Updated 07 July 2014

Visit your doctor: When to see a specialist

What if the ECG and blood tests are not normal? When should one see a specialist instead of your GP? Your GP will refer you, but here are the guidelines.


What if the ECG and/or blood tests are not normal?

Depending on the findings, you could be referred to a specialist. If heart failure or enlargement of the heart chambers is suspected, an echocardiogram could be required. This test shows the size and pumping action of the heart. It can confirm early enlargement (hypertrophy) or thickening of the walls of the heart, due to hypertension. It is called “left ventricular hypertrophy” and requires more aggressive treatment.

Referral to a specialist
Most hypertensive patients are treated by family doctors who will refer you for specialist treatment if indicated. Specialist treatment may be indicated in the following cases:

  • Your blood tests or ECG is abnormal.
  • You have multiple risk factors or complications of hypertension. 
  • The specialist can help confirm possible “isolated systolic hypertension” and other less common conditions.
  • If urgent treatment is needed, as in severe hypertension or malignant hypertension, referral is indicated. This includes certain conditions in pregnancy, called preeclampsia and eclampsia. 
  • A specialist can help identify a possible underlying cause and assess the patient who is resistant to treatment. 
  • Specialists usually manage problems with anti-hypertensive drugs like intolerance or multiple contraindications.


Read more:
Hypertension in SA


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Hypertension expert

Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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