Types of Cardiology?

[Gleevec]

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What is the difference between interventional, invasive, non-invasive, and diagnostic cardiology? I see these terms thrown around a lot, and while some of the distinctions are clear (ie invasive vs non-invasive) others are more confusing to me (interventional vs the others).

Just curious. Thanks for any help you can provide.

Gleevec

 

[tripeptide]

Here are my thoughts:

Diagnostic: angiography only, using catheters passed from the femoral artery and shooting dye to look at blood flow, taking pressure and pO2 measurements, but not making any changes to the tissue or implanting any devices.

Interventional: Actually performing a procedure with endovascular tools: ballon angioplasty, stenting, and for neurosurgery, aneurysm repair, AVM and tumor embolization, etc.

Both are invasive since they require a puncture wound (again, usually femoral artery, sometimes brachial, radial, etc) to insert the catheter that's threaded up to the area of interest under fluoroscopic guidance.


These are my impressions of those names after I did some neurosurg endovascular research over the summer.

tripeptide

 

[Resident Alien]

seems like interventional radiologists do EXACTLY the same thing mentioned above.

 

[HiddenTruth]

Do you have to do a radiology residency and then a fellowship in interventional radiology to become a interventional radiologist or is there a straight program and how long is the fellow if there is one, or the program? Thanks

 

[Resident Alien]

Its a fellowship after radiology, is either 1 or 2 years depending on whether the fellowship has a research component

 

[atsai3]

Bernard Lown discusses preventive cardiology in a recent talk paper for the Indian Heart Journal:

"Cardiology at the Crossroads: Challenges for India and Lessons from the West"

 

[DALABROKA]

Interventional: As stated before, PTCA, stents, etc.

Invasive: Cardiologists who do diagnostic caths, but no PTCA or stents. Often, cardiologists who complete a fellowship for pacemaker placement, rather than interventional procedures, fit in this category, just as specialists for pacemakers.

Noninvasive: Cardiologists who don't perform procedures. They specialize in the management of the short term care of inpatients and long-term care of outpatients, but refer to another cardiologist for procedural work.

Diagnostic: Perform noninvasive procedures (ex. TEE), diagnose echocardiography, tilt tests, etc... No caths, pacemakers, or those types of things.

Keep in mind that there is a lot of overlap between these groupings. Everyone does a 3 year general cardiology fellowship, and then can subspecialize in to interventional, electrophysiology, pacemakers, etc. with an additional fellowship. The general fellowship has a couple of different tracks. One for invasive in which you have a sufficient number of cath procedures to qualify you to perform caths. Another track that focuses on noninvasive patient care and offers much less exposure to the cath lab. Then, there is the diagnostic track, with a focus on interpretation of tests. I'm sure that there is quite a bit of variation in each of the different fellowship programs. The information I have has just been gained from speaking with a bunch of cardiologists in the past. I hope this helps.

DALA