Referring a patient to a General Cardiologist versus an Interventional Cardiologist
We know that, as a primary care physician,
your patient relationships are a top priority and that making the right referrals across a huge range of specialties is an important part of your job. To help make referrals of heart patients easier, let’s talk about the difference between a General Cardiologist and Interventional Cardiologist.
A General Cardiologist treats and manages patients who have high cholesterol, high blood pressure, and many heart- related issues. He or she may prescribe a treatment plan of diet, exercise, and medication.
However, if your patients’ symptoms are persistent, even in conjunction with diet, exercise, and medication therapy, their heart disease may be too far progressed and could benefit from an evaluation for stent placement (percutaneous coronary intervention, PCI) by an Interventional Cardiologist. Interventional Cardiologists perform stenting procedures - and for complex or high-risk patients may use an Impella CP® with SmartAssist® heart pump during the procedure (Protected PCI), to help reduce symptoms related to coronary artery disease (CAD) and to improve patients’ quality of life1,2.
Referring your heart failure and CAD patients to an Interventional Cardiologist
An Impella CP® heart-pump-supported percutaneous revascularization procedure performed by an Interventional Cardiologist could greatly improve your patients’ chances of heart recovery—including patients who were turned down for surgical revascularization. In fact, 8-in-10 patients treated with Impella CP heart pumps experienced reduction in heart failure symptoms or improvement in heart function.2,3 There are certain conditions that may make a patient a good candidate for Impella CP, including showing signs of severe CAD, procedure-based risks, or hemodynamic risks, or if they have comorbidities.
Referring your surgically turned down patients to an Interventional Cardiologist
Your patient may have been turned down for open heart surgery due to being too high-risk for the operation. However, your high-risk patient may still be a candidate for Protected PCI with an Interventional Cardiologist. Consider sending them for further evaluation.
Support is nearby
Impella CP therapy awareness managers (TAMs) provide education on CAD and heart failure and assist in finding appropriate treatment options for your patient. Your TAM will provide insightful information to help you decide if an Impella CP could benefit your patients who have complex heart conditions. A TAM can connect you with an Interventional Cardiologist who performs PCI with an Impella CP.
References
- Wollmuth, et al. JSCAI, 2022 1(5), 100350–100350. https://doi.org/10.1016/j.jscai.2022.100350
- O’Neill, et al. AHJ, 2022 248, 139–149. https://doi.org/10.1016/j.ahj.2022.02.006
- Study was based on Impella 2.5 which is no longer in market and replaced with Impella CP. Findings for 2.5 would be transferable to Impella CP
As with any medical treatment, individual results may vary. Only a physician can determine whether Impella is an appropriate course of treatment. There are potential risks including acute renal dysfunction, Aortic valve injury, Bleeding, Cardiogenic shock, Cerebral vascular accident/Stroke, Death, Hemolysis, Limb ischemia, Myocardial infarction, Renal failure, Thrombocytopenia and Cardiac or Vascular injury (including ventricular perforation). These risks need to be discussed with your doctor and recovery takes time. The success of this procedure depends on many factors, including your physical condition and your body’s ability to tolerate the procedure. Use care in the selection of your doctors and hospital, based on their skill and experience.
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