If you are searching for a holistic, integrative or functional medicine cardiologist, it helps to know what those words do and do not mean. A cardiologist is a physician with specialty training and, usually, board certification in heart disease. "Integrative" and "holistic" describe an approach to care, not a separate specialty, and they are not a credential.
So let us be plain about who we are. Dr. Kenneth Varano is a D.O. and an integrative physician. He is not a cardiologist. Cardio Res-Q is his heart-disease prevention program for adults who feel well and want to understand and lower their risk. This page explains what that kind of care looks like, what it cannot do, and when you need a cardiologist instead.
Key takeaways
- "Integrative cardiologist" mixes a specialty title with a style of care, so check the actual credential.
- Dr. Varano is a licensed osteopathic physician practicing integrative medicine, and he is not a cardiologist.
- Prevention care focuses on finding and managing risk in people without symptoms, and it includes medicine when needed.
- Symptoms, known heart disease or an abnormal heart test call for a cardiologist, and emergencies call for 911.
- You can do both: many patients keep their cardiologist and share their Cardio Res-Q results.
What a cardiologist is
A cardiologist is a medical doctor (M.D. or D.O.) who, after medical school, completes residency training in internal medicine and then a fellowship in cardiovascular disease. Most then become board certified in cardiovascular disease, through the American Board of Internal Medicine or its osteopathic counterpart. Some go on to subspecialize in areas such as heart rhythm problems, heart failure or procedures like stents.
If a doctor calls themselves a cardiologist, you can check their board certification with the certifying board. A doctor who describes their practice as integrative or holistic may or may not be a cardiologist, so look at the training, not the label.
What integrative and holistic mean
Integrative medicine usually means care that looks at the whole person: diet, activity, sleep, stress, weight, metabolic health and medical history, alongside conventional tests and treatments. "Holistic" and "functional medicine" are used in similar ways. None of these terms is a board-certified specialty in heart disease.
A D.O., or doctor of osteopathic medicine, is a fully licensed physician who can diagnose, order tests and prescribe medicine, the same as an M.D. Dr. Varano's approach is integrative, and his program focuses on prevention rather than on treating established heart disease.
What prevention care with Cardio Res-Q looks like
Cardio Res-Q starts with a first-time assessment: the Comprehensive Assessment at $775 or the Enhanced Assessment at $999. Both include:
- Labs drawn at least a week ahead: ApoB, Lp(a), hs-CRP, homocysteine, insulin, glucose, A1c and the Cleveland HeartLab panel.
- A 1-hour consult with Dr. Varano to go through your results, history and lifestyle.
- A lifestyle and risk evaluation covering family history, blood pressure patterns, weight, sleep, stress, nutrition, exercise and sexual function.
- A personalized heart protection plan.
The Enhanced Assessment adds a CIMT ultrasound in our Conshohocken office and a coronary calcium score at an outside imaging center.
The emphasis on daily habits is not a soft extra. The 2019 US primary prevention guideline names a healthy lifestyle throughout life as the most important way to prevent heart disease and stroke.1 Medicine still has a place. The clinic prescribes statins and non-statin medicines itself, case by case, and does not refer out for prevention care. Dr. Varano started the program after losing his father to a sudden heart attack at 54, in 1984.
What integrative prevention care cannot do
- It is not emergency care. Cardio Res-Q does not treat heart attacks, strokes or acute symptoms.
- It does not include procedures. Stents, catheterization and rhythm procedures are cardiology care.
- It is not a diagnostic workup for symptoms. The assessments do not list a stress test, an echocardiogram or a heart rhythm monitor.
- It cannot promise outcomes. Tests refine a risk estimate. In 2018 the US Preventive Services Task Force found the evidence insufficient to judge adding a calcium score or hs-CRP to standard risk assessment in adults without symptoms.2
- It cannot lower Lp(a). Lp(a) is measured once as an inherited marker, and nothing approved lowers it yet.
When you need a cardiologist instead
See a cardiologist, or your primary care doctor first, if any of these apply:
- Chest pain, pressure or tightness, especially with effort.
- New shortness of breath, palpitations, fainting or near-fainting.
- Known coronary disease, a past heart attack, a stent or bypass surgery.
- An abnormal stress test, ECG or echocardiogram.
- Heart failure, a valve problem or a heart rhythm problem such as atrial fibrillation.
Chest pain needs a structured medical evaluation. US guidelines set out how to evaluate chest pain, with testing chosen by how likely a heart cause is.3 That is cardiology's job. If symptoms are sudden or severe, call 911 and do not wait for any appointment. For a side-by-side view, see Cardio Res-Q compared with a cardiologist visit, and for the full list of who should and should not book, see who Cardio Res-Q is for.
Using both
You do not have to choose. Many patients keep their cardiologist or primary care doctor and bring their Cardio Res-Q results to them. The clinic is happy to share results and work alongside your existing doctors. Our guide to sharing results with your doctor explains how that works.
Next step: how to book
If you feel well and want a prevention-focused look at your heart risk, choose the Comprehensive Assessment ($775) or the Enhanced Assessment ($999) on the Cardio Res-Q program page. Both are direct-pay and are not billed to insurance. Optional ongoing care is available afterward, including the Cardio Res-Q Specialty Treatment Plan at $125 per month and YoungerMeMD membership at $279 per month. Neither is required.
If you have symptoms, start with your doctor or a cardiologist instead. Questions? Contact our team.
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
Is Dr. Varano a cardiologist?
No. Dr. Varano is a D.O. and an integrative physician. He runs a heart-disease prevention program and does not provide cardiology procedures or emergency care.
Can the clinic prescribe cholesterol medicine?
Yes. The clinic prescribes statins and non-statin medicines case by case when appropriate. Do not start, stop or change a medication without your prescriber.
Should I stop seeing my cardiologist?
No. If you have a cardiologist, keep seeing them. Cardio Res-Q is meant to sit alongside your care, and results can be shared with your doctors.
Are follow-up visits virtual?
Follow-ups can be by telehealth when no repeat CIMT or EndoPAT testing is recommended, for patients in Pennsylvania. Whether the first consult can be virtual is something to ask our team.
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.
