Learning the Lingo: Decoding Your Cardiologist

This may be a relatable experience for you: nodding along to what your doctor says but not really understanding what's going on. You and your doctor use different terms and phrases to describe the same thing. Cardiologists have been through more than a decade of medical training, and this language comes naturally, but for anyone else it can sound like gibberish. Even when cardiologists try hard to use everyday terms, it's easy to slip into the natural repertoire of medical language.

To bridge the language divide, we've composed this "cheatsheet" defining some common cardiology terms. Familiarizing yourself with these terms can help you make the most of your clinic visit. We recognize that there are a number of resources on the internet with general tips for speaking to your cardiologist; in contrast, our focus here is on explaining specific terms that he or she may use. This is by no means a comprehensive list, but we hope it helps you better communicate with your cardiologist to make the most informed decisions about your heart health.

Common Prefixes or Descriptors

These are common words or word beginnings attached to cardiology terms:

-- Acute: severe and sudden

-- Brady: too slow

-- Cardio: relating to the heart

-- Chronic: long-standing

-- Hyper: more than normal

-- Hypo: less than normal

-- Infarction: heart cell death due to lack of blood flow

-- Fibrillation: irregular beating of the heart

-- Myocardial: relating to the heart muscle

-- Stenosis: tightening or blockage

-- Tachy: too fast

Example: An acute myocardial infarction is a severe and sudden blockage in blood flow through the heart's arteries causing heart muscle cells to die, also known as a "heart attack."

[See: 17 Ways Heart Health Varies in Women and Men.]

Anatomy

These are basic components of a human heart:

-- Aorta: main blood vessel that carries blood from the heart to the rest of the body

-- Artery: any blood vessel that carries blood away from the heart

-- Atrial: top chamber(s) of the heart

-- Coronary: relating to the arteries of the heart

-- Pulmonary: anything regarding the lungs

-- Pericardial: relating to the thin lining around the heart

-- Valves: barriers between the different sections of the heart with membranes opening and closing to regulate blood flow

-- Vein: blood vessels that carry blood back to the heart

-- Vena cava: large vein (humans have two) carrying blood back to the heart

-- Ventricular: bottom chamber(s) of the heart

Example: Atrial fibrillation is when the top chambers of the heart beat in an irregular fashion and out of coordination with the bottom chambers of the heart.

Symptoms

-- Angina: pain in the chest caused by reduced blood flow to the heart that feels like squeezing, pressure, heaviness or tightness

-- Palpitations: a feeling of rapid, stronger than usual or irregular heartbeats. It can feel like your heart is skipping a beat or fluttering.

-- Dyspnea: shortness of breath, or difficult or labored breathing

-- Syncope: passing out (losing consciousness) suddenly

Example: Chronic stable angina is long-standing pain in the chest due to reduced blood flow to the heart that occurs predictably with activity and goes away with rest.

Risk Factors

Even if you don't have symptoms, cardiologists can help assess your risk of heart disease and prevent it

Lipids and lipoproteins. Lipids are fats in the blood such as cholesterol and triglycerides. However, just as oil and water don't mix, these fats (oil-based) and the bloodstream (water-based) don't mix. To get around this inconvenience, the body encases lipids in proteins with water-attracting properties to make transportation through the bloodstream work.

-- Low-density lipoprotein cholesterol (LDL or LDL-C): "Bad" cholesterol, the garbage of lipid metabolism. It travels in lipoproteins that stick to and enter damaged blood vessels, causing plaque buildup and clogged arteries.

-- High-density lipoprotein cholesterol (HDL or HDL-C): "Good" cholesterol. High levels usually are associated with lower risk of heart disease, but this may be due more to the company it keeps than HDL-C itself. Recent genetic and clinical trial evidence shows that HDL-C is not a direct cause of heart disease.

-- Triglycerides: A type of blood fat that circulates along with cholesterol inside lipoproteins. Lipoproteins containing lots of triglycerides are called very low density lipoproteins. They are less common than LDL cholesterol but may also cause heart disease.

Hypertension/high blood pressure. The force of blood against the walls of the artery is abnormally high for a prolonged period of time. This stresses the heart and weakens the blood vessels, making them more susceptible to damage.

Diabetes. Increased sugar (in the form of glucose) levels in the blood can increase the risk of heart and blood vessel damage.

Smoking. Cigarette smoking can contribute to plaque formation in the arteries and is a major risk factor for heart attacks and strokes.

Example: Statins are a common medication to protect against heart attacks and strokes by lowering LDL cholesterol.

[See: 10 Heart Health Breakthroughs.]

Diagnostic Tests

These are some of the common tests that cardiologists use to diagnose and guide treatment:

-- Electrocardiogram (ECG or EKG): A test that measures the heart's electrical activity and gives information on the electrical and muscle functions of the heart. It appears as line tracings on paper.

-- Lipid panel: A routine blood test that measures total cholesterol, HDL cholesterol and triglycerides and calculates LDL cholesterol.

-- Echocardiogram (echo): An ultrasound of the heart that uses sound waves to learn more about the size and function of your heart's chambers, valves, walls and blood vessels.

-- Coronary artery calcium scan (CAC scan): A computed tomography (CT) scan uses radiation to measure the amount of calcium in the coronary (heart) arteries. The more calcium, the higher the risk of heart disease.

-- Cardiac catheterization (cardiac cath or heart cath): During this test, a thin tube called a catheter is inserted into the left- and right-sided arteries of your heart (coronary arteries). High-speed X-rays track dye that is injected from the tip of the catheter into and through the coronary artery to show where blockages may occur.

Example: An EKG shows large voltages of electricity, which indicate thickened heart muscle.

Types of Cardiologists

There are a number of different subspecialties within cardiology, reflecting the variety of diagnoses:

-- General cardiologist: first stop for diagnosis, treatment and prevention of heart disease.

-- Interventional cardiologist: performs procedures such as angiography, stenting and valve replacement.

-- Heart failure specialist: treats failing hearts with medicines and, in advanced cases, with ventricular assist devices and heart transplant.

-- Electrophysiologist: focuses on heart rhythm disorders and performs procedures such as catheter ablation and implantation of pacemakers.

Example: An interventional cardiologist opens up a blocked artery in a patient having a heart attack.

Diagnoses A wide range of problems can affect the heart. Here are a few:

-- Arrhythmia: The heart's electrical system malfunctions, leading to heartbeats that are too fast (tachycardia), too slow (bradycardia) or offbeat.

-- Coronary artery disease/Coronary heart disease (CAD/CHD): Plaque (or atherosclerosis) builds up over decades in the major arteries that surround the heart, limiting blood flow.

-- Congestive heart failure (CHF): The muscle of the heart doesn't squeeze as well as it should or has trouble relaxing because it is too stiff, leading to poor blood flow.

-- Familial hypercholesterolemia (FH): A genetic disorder that prevents the body from disposing of LDL cholesterol, resulting in abnormally high amounts of LDL cholesterol in the blood. This could be heterogeneous FH, which means the patient received the FH gene from one parent. This is the most common type of FH and is less severe. Or it could be homogeneous FH: The patient received the FH gene from both parents. It's rarer, but also more severe.

-- Heart valve regurgitation: a leaky heart valve.

-- Heart valve stenosis: A heart valve does not work properly, causing too little blood to pump through the heart.

Example: Aortic stenosis is a tightening of the aortic valve blocking blood flow and can be diagnosed by echocardiogram.

Cardiac Events

-- Cardiac arrest: The heart suddenly stops beating. This can be due to a malfunction of the electrical system in the heart or due to a heart attack.

-- Myocardial infarction (heart attack): A coronary artery becomes blocked and stops blood flow to part of the heart. The oxygen-deprived cells in that area die as a result.

-- Stroke: Blood flow to an area of the brain is cut off, causing brain cell death in that section.

Example: Cardiac arrest is a situation in which CPR is performed, and an individual may need an electrical shock to restore their heart rhythm.

Treatment and Medication

Specifically, medications and procedures that have strong evidence for their benefit to the heart, including:

-- Cholesterol-lowering medications: lower LDL cholesterol (examples include statins and PCSK9 inhibitors, which work on the liver to increase cholesterol removal, and ezetimibe, which blocks absorption of dietary cholesterol).

-- Antihypertensive medication: lower blood pressure. Examples include ACE inhibitors, beta blockers, diuretics and calcium channel blockers.

-- Antiplatelet drugs: block platelets from clumping to prevent blood clots. Examples include aspirin and P2Y12 inhibitors.

-- Cardiac ablation: A method to fix arrhythmia. A catheter is inserted into a vein and sends a painless burst of energy, killing a small number of heart cells that cause the rogue heartbeats. This fixes the abnormal heartbeat.

-- Coronary angioplasty: A catheter is inserted into a blocked coronary artery and inflated, pushing the plaque buildup inside the artery aside. The catheter is then removed. Stents, tiny wire mesh tubes, are often fitted around a catheter. They stay in the artery permanently and help keep it unblocked after the catheter is removed.

-- Coronary bypass surgery: A blood vessel from the chest or leg is grafted onto the heart to allow blood to flow past a blocked coronary artery.

-- Defibrillator: A small device inserted into the chest that can monitor the heart and pace or shock the heart if needed.

-- Heart valve surgery: The malfunctioning heart valve is repaired or replaced with a prosthetic one.

-- Pacemaker: A small device inserted into the chest that can stimulate the heart to beat.

[See: 6 Signs You're Having a Heart Attack.]

Example: After syncope due to bradycardia, a pacemaker is implanted.

Medical lingo may seem daunting, but it gets easier to understand over time. The key to living with heart disease is learning to take charge of your own health and treatment, and that starts with an understanding of what your body is going through.

Although this is a list of some of the most common cardiology terms out there, it's by no means a list of everything. If you're ever confused by anything your cardiologist says, just ask.

Jennifer Jung is a student in Howard County, Maryland, who is interning under Dr. Martin in Cardiology at Johns Hopkins Medicine. She plans to continue studying medicine and cardiology in the future. Her other interests include student government, violin and taekwondo.