms.”
A cardiovascular disease specialist would spend much of their time focusing on prevention, diagnosis, and management of various disorders within the field of cardiology. Some of the most common issues that a cardiovascular disease specialist may deal with are heart attacks, coronary heart disease, heart failure, strokes, and arrhythmia.
There are many important decisions that need to be made between physician and patient when it comes to these diseases. These include decisions about whether to pursue surgery or other smaller procedures such as ablation, balloon angioplasty, or heart catheterization. All of these procedures need to be taken very seriously, as they are all dealing with the heart.
A cardiovascular disease specialist will often be working with patients in dire situations. Because of this, it is important to be prepared to communicate in a clear and compassionate manner with patients and their families. They are facing what may be some of the most trying moments of their lives.
3. Advanced Heart Failure and Transplant Cardiology ![]()
Heart failure, as its name indicates, is a critical failure of the heart. Heart failure can progress in a slow manner, but it can also progress at a rapid rate. Heart failure will end up leading to death if left uncared for. Often, a transplant is required in order for the patient to continue to live as long as possible. As a result of this specific area of concern, the specialization known as Advanced Heart Failure and Transplant Cardiology is one that will continue to need qualified doctors willing to deal with this pressing issue.
Physicians with this specialty are trained in the management of advanced or complicated heart failure. Heart failure and transplant cardiologists will often work in clinics or transplant centers. This is where cardiac transplantation will most often take place.
Some specialists in this field will also work in the office consulting patients. They will need to consult with and assist other physicians who have patients with cases of heart failure. Specialists in this field are responsible for the care of heart failure patients before, during, and after transplants.
Advanced heart failure and transplant cardiologists are also trained to assist those who have devices in their hearts. An example of such a device is the ventricular assist device. The training to become an advanced heart failure and transplant cardiologist is usually a one-year program. During this year, cardiologists will complete clinical training to specifically deal with heart transplant issues.
4. Interventional Cardiology ![]()
Interventional cardiology is highly relatable and is often associated with many other areas of cardiology, specialized and general. Specifically, the subspecialty of interventional cardiology deals with heart catheters and catheter-based treatment of various heart diseases.
There are many heart procedures that fall under the category of interventional cardiology. These include cardiac catheterization, stent implantation, balloon angioplasty, and atherectomy, just to name a few. Interventional specialists are the cardiologists who are responsible for diagnosing and treating various diseases. These may include coronary heart disease, vascular disease, and acquired structural heart disease, as well as congenital heart defects.
All catheter related cardiac procedures must be completed by an interventional cardiologist. Although these specialists do not perform open heart surgeries, they are responsible for many life-saving procedures. These procedures are used to treat patients with heart disease, valve defects, or structural issues of the heart.
An interventional cardiologist is not usually part of a patient’s care team, as their specialty is performing a specific procedure. This does not usually involve preventative or follow-up care. To become a specialist in this area, you must complete an additional one to two years of specialized training.
5. Electrophysiology ![]()
Electrophysiology is the cardiology specialty tasked with addressing the electrical elements of the heart and circulatory system. In other words, an electrophysiologist’s main job is to test for and treat problems involving irregular heart rhythms. The technical term for an irregular heart rhythm is arrhythmia.
While many don’t realize it, the heart system is very much dependent upon electrical pulses and charge for regulation and individual functions. Per the American Heart Association, “Electrophysiology studies test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is coming from. These results can help you and your doctor decide whether you need medicine, a pacemaker, an implantable cardioverter defibrillator (ICD), cardiac ablation or surgery.”
There are many types of heart rhythm disorders. Some of the most common include atrial fibrillation, atrial flutter, ventricular fibrillation, ventricular tachycardia, and supraventricular tachycardia. Cardiac EPs are trained to test for, diagnose, and treat all types of irregular heart rhythms.
Some of the tests that electrophysiologists do are EKG (electrocardiogram) testing and 24-hour Holter monitoring. Cardiac EPs are also trained to perform procedures related to arrhythmias. The most common of these is cardiac ablation. This is a procedure in which scars are created to block irregular signals within the heart. Other procedures performed by a cardiac EP may include the insertion of a pacemaker or defibrillator.
To become a specialist in cardiac electrophysiology, you must complete an extra two years of training. This specialization includes extensive technical training. It is clear to see this is a very important specialization in the field of cardiology.
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From its humble beginnings, the field of cardiology has matured and grown abundantly. As a result, those wishing to work in this field can choose from not only general types of functions and careers but also some more complex specialties. Heart disease continues to be a leading cause of disease and death, and the need for competent cardiologists is greater than ever. We hope that this article has shed some light on specialty areas and what each of them entails.
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MPH Staff, Updated September 2022