Who is a cardiac specialist?

Several doctors specialise in the heart. A cardiologist diagnoses and treats heart disease with tests and medicines. An interventional cardiologist treats it with catheters, for example stents or TAVR. An electrophysiologist treats rhythm problems. A cardiac surgeon operates on the heart, its valves and the aorta. In a Heart Team, these specialists work together on your case.

What are the four signs your heart is quietly failing?

Four common warning signs of heart failure are breathlessness on exertion or when lying flat, swelling of the ankles or legs, unusual tiredness, and rapid weight gain from fluid. Palpitations and a persistent cough can also occur. These signs have other causes too, so they need a proper assessment. See your doctor promptly, and seek urgent care if breathlessness is severe.

What happens at a cardiac rehab appointment?

The first visit is usually an assessment. The team reviews your history, medicines and risk factors, and may do an exercise test. After that, sessions combine supervised exercise, with your heart rate and blood pressure monitored, and education on diet, medicines, stress and returning to activity. Cardiac rehabilitation is a key part of recovery after a heart attack, a procedure or heart surgery.

What are the three foods cardiologists say not to eat?

There is no official list of three, but cardiologists commonly advise limiting processed meats such as sausages and ham, sugary drinks, and deep-fried or ultra-processed foods high in salt and unhealthy fats. Most of us benefit from eating more vegetables, fruit, legumes, whole grains, fish and olive oil. If you have heart disease, your team can give advice that fits your condition.

The Heart Team: why your heart deserves more than one opinion

Q: What is a Heart Team?

A Heart Team is a group of specialists who review your case together before recommending treatment. It usually includes a clinical cardiologist, an interventional cardiologist, a cardiac surgeon, a cardiac anaesthetist and an imaging specialist. International guidelines recommend this approach for complex coronary disease, severe valve disease and procedures such as TAVR. You are part of the team, and the final decision is made with you.

What a Heart Team is, what the ESC and ACC/AHA guidelines recommend, and the questions to ask before agreeing to heart surgery, TAVI or MitraClip.

Finding out you have a heart condition, and that you may need surgery or another procedure, is not easy. The natural reaction is fear, and that is completely normal.

When someone is told they need heart surgery, or even that it is a possibility, the first thing that appears is uncertainty. What is the best option? Open surgery? A less invasive procedure? Is it urgent, or can it wait?

For many years these decisions depended largely on the judgement of one doctor. Today that has changed. In modern cardiology, important cases are not decided in a single consultation: they are discussed by a team. That team is called the Heart Team, and it is not a theoretical idea. It is the standard recommended by the leading international guidelines, and it directly affects the safety and the result of every patient. You are a fundamental part of that team.

What is a Heart Team?

A Heart Team is a group of specialists, all involved in your care, who analyse your case together to decide the best approach. It is not simply several doctors giving opinions. It is a structured discussion in which each specialist brings a different perspective to the same problem:

The clinical cardiologist understands how your disease behaves and how it is likely to progress.
The interventional cardiologist assesses the catheter-based options: stents, TAVI, MitraClip.
The cardiac surgeon assesses whether surgery is feasible, including minimally invasive and robotic approaches.
The cardiac anaesthetist contributes a view of the risk of the procedure itself.
The imaging specialist, the echocardiographer or radiologist, provides the detailed anatomy on which every option depends.

Together they build a complete picture that no single specialist can provide alone.

Why does it matter so much?

Because the same condition can often be treated in very different ways, and the best one depends on factors that need several perspectives to weigh.

Take a patient with severe aortic stenosis. An interventional cardiologist might recommend TAVI. A cardiac surgeon might recommend minimally invasive valve replacement. The anaesthetist might flag a risk that changes the balance, and the imaging specialist might find an anatomical detail that favours one approach over the other. Our guide to TAVI or aortic valve surgery shows how many factors are involved.

Without that joint discussion, the patient hears only one perspective, shaped by the training, experience and tools of that one specialist. It is not necessarily wrong, but it is incomplete. The Heart Team makes sure the recommendation reflects the best collective judgement, not one specialist’s preference.

A clear example: the mitral valve

Decisions about the mitral valve show this especially well. A leaking mitral valve can be watched, repaired surgically, replaced, or treated with a catheter-based clip, and each option suits a different patient. Whether a valve can be repaired durably is a surgical judgement; whether a clip is reasonable depends on the anatomy and on the real surgical risk. Without both perspectives in the room, a patient may receive a less durable treatment simply because it was the one available. We explain this in detail in our guides to mitral regurgitation and to MitraClip.

What the international guidelines say

Both the European guidelines (ESC/EACTS) and the American guidelines (ACC/AHA) recommend Heart Team evaluation for:

Complex coronary artery disease, such as disease of several vessels or the left main artery
Severe valve disease that needs treatment
Transcatheter procedures such as TAVI and MitraClip
Any case where the choice between a catheter-based and a surgical treatment is not clear-cut

This is a standard of care, not a suggestion. Even so, in many centres, in Mexico and around the world, these decisions are still made by a single specialist.

What it means for you as a patient

If you have been told you need a cardiac procedure, these questions are worth asking:

“Has my case been discussed by a Heart Team?” In other words, have a cardiologist, a cardiac surgeon and the other relevant specialists all reviewed your case and discussed the options together?
“What are all the options for my situation?” Not only the one the specialist in front of you performs, but all of them, including surgery.
“What happens if we wait, and what happens if we act now?” The timing of treatment matters, and answering honestly requires the complete picture.

If any of the answers is unclear or incomplete, a second opinion is always reasonable, and in complex cardiac cases it is often the most important step a patient can take.

The Heart Team in our practice

The Heart Team is not something we defend only in theory. It is how we work on every case. Our team’s training covers conventional open surgery, minimally invasive surgery, robotic surgery and transcatheter procedures such as TAVI and MitraClip, and we work alongside cardiologists, anaesthetists and imaging specialists. That lets us look at each case without bias towards any one technique, and recommend what truly fits your situation, not what we happen to prefer doing.

When a patient arrives with valve disease, coronary disease or a problem of the aorta, the first conversation is always about options, all of them, before we talk about procedures. You can read more about the different types of heart specialist and what each one does.

If you feel you have received a recommendation without that complete assessment, bring your studies to a consultation, in person in Guadalajara, Querétaro or Hermosillo, or by video from anywhere, and we will give you the perspective that is missing.

About the author

Dr. Alejandro Molina Romo is a cardiovascular surgeon practising in Guadalajara, Querétaro and Hermosillo. He trained in cardiothoracic surgery at the Universidad de Guadalajara, completed advanced training in cardiac surgery, minimally invasive surgery, robotic surgery and structural interventions at the University of Montreal, and a fellowship in structural cardiology and TAVI at CHU Bordeaux, France. He performed the first robotic mitral valve repair in the Ángeles Health System and the first robotic heart surgery in Guadalajara.

Medical degree: Universidad Autónoma de Guadalajara, Cédula Profesional 5757260 · Cardiothoracic surgery: Universidad de Guadalajara, Cédula de Especialidad 10768871 · Current certification, Consejo Nacional de Cirugía del Tórax, no. 447

This content is educational and does not constitute personal medical advice. Every cardiac case is unique and requires individual assessment by a specialist medical team. Always consult the doctor treating you before making decisions about your treatment.