What is the difference between Cardiologist and Cardiothoracic Surgeon

The heart is probably the most discussed organ in our body, and mostly for medical reasons. It is a vital organ that takes the onus of pumping blood carrying oxygen and nutrients to the various tissues and cells of the body. Like every other organ in the body, it works relentlessly to keep us doing whatever it is we do.

As strong as we assume it to be, it is still susceptible to a lot of problems and diseases, and more so due to how we treat our bodies and what we put into it. In the recent past, the number of people suffering from heart disease has vastly increased, and this in part is a result of poor lifestyle choices and habits, and partly due to other genetic and environmental factors.

The study of the heart, its function, its problems, and their management has always been a core area of medical science, and with the advent of new technology, and improvement in the understanding of many hitherto unknown facts, the fields of cardiology and its subspecialties and cardiothoracic surgery have now more than ever taken an important place in healthcare. So, chances are if someone is having a heart-related health issue that needs treatment, the first question that would pop up is “where can I find a good cardiologist near me”?, or “do you know of a good cardiothoracic surgeon near me”? So, how are these two specialists different, and what do they do for a patient in terms of treatment and management of heart diseases?

Who are cardiologists and what do they do?

Cardiologists are doctors who specialize in the evaluation, diagnosis, and treatment of medical conditions and diseases affecting the heart and its blood vessels. In terms of education and training, they would have undergone extensive training for 5 ½ years in MBBS, followed by 3 years of training in MD or DNB General Medicine, followed by another 3 years of super specialty training in DM Cardiology. Other certifications and fellowships may also be done to acquire specific skills and expertise in some procedures or treatment modalities.

Cardiology as super specialty also includes subspecialties such as Critical Care Cardiology that deals with emergency medical situations related to the heart, Congenital Heart Disease Specialty that deals with heart defects that are present at birth, Cardiac Oncology that deals with cancers of the heart, Electrophysiology that deals with heart rhythm and electrical activity problems of the heart, Heart Failure and Transplant Cardiology that deals with management of advanced heart failure and pre and postoperative care after a heart transplant surgery, Interventional Cardiology that deals with management of heart disease through minimally invasive catheter based procedures, Nuclear Cardiology that deals with diagnosis of heart disease through the use of radioactive materials, Pediatric Cardiology that deals with heart problems and diseases in infants and children, General Clinical Cardiology that deals with early diagnosis and management of problems affecting the heart and its blood vessels. 

Cardiologists treat a variety of conditions usually with medications, and advice related to lifestyle modifications, while a few specialists from some subspecialties perform minimally invasive catheter-based procedures for the treatment of specific heart problems such as blocked coronary blood vessels, or closed valves, etc. Cardiologists may work alongside surgeons from CT surgery as well as other surgical specialties when operative procedures are done on individuals with heart disease. 

Common conditions by cardiologists

Common conditions that are treated by cardiologists with or without minimally invasive surgical procedures include

• Hypertension
• Coronary artery disease
• Cardiomyopathies
• Heart rhythm disorders
• Congenital heart diseases
• Myocardial infarction
• Angina

.When a heart problem can no longer be treated by medications or conservative therapy or is not responding to it, then a referral would be made to a cardiothoracic surgeon, who would then perform surgical procedures to address and manage the problem and restore normal function of the heart. 

Who are cardiothoracic surgeons and what do they do?

A cardiothoracic surgeon is a surgeon who specializes in the treatment of diseases and medical conditions affecting the organs in the chest cavity and the mediastinum including the heart and the lungs. In terms of training a cardiothoracic surgeon would have completed 5 ½ years of training in MBBS, followed by 3 years of training as MS/DNB General Surgery, followed by a further 3 years of training as MCh Cardiothoracic Surgery. Additional fellowships and certifications may also be done to gain experience and expertise in performing specific procedures or surgeries.

Cardiothoracic Surgery has subspecialties such as Cardiac Surgeon/Heart Transplant Surgery that focus exclusively on surgeries of the heart and in the replacement of a diseased heart with a healthy donor heart, General CT Surgery that focuses on surgical procedures on the heart, lungs, and the esophagus, Lung Transplant Surgery that focuses on the surgical replacement of diseased lungs with healthy donor lung tissue, Congenital CT Surgery that focuses on surgical procedures for the treatment of structural birth defects affecting the heart and the major blood vessels arising from it. 

Cardiothoracic surgeons in most cases receive a referral from cardiologists, pulmonologists, gastroenterologists, etc. when surgical procedures are the only treatment option available or left for the management of a disease or medical condition. Cardiothoracic surgeons perform open surgeries where the chest cavity is opened, and the organs inside are accessed. Some surgical procedures that are done by cardiothoracic surgeons include heart transplantation, coronary artery bypass grafting, valve replacement surgeries, lung transplantation surgeries, surgeries to correct congenital birth defects such as tetralogy of Fallot, transposition of great arteries, etc. 

In practice, cardiothoracic surgeons and their services and patient interaction are limited to the pre and immediate postoperative periods and their major work with the patient is the surgical procedure itself. In most cases, the follow-up after cardiac surgery by a CT surgeon is done by cardiologists who then monitor the recovery, progress, recurrences, and complications of the medical problems for which the surgery was done.