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Once you are diagnosed with CAD, your PCP will help you develop a treatment plan and will also decide whether you need to start taking medications or whether you need certain procedures to diagnose the severity of your CAD. For this reason, it is important that you are open with your doctor and make sure that he or she knows of any changes in your symptoms.

In general, you should visit your PCP once every few months to make sure that you are on track with your CAD treatment and to continue with your general medical care. In addition to a physical exam at each visit, you and your doctor should review your progress with lifestyle modifications and, if applicable, experiences with your prescribed medications. If you have new or changing symptoms, your PCP may perform or request the following tests:

• An electrocardiogram (EKG, ECG) looks at the electrical rhythms of your heart and provides evidence that your heart may not be receiving adequate blood flow (ischemia), that a heart attack has occurred, or that one or more of the chambers of your heart are enlarged.
• An exercise stress test monitors the heart's activity during exercise and helps assess the severity of CAD.
• A chest X-ray provides evidence of heart failure.

Most primary care physicians are qualified to develop and manage treatment plans for chronic diseases such as CAD. However, if you develop complications or have more severe CAD that needs a procedure or surgery as treatment, your primary care physician may refer you to a specialist.

What is the role of specialists in caring for people with coronary artery disease?

In some cases a cardiologist will serve as your primary point of contact in treating and managing your CAD. Whether you work more closely with a primary care physician (PCP) or a cardiologist depends on a number of factors, including the nature of your condition and the relationship you may already have with either physician. Whether you see your cardiologist to treat mild atherosclerosis or to provide follow-up care after a major surgery, this specialist will add heart-specific expertise to your treatment plan.

There are also specialists within cardiology. For example, an interventional cardiologist can perform a cardiac catheterization, an invasive procedure used to take X-rays of your arteries and diagnose any narrowed areas in your coronary arteries. An interventional cardiologist can also perform an angioplasty and place stents during a cardiac catheterization to open narrowed or blocked arteries.

What is the role of a cardiac surgeon?

In more advanced stages of coronary artery disease, open-heart surgery may be recommended to bypass the blocked vessel and allow blood to reach the heart. In the event that medications and/or catheterization are not enough to diagnose and treat CAD, or in some emergency cases (such as a heart attack), open-heart surgery may be necessary.