What it is
Coronary artery disease happens when the arteries that supply blood to the heart muscle become narrowed or blocked, often over many years. A heart attack occurs when blood flow to part of the heart is suddenly reduced or cut off.
Common symptoms of a heart attack can include chest pressure or discomfort, pain that spreads to the arm, jaw or back, shortness of breath, sweating, nausea or unusual tiredness. Symptoms can look different from person to person, and they are not always dramatic.
Genetic heart testing looks at DNA for variants linked to certain inherited heart conditions or cholesterol-related risks. It shows risk or carrier status; it does not diagnose heart disease on its own, and it is only one piece of a larger picture that includes personal and family history, exam, imaging and bloodwork.
How it’s traditionally been approached
Cardiologists have traditionally started with a conversation about symptoms and family history, followed by a physical exam and tests such as an electrocardiogram, blood tests, stress testing or imaging. These help show how the heart is working and whether arteries may be narrowed.
When a closer look at the arteries is needed, a cardiac catheterization may be used. In this procedure a thin tube is guided through a blood vessel to the heart so a clinician can view the arteries and, in some cases, treat a blockage during the same procedure.
Approaches to blocked arteries have included lifestyle guidance, medicines, a heart stent procedure, and coronary bypass surgery, which reroutes blood around a blocked area. Which option, if any, is appropriate is decided by a licensed clinician after an evaluation. Many people also seek a second opinion before heart surgery, which is a common and reasonable step.
How the right cardiologist may help
The right cardiologist may help you make sense of symptoms, risk factors and test results in plain language. A first visit generally includes questions about your health history, your family's heart history, medicines you take and how you have been feeling, followed by an exam and possibly some tests.
If inherited risk is a concern, a cardiologist, electrophysiologist or genetic counselor may discuss whether genetic heart testing makes sense for you. Genetic counseling before and after testing is generally recommended, and if a disease-causing variant is found, cascade testing of relatives may be discussed. A negative result does not rule out risk, and a variant of uncertain significance is not a diagnosis.
Helpful questions to ask: What do my results mean for me? What are my options, and what are the trade-offs of each? Would a second opinion be reasonable? How does my insurance handle testing or procedures? In the US, GINA protects against genetic discrimination in health insurance and employment, but it does not cover life, disability or long-term-care insurance, so ask about those before testing.
The whole-person view
The body, mind and stress affect each other. Worry about chest symptoms can raise tension and sleep problems, and long-term stress can influence how people feel day to day. A frightening health event or a new diagnosis can also bring anxiety or low mood.
Some people find body-based support such as Somatic Experiences helpful for working with stress held in the body, and others value talk therapy through Therapists.plus. These are complementary options to discuss with your care team, not replacements for medical care, and no approach is better for everyone.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: anxiety panic and ocd →Therapists.plus: mind body connection →
Keep in mind
- This page is educational only and is not medical advice; licensed professionals should guide all decisions about testing, procedures and care.
- Chest pain, pressure, trouble breathing or other possible heart attack signs can be an emergency: call 911 right away rather than waiting or driving yourself.
- If you feel overwhelmed or in crisis, call or text 988 (the Suicide & Crisis Lifeline) to reach support.
- Coverage for genetic testing and cardiac procedures varies by insurer, state and diagnosis, so confirm details with your insurer and provider; genetic counselor licensing also varies by state.
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Cardiologist types
Frequently asked questions
What are the symptoms of a heart attack?
Symptoms of a heart attack can include chest pressure or discomfort, pain spreading to the arm, jaw, neck or back, shortness of breath, cold sweats, nausea and unusual fatigue. Symptoms can differ from person to person. If you think you may be having a heart attack, call 911 immediately.
What is genetic heart testing?
Genetic heart testing is a DNA test that looks for variants linked to certain inherited heart conditions or cholesterol-related risks. It shows risk or carrier status rather than diagnosing disease, and results must be interpreted with your history, exam, imaging and bloodwork by a qualified professional. Genetic counseling before and after testing is recommended.
Does a negative genetic heart test mean I am safe?
No, a negative result does not rule out risk. Not all genetic causes are known or tested for, and heart disease also has many non-genetic contributors. A variant of uncertain significance is likewise not a diagnosis, so ask your cardiologist or genetic counselor how to interpret your result.
When should I see a doctor for chest pain?
Sudden chest pain or pressure, especially with shortness of breath, sweating, nausea or pain spreading to the arm or jaw, calls for 911 right away. For milder or recurring chest discomfort, it is generally wise to book an evaluation with a licensed clinician rather than wait. A provider can help work out the cause.
What is a cardiac catheterization?
A cardiac catheterization is a procedure in which a thin tube is guided through a blood vessel to the heart so a clinician can look at the arteries and measure how the heart is working. In some cases a blockage may be treated during the same procedure. Whether it is appropriate for you is a decision for your cardiologist after an evaluation.
Should I get a second opinion before heart surgery?
Seeking a second opinion before heart surgery is common and reasonable. Another cardiologist or surgeon may review your tests and discuss options, including stent procedures or coronary bypass surgery, in their own words. Ask your provider and insurer how to share records and whether coverage applies.
Educational resource. CardioGenes shares general information and connects people with independent cardiologists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.