annual exam with Echo or not?

[Megan]

Hi all! Its been some time since Ive been here..I am 3.5 yrs post op with ATS aortic valve replacement. At my annual check up this week, my ACH Dr. said i did not need an echo because my exam, EKG, etc were "Normal"! thank god for that! But it is the first year in 40 yrs that I havent had an annual echo and Im wondering what other people who are now deemed "Normal"! post-op have experienced. any thoughts? thanks!

 

[Duffey]

I can't speak to the ATS replacement, but I have an annual echo with my bovine pericardial. I think I've read of others with mechanicals who do not get yearly echos, so maybe they will chime in. In the meantime, congrats on the 3.5 post-replacement good exam!

 

[AgilityDog]

I was getting echos at least once per year, sometimes more, between valve 1 and valve 2. Now I'm down to once per year, but he has to keep an eye on my EF, since it's low, among other things.
If you are "Normal" maybe that frequency can be safely reduced, but I know it won't be for me, as I am Abby-normal.

 

[Janie]

I was getting echos yearly until I had my mitral valve repaired in 2009. My cardiologist basically thought I was fixed. I had annual EKG's etc that were perfect and he could hear that I wasn't leaking anymore. However, a recent echo (only having on a whim, really) showed my Ejection Fraction at a 45. No symptoms, nothing. So, this was a shock to me and I think, to my doc. I'm now on Coreg to hopefully get that number up. But, I've decided not to stress about it. I just wonder if I had had annual echo's I may have caught this sooner? So, I'd recommend annual ones for sure too. Good luck!

 

[ElectLive]

This will always be an individual doctor patient-based decision, but for what it's worth, here are what the Valve Disease guidelines (page e200 here: http://circ.ahajournals.org/content/114/5/e84.full.pdf) have to say:

"The asymptomatic uncomplicated patient needs to be seen only at 1-year intervals, at which time a complete history and thorough physical examination should be performed. ECG and chest X-ray examinations are not routinely indicated but are valuable in individual patients. Additional tests that are often performed include hemoglobin, hematocrit, and lactate dehydrogenase. No further echocardiographic testing is required after the initial postoperative evaluation in patients with mechanical valves who are stable and who have no symptoms or clinical evidence of LV dysfunction, prosthetic valve dysfunction, or dysfunction of other heart valves, in keeping with the ACC/AHA/ASE 2003 Guidelines for the Clinical Application of Echocardiography (2). Once regurgitation is detected, close follow-up with 2D and Doppler echocardiography every 3 to 6 months is indicated. Echocardiography is indicated in any patient with a prosthetic heart valve whenever there is evidence of a new murmur or change in clinical status, when there are questions about prosthetic valve integrity and function, and when there are concerns about ventricular function."

 

[Janie]

Thank you for that info! I guess I'm finding myself feeling pretty luck we even did an echo.

Good info and I guess you gotta trust your doctor and your gut feeling that something may not be quite right.

Thanks, again!

 

[Jkm7]

If you requested it for 'peace of mind', would your cardio refuse it?

If I felt uncomfortable about missing my annual ECHO, I would speak with my cardio about my need for assurance all is well. We need to be our own best advocates. If you will stress about it and worry about the condition of your valve, that is reason enough, IMO, for you to have it. It isn't an unreasonable request.

 

[yotphix]

My cardio told me at last visit (2 years out) that he wouldn't need to see me more often than every three years unless I have a problem. Since my echo was for him, that means no more annual echo unless I request it. My GP or PCP or whatever we call him these days, will send me for pretty much anything I ask for, so if I really want one, I can have it. I haven't decided yet, but I probably won't bother as long as I'm still improving my running times, and especially my hill ability.

 

[scott.eitman]

I find this unusual. I have had an echo yearly since 1988. I would think with all you have gone through, it would be once a year. Since 1998, I have got one about every 12 - 15 months.

Stay well
Scott

 

[tom in MO]

I had a mechanical put in in February. My cardiologist did an echo in April and said it was great. He wants to see me at year anniversary and once a year after that. As long as all was well with the EKG etc., we'd do an echo again in about 5-10 years. I then saw my surgeon, and he said he'd have one at the 1 or 2 year mark for good measure.

Personally, with my insurance echos are expensive until your deductable is met. I'll ask for one at the two year mark and probably as for one to be done every year my deductable is met.

 

[Superbob]

My cardiologist now recommends an echo every other year for me. And that's fine with me, because in recent years, since I moved from the state where I had my surgery, I've had technicians and cardiologists consistently misinterpret my results -- mistaking my stentless root/valve replacement device for an aneurysm. Echos can be useful as an early-warning test, but my experience is the data are inexact and subject to varying interpretation.

 

[catwoman]

I've had an echo every year since my MVR. John had an echo every year since his MV repair until now. He gets to skip one next year.
His dad had MVR in 1979 (porcine valve). After several years of hearing "you're doing just fine," he decided to skip going to the cardio. Not a good idea ... His porcine valve failed, he had AV problems, an aneurysm and needed a quad CABG. When I had my MVR, I resolved to not be like my father-in-law (avoid doctors).

 

[DavesMom]

Hi there,

I had AVR/aneurysm repair in 99 and have had a yearly echo ever since. When it comes to my heart I tend to be a bit of a nervous Nellie anyway, so I personally would feel uncomfortable not having one annually. I always feel a lot better when they come back normal. I also get yearly CT scans to keep track of an ascending aortic aneurysm, which never shows up on my echo.

I would also not want to rely solely on EKG results since, from what I've read, they are often inaccurate.

Best of luck and Happy Holidays to everyone!