Caregiver Resource: Non-Invasive Cardiologist

In the second installment of our Caregiver Resource series, we talked to Dr. Jeffrey Wuhl, a Non-Invasive Cardiologist.

Dr. Jeffrey Wuhl, M.D., F.A.C.C.

I am a non-invasive cardiologist. I don’t perform surgeries. I don’t put in stents or pacemakers. But I can save your life. Here’s a little more about what I do as a Non-Invasive Cardiologist:

1. I am keenly interested in the prevention of cardiovascular disease. In other words, the most important part of my job is helping my patients avoid stents, surgeries, and pacemakers, among other unpleasant and costly procedures. There is an ancient Chinese proverb that states: “The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness.” In today’s world, that may be an almost impossible standard to uphold, but my professional goal is to get as close as possible to being a ‘superior’ doctor.
2. I am an expert in the management of cardiovascular risk factors, especially hypertension and hyperlipidemia. A major part of preventing cardiovascular disease is identifying and treating individual risk factors. During cardiovascular fellowship, budding cardiologists spend a great deal of time learning the intricacies of cardiac physiology; this is a powerful tool for understanding the mechanisms of hypertension and how best to treat it. We also become experts in “Lipidology”, a fancy way of saying that we are proficient in the pathophysiology of cholesterol abnormalities and how the different lipid lowering medications on the market work.
3. I am an expert at diagnosing cardiovascular disease. Unfortunately, we can’t always prevent disease, and many times patients come to us after the disease process has already begun. In those cases, I decide the best course of action based on the patient’s medical history, family history, symptoms, blood work, and physical exam. Cardiology is a technologically rich field, and I have many tools at my disposal to help me figure out what exactly is going on and how best to treat it. I might order an echocardiogram, or ultrasound of the heart, to get a good look at the heart muscle and valves. If I am worried about a blocked coronary artery, a stress test—on a treadmill or with an injection for patients who can’t walk on a treadmill for some reason—might help me rule this in or out. I am trained to interpret these studies, and thus don’t have to rely on another doctor who doesn’t know my patient to read them for me. Often times patients will come see me not because they are having any symptoms, but because they are concerned about their cardiac status (frequently because of a strong family history of cardiovascular disease). In those cases, I will examine them, look at their EKG (electrocardiogram) and blood work, and either reassure them or order further testing if I need more information. One screening test I like to order frequently is a coronary calcium score, which is a special low radiation CAT scan looking for calcium in the arteries supplying the heart muscle. Calcium is a marker of healed coronary plaques, and the more calcium there is, the higher the risk of a future cardiovascular event (such as a heart attack or stroke). This test can be invaluable in helping me determine how aggressive I should be in managing a patient’s risk factors.
4. I am also sort of a life coach. Everyone knows that lifestyle plays a major role in the development of cardiovascular disease. I often joke with patients that I will make them a follow up appointment so I can “yell at them again” in a few months about smoking, too little exercise, too much stress, poor eating habits, not taking their medications as prescribed, or whatever other vices they have that may be preventing me from being a ‘superior’ doctor. But in all seriousness, there is overwhelming data that lifestyle modification can profoundly reduce the risk of the development of cardiovascular disease, and future events in patients who have already been diagnosed with cardiovascular disease.

This is just a sampling of what I and other non-invasive cardiologists do on a daily basis. It really is rewarding work, and quite important for the health and well-being of our patients and the population at large.

Dr. Jeffrey A. Wuhl, M.D., F.A.C.C. is in private practice with the Bryn Mawr Medical Specialists Association at Lankenau Medical Center in Wynnewood, Pennsylvania. For any questions or to make an appointment, he can be reached at 484-380-2808 or by email at wuhlj@mlhs.org