The immediate answer to whether a cardiologist performs surgery is generally no. A cardiologist is a medical doctor specializing in diagnosing and treating diseases of the heart and blood vessels, primarily managing heart health through medication, lifestyle changes, and advanced diagnostics. The confusion arises because the subspecialty of interventional cardiology performs highly technical, invasive procedures that do not involve the traditional, open-chest surgery associated with a cardiac surgeon.
The Primary Focus of a Cardiologist
A general cardiologist focuses on the non-procedural aspects of cardiovascular care and long-term heart health management. This includes comprehensive patient evaluation, risk stratification, and the medical management of chronic conditions like hypertension, high cholesterol, and heart failure. They determine a patient’s overall cardiac risk profile and establish preventative care strategies.
The majority of a cardiologist’s work involves utilizing non-invasive technology to assess the heart’s function and structure. Diagnostic tools commonly employed include the electrocardiogram (EKG), which records the heart’s electrical activity, and echocardiograms, which use ultrasound to visualize the heart chambers and valve movement. Stress tests, performed with exercise or pharmacological agents, also fall under their purview, monitoring how the heart responds to increased demand. This diagnostic and medical oversight is foundational to preventing disease progression.
Interventional Cardiology Procedures
The subspecialty of interventional cardiology performs highly skilled, minimally invasive treatments. These procedures use slender, flexible tubes called catheters, which are inserted through a small puncture, typically in the wrist or groin, and threaded through the blood vessels to the heart. This approach avoids the large incisions and extended recovery time associated with open surgery.
One common intervention is percutaneous coronary intervention (PCI), often called angioplasty, where a balloon-tipped catheter is inflated at the site of a coronary artery blockage to restore blood flow. A stent, a small mesh tube, is often deployed to keep the artery open. Interventional cardiologists also perform atherectomy, a technique that uses specialized devices to shave or vaporize hard plaque from the artery walls. Pacemaker and implantable cardioverter-defibrillator (ICD) placements are also handled by interventionalists or electrophysiologists using minimally invasive approaches.
The Specialization of the Cardiac Surgeon
The role of the cardiac surgeon is entirely separate, focusing on complex, open procedures that require direct access to the heart and great vessels. A cardiac surgeon undergoes extensive surgical training, which is a different track from a cardiologist’s internal medicine residency. Their work involves operating directly on the heart muscle, valves, and surrounding structures, necessitating opening the chest cavity.
The procedures they perform are reserved for advanced heart disease where catheter-based solutions are not suitable. Examples include Coronary Artery Bypass Grafting (CABG), where blood vessels from elsewhere in the body create a new route for blood flow around blocked coronary arteries. They also perform open heart valve replacement and repair, as well as heart transplants. These operations require cardiopulmonary bypass, where a heart-lung machine takes over the function of the heart and lungs during the procedure.
When Cardiologists and Surgeons Collaborate
While their primary roles are different, cardiologists and cardiac surgeons frequently work together to optimize patient care, often formalized as the “Heart Team.” This collaborative model is used for complex decision-making, such as determining the best treatment pathway for multi-vessel coronary disease or severe heart valve issues. The cardiologist provides the diagnostic context, while the surgeon assesses the feasibility of surgical repair.
This collaboration is especially important in the growing field of hybrid procedures, which combine surgical and catheter-based techniques. Procedures like transcatheter aortic valve replacement (TAVR) often require the skills of both an interventional cardiologist and a cardiac surgeon working side-by-side. The cardiologist manages the catheter delivery, while the surgeon is present for immediate intervention should a complication arise. This teamwork ensures the patient receives the most appropriate intervention.