A cardiologist is a heart specialist who diagnoses and treats heart disease. That is who you need if you have symptoms, a known heart condition, or a possible need for a procedure. Cardio Res-Q is a preventive risk evaluation for adults who feel well and want a detailed look at their risk before any disease shows itself.
The two are not competitors, and one does not replace the other. Many of our patients keep their cardiologist or primary care doctor, and we share results with them. Cardio Res-Q comes as two one-time assessments: the Comprehensive Assessment at $775 and the Enhanced Assessment at $999.
Key takeaways
- A cardiologist diagnoses and treats heart disease, while Cardio Res-Q evaluates risk in adults who feel well.
- Neither replaces the other, and results can be shared with your existing doctors.
- Symptoms, a known heart condition or an abnormal heart test call for a cardiologist, and sudden or severe symptoms mean calling 911.
- Not every test in a preventive workup is equally well supported, and CIMT has weaker evidence than a calcium score.
- Talk to the prescribing doctor before changing any medication.
The short comparison
| Cardiologist visit | Cardio Res-Q assessment | |
|---|---|---|
| Main purpose | Diagnose and treat heart disease | Evaluate heart risk before symptoms |
| Best for | Symptoms, known heart disease, abnormal test results, procedures | Adults without symptoms who want a deeper risk picture |
| Typical tests | Chosen for your problem: for example an ECG, echocardiogram, stress test or angiogram | ApoB, Lp(a), hs-CRP, homocysteine, insulin, glucose, A1c, the Cleveland Heart cardiac panel. Enhanced adds CIMT and a calcium score |
| Procedures and emergencies | Yes, including hospital care | No. Not emergency care and no procedures |
| What you get | A diagnosis and a treatment plan for a heart condition | A risk profile and a personalized heart protection plan |
| Payment | Usually billed to insurance | Direct-pay: $775 or $999. No insurance billing or reimbursement forms |
What each one does
A cardiologist. Cardiologists complete years of specialty training in diseases of the heart and blood vessels. They work out the cause of chest pain, breathlessness, palpitations and fainting. They manage heart attacks, heart failure, rhythm problems and valve disease. They prescribe and adjust heart medications, and some perform procedures such as stents.
The tests they use are built to answer specific questions about a specific problem. US guidelines lay out an evidence-based diagnostic workup for chest pain, with testing chosen according to the level of risk.1 That is a different job from screening a person who feels fine.
Cardiologists also do prevention, and some specialize in it. If your cardiologist already manages your risk closely, you may not need anything more.
Cardio Res-Q. Cardio Res-Q is a structured, one-time evaluation of risk in people without symptoms. Dr. Varano is a D.O. and an integrative physician, not a cardiologist. Both assessments include Dr. Varano's clinical evaluation, advanced labs (ApoB, Lp(a), hs-CRP, homocysteine, insulin, glucose and A1c), the Cleveland Heart cardiac panel, a lifestyle and risk evaluation, and a personalized heart protection plan. The Enhanced Assessment adds a CIMT ultrasound and a coronary calcium score, which is ordered by your provider and done at an outside imaging facility as a separate self-pay study of typically $100 to $200.
The emphasis is on the review and the plan: what the results mean together, and what to do about them across nutrition, exercise, blood pressure, lipids and metabolic health.
Dr. Varano started the program for a personal reason. He lost his father to a sudden heart attack at age 54 in 1984. That is why the program concentrates on finding risk early in people who look healthy.
Where the evidence stands on extra testing
You should weigh this honestly. Not every test in a preventive workup carries the same weight.
A calcium score is well supported for one use. Current US lipid guidance says a score of zero supports holding off on drug therapy and rescanning in three to seven years, unless you have diabetes, smoke, or have familial hypercholesterolemia or a strong family history.2
CIMT is weaker. The 2013 ACC/AHA risk assessment guideline does not recommend routine CIMT measurement for predicting a first heart event.3 We use it as a baseline to follow over time, not as a deciding test.
And the wider question is still open. The US Preventive Services Task Force found the evidence insufficient to judge whether adding a calcium score or hs-CRP to traditional risk assessment improves outcomes in adults without symptoms.4 Your cardiologist or primary care doctor may reasonably order fewer tests than we do. That is a difference in approach, not a sign that anything was overlooked.
When you need a cardiologist, not Cardio Res-Q
Skip a screening assessment and see a cardiologist, or your primary care doctor for a referral, if you have:
- Chest pain, pressure or tightness, especially with exertion
- Shortness of breath that is new or getting worse
- Palpitations, fainting or near-fainting
- A previous heart attack, stent, bypass surgery, heart failure, rhythm disorder or valve disease
- An abnormal ECG, stress test or echocardiogram that has not been followed up
For sudden or severe symptoms, call 911. Cardio Res-Q is not for emergency cardiac care, acute cardiac symptoms or interventional procedures. Our article on who Cardio Res-Q is for goes through this in more detail.
How the two work together
Most people who book are in one of three situations:
- You have no cardiologist and no symptoms. The assessment gives you a baseline. If it turns up something that needs specialist care, your provider will tell you, and a cardiologist is the next step.
- You have a cardiologist for a stable condition. Keep them. Take your Cardio Res-Q results and plan to your next visit. We are happy to share results and collaborate with your existing doctors.
- You already take a statin or blood pressure medication. Many patients use the evaluation to see whether their current treatment is controlling their risk well enough. Do not change any prescription without talking to the doctor who prescribed it. See already on a statin for more.
How to book a Cardio Res-Q assessment
If you have no symptoms and want the preventive evaluation, go to the Cardio Res-Q program page and select the Comprehensive ($775) or Enhanced ($999) assessment. Both are direct-pay and are not billed to insurance. Fast for 10 to 12 hours before your labs. Ongoing care afterward is optional.
Not sure which side of the line you are on? Contact our team before you pay. If your situation sounds like one for a cardiologist, we will say so.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
Do I need a referral for Cardio Res-Q?
The assessments are booked and paid for directly through the program page, and they are not billed to insurance. If you are unsure whether you need anything from your current doctor first, ask our team when you book.
Will you send my results to my cardiologist?
Yes. We are happy to share results and collaborate with your cardiologist or primary care doctor. Ask our team how to arrange it.
My cardiologist did not order these tests. Does that mean something was overlooked?
No. Guidelines do not call for every one of these tests in every person, and expert groups differ on how much some of them add. Your cardiologist chooses tests based on your situation. Cardio Res-Q is a broader preventive look that you choose to pay for yourself.
I have a stent. Should I book?
Talk to your cardiologist first. With known heart disease, your cardiologist leads your care and the main risk question is already answered. Some people with a stable condition still want the metabolic and inflammation labs and the lifestyle plan, but that is a decision to make with your cardiologist.
Can Cardio Res-Q find a blocked artery?
No. A calcium score measures calcified plaque, and a CIMT ultrasound looks at the neck arteries. Neither shows whether a heart artery is narrowed or blood flow is reduced. That takes tests a cardiologist orders, such as a stress test or angiogram.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
