Echos - a question

[Emma]

Hi all - this is pure curiosity having been reading another thread on the frequency of echos and not wanting to hijack it!

It sounded from some of the replies on there that although checkups afte VR are regular, the cardi then decided whether or not to do an echo or not if he feels its needed.

Chloe's checkup always consists of ecg, echo and chest xray and then consultation with her cardiologist. Always has done, even before her vr - as does any other child with CHD that I know.
Does this change as an adult or is it only in the US that you don't get an echo every checkup??

As I say, only curiosity (nosiness, whatever you want to call it), but wanted to ask as it just sounded unusual to me.

Thankyou
Love Emma
xxx

 

[Ross]

In the U.S., Doctors are constantly bashed for requesting testing unnecessarily, so generally speaking, unless there is a distinct reason for the test, none are done. My Cardio always wants a yearly echo done as a safety precaution, but that's about the extent of tests for me.

 

[tobagotwo]

Whether an echo is taken should be tailored to the individual's issues. It should depend on the complexity or the case, the stability of the systems, and the reliability of other means to determine if things are deteriorating.

The ACC recommendation was a split one, and more centered around simple cases. In your position, I would have to have an awful lot of reassurance to allow them to not do an annual echo.

Best wishes

 

[ClickerTicker]

Hi Emma
I have been having an echo every year prior to seeing my cardiologist. Initially it was at the Chalybeate (now BUPA Southampton), but since my insurance company declared my condition "chronic" and stopped paying I've had it done at Southampton General. The echo service at Sot'n is great, never had to wait long. Parking is a nightmare, but that's a different story!
Did have an echo in Australia - what a difference... it was much more thorough, took almost an hour, and the video was reviewed by a top cardiologist in Perth. Very detailed report. Even before I claimed it back from their Medicare, it was less than 100 quid - and I got all but a few quid back anyway. Compare that to 400 at the Chalybeate....

 

[Emma]

Thanks for all that. As i say, its just nosiness and wondering what kind of care Chloe might get in the future (be that a long way from now I know).
Seems it must be a US thing.
Bob, you're so right - I would need a LOT of reassurance before I let them do anything less than yearly echo.
And Ross, i thought it might have something to do with over-ordering tests (seen it all on ER you see! LOL)
ClickerTicker, we are also seen at Southampton General - were up there Monday in fact, for Chloe to have an enalapril increase. Who is your consultant and surgeon?? I know a lot of Chloes pead ones also do adults.

Thanks again
Emma
xxx

 

[Phyllis]

Hi Emma,
I was the one that posted the original question and did the research on the American Heart Ass. guidelines. Dick's situation is very different from Chloe's!
He is 71 years old, had avr 1 1/2 years ago and has no other issues. He was one of the lucky ones that had a relatively easy surgery and recovery and is very athletic for his age. We were just wondering if there is no murmur heard and the ekg is good, a yearly echo is necessary in these early years of a new valve. In Chloe's case, I would not question having a yearly echo.
Best wishes,
Phyllis

 

[Emma]

Thanks Phyllis,
It was actually someone else reply on there from the UK that prompted me to ask, but as I say, I'm not worried about it in the slightest - more nosey than anything! lol
Chloe also doesnt have any other issues really other than the valve replacement any more (apart from a slight tricuspid leak), although she was born with a complex CHD, all other issues are corrected (heart back to normal size etc). She does of course have a murmer still and I would never be happy without a yearly echo, as at her age and with her history, you just never know!
Interesting to see on these boards though, how different countries and diffferent hospitals even treat in such varying ways.

Love to you
Emma
xxx

 

[ClickerTicker]

Emma - my cardiogist is Iain Simpson, the surgeon was Steven Livesey. BTW - found this link just now:
http://society.guardian.co.uk/nhsperformance/data/0,15863,1439873,00.html

 

[Gemma]

Hi Emma,

Am I the other UK person? If so, just thought I'd clarify Jim's echo history to date:
pre-op, every 3 months
Dec 2003 - AVR
Jan 2004 - back in hospital with atrial flutter, had an echo and x-ray done then
Nov 2004 - saw cardio, no echo or x-ray (assumed this was as it was still less than a year since last one)
Aug 2005 - watch this space!

I'll try to find out what the UK recommended timescale is for echos in adults with valve replacements, or at least for Jim. It'd be nice to have another echo done next month if only to see how things have or haven't changed since the last one, which was only a month post-op. Think it'd give a better idea of how things are going long-term to have another one done, but it probably depends on whether there's a tech there to do it! (v. small hospital that he sees his cardio at, but better than battling for a parking space in Chester!).

Gemma xx.

 

[Emma]

no Gemma you werent the other one, but thanks anyway. Be peace of mind for you and Jim to get another echo though - sure it'll be fine but it never hurts to check. I was just surprised to find that an ecg, echo and xray (ok - perhaps not the xray) weren't the norm for everyone. Guess Chloe has been lucky with the huge amount of echos shes always had - whether its cos shes a child or cos of her condition I don't know but thanks for your info everyone!

Love Emma (with her nosiness now satisfied!)
xxx

 

[Mama2Rylan]

Hi Emma!

I am 24 years old and I have always had an echo done when I go to see my cardiologist...actually I have the same...and ecg, echo, xray and now that is closer to surgery date, I will be on my second MRA...so unless it's some kind of twisted "special" treatment, that is how they do it where I'm from

 

[Peachy]

Hi Emma

Before my op I was getting echos every two years. Since my op three years ago I have had at least one every year at my checkups. They weren't happy at the last checkup and I went back after six months for another echo. This was ok but I am due to go back next month again for a followup one. Will probably revert back to every two years once they are happy that everything is ok.