High Cholesterol and Heart Murmurs: Which Specialist to See First?

High cholesterol levels in the heart, heart murmurs?

Hello, doctor.
My mother recently had a blood test arranged by the rheumatology and immunology department, followed by a scheduled echocardiogram and CT scan (which has not yet been completed).
After the echocardiogram, it was found that she has high cholesterol levels in her heart and has developed a heart murmur.
The rheumatology and immunology department has scheduled a follow-up appointment in three months to review the results.
Should we first return to the rheumatology and immunology department or see a cardiologist for evaluation?

Miss Yan, 30~39 year old female. Ask Date: 2023/11/11

Dr. Cai Mingsong reply Internal Medicine

If possible, you may consult your original physician to review the report earlier.
You can also consider an outpatient consultation with a cardiologist to evaluate whether treatment or further testing is necessary.
If you experience any discomfort, please return to the hospital for assessment.

Reply Date: 2023/11/11

More Info

When dealing with high cholesterol levels and heart murmurs, it is essential to prioritize which specialist to consult first for a comprehensive evaluation. In your mother's case, given the findings from the echocardiogram indicating elevated cholesterol levels in the heart and the presence of a heart murmur, it is advisable to see a cardiologist first.
A cardiologist specializes in diagnosing and treating heart-related conditions, including those associated with high cholesterol and heart murmurs. High cholesterol can lead to atherosclerosis, which is the buildup of plaques in the arteries, potentially resulting in coronary artery disease (CAD) or other cardiovascular issues. The presence of a heart murmur can indicate underlying heart valve problems or other structural heart issues that require further investigation.
The echocardiogram is a crucial tool that can provide insights into the heart's structure and function. If the heart murmur is due to a valve issue, such as stenosis (narrowing) or regurgitation (leakage), the cardiologist can recommend appropriate management strategies. Additionally, they can assess the implications of high cholesterol on your mother's cardiovascular health and determine if medication or lifestyle changes are necessary to manage her cholesterol levels effectively.

While the rheumatology department may have initially referred your mother for these tests, their focus is typically on autoimmune or inflammatory conditions that could affect the heart. If the rheumatologist suspects that the heart murmur or high cholesterol is related to an underlying rheumatic condition, they may still play a role in her care. However, the immediate concern regarding the heart's health should be addressed by a cardiologist.

In terms of follow-up, once the cardiologist has evaluated your mother and provided a treatment plan, it may be beneficial to return to the rheumatologist if there are any concerns about how her heart condition may interact with any rheumatic diseases she may have.
In summary, I recommend that your mother schedule an appointment with a cardiologist as soon as possible to evaluate her heart murmur and high cholesterol levels. This will ensure that any potential cardiovascular issues are addressed promptly and appropriately. After the cardiology assessment, you can then decide if a follow-up with the rheumatologist is necessary based on the cardiologist's findings and recommendations.
Furthermore, it is essential to monitor her cholesterol levels regularly and maintain a heart-healthy lifestyle, which includes a balanced diet low in saturated fats and cholesterol, regular physical activity, and avoiding smoking. If she is prescribed medication for cholesterol management, adherence to the treatment plan is crucial for reducing the risk of cardiovascular events.

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