Echo's result accuracy

[Iggy]

Hello,
Has anyone here ever had issues with echocardiogram results? I've been getting echos twice a year for the most part since my last MV repair, and the results are roughly the same and not of concerns to my doctors. However, I've been having symptom of fatigue from exertion and low energy for a few months now. The symptoms are similar to ones I had when my heart valve was leaking severely. The doc ran the tests and the echo results come back normal. I think an echo is a gold standard for checking heart function, but is there any other test I could ask my doctor about? Thank you!

 

[pellicle]

Hi Iggy

what issues do you mean?

echocardiogram is not the "gold standard" its actually a simple and non-invasive procedure to get an idea. Further studies may present as being warranted, but to my knowledge there is no "one gold standard" test its all a cumulative set of data to refer to.

 

[Iggy]

Hey pellicle!
By issues I meant if the echo fails to pick up something like valve stenosis or leakage or if a degree of stenosis/leakage is not correctly measured (worse in reality but shows up ok on an echo, for example)

 

[MdaPA]

I've been getting echos twice a year for the most part since my last MV repair, and the results are roughly the same and not of concerns to my doctors.

Why are you getting echos twice per year? Because of your symptoms? Unless a problem is suspected, routine echos are usually annually or greater, especially if the results are "roughly" the same between echo. Also, insurance company's normally require evidence of a suspected problem from your doctor if you are getting more than one echo per year.

since my last MV repair

Was your MV repaired more than once and how long ago?

not of concerns to my doctors

So more than one doctor had the same conclusion and are not concerned?

I've been having symptom of fatigue from exertion and low energy for a few months now.

is there any other test I could ask my doctor about?

Have you had blood work or a general exam outside of your echo as these symptoms can be caused by a myriad of other things?

By issues I meant if the echo fails to pick up something like valve stenosis or leakage or if a degree of stenosis/leakage is not correctly measured (worse in reality but shows up ok on an echo, for example)

Do your echo results indicate any present stenosis or leakage and if so, what was the degree of severity?

 

[pribanic4]

Hello,
Has anyone here ever had issues with echocardiogram results? I've been getting echos twice a year for the most part since my last MV repair, and the results are roughly the same and not of concerns to my doctors. However, I've been having symptom of fatigue from exertion and low energy for a few months now. The symptoms are similar to ones I had when my heart valve was leaking severely. The doc ran the tests and the echo results come back normal. I think an echo is a gold standard for checking heart function, but is there any other test I could ask my doctor about? Thank you!

My condition is stenosis , tiny leak no

Hello,
Has anyone here ever had issues with echocardiogram results? I've been getting echos twice a year for the most part since my last MV repair, and the results are roughly the same and not of concerns to my doctors. However, I've been having symptom of fatigue from exertion and low energy for a few months now. The symptoms are similar to ones I had when my heart valve was leaking severely. The doc ran the tests and the echo results come back normal. I think an echo is a gold standard for checking heart function, but is there any other test I could ask my doctor about? Thank you!

The best test I’m told is the Tee , I didn’t want that , I have getd and my esophagus is typically itratated so they did an Echo-Stress to get a much better assesment.

 

[carolinemc]

Hello,
Has anyone here ever had issues with echocardiogram results? I've been getting echos twice a year for the most part since my last MV repair, and the results are roughly the same and not of concerns to my doctors. However, I've been having symptom of fatigue from exertion and low energy for a few months now. The symptoms are similar to ones I had when my heart valve was leaking severely. The doc ran the tests and the echo results come back normal. I think an echo is a gold standard for checking heart function, but is there any other test I could ask my doctor about? Thank you!

Not it is not the only test to go by, EKG, Caths, and other testing options can do more in that area. Good luck, and there is another option, another cardio if you are not getting answers.

 

[Chuck C]

Hi Iggy.

By issues I meant if the echo fails to pick up something like valve stenosis or leakage or if a degree of stenosis/leakage is not correctly measured (worse in reality but shows up ok on an echo, for example)

Echos generally do a good job of picking up stenonis and regurgitation (leakage) and also indicated severity.

The doc ran the tests and the echo results come back normal.

I've been having symptom of fatigue from exertion and low energy for a few months now.

The question is what your doctor means by "normal"? Normal for a person with stenosis? Normal meaning what he would expect to see for any other person your age? Some cardiologists dumb down the results of tests when communicating with their patients. This was the case with my first cardio- he would typically say things like "you won't need surgery for a long time." I am a detail person and it seemed like it would bother him when I would ask for copies of my echos and other reports. He was not at all concerned and said nothing of the fact that my aortic valve was only 1cm2, right on the borderline of moderate/severe. I think his attitude was that he would keep the info he gives me on a "need to know" basis. I soon moved on to him to a cardiologist who was a good communicator and believed that the patient deserved detailed discussions about their condition.

You've had a MV valve procedure before and it sounds like they are probably monitoring things, possibly even keeping an eye on your aortic valve as well. If they are seeing you every 6 months, that means that there may be some concern over progression. I would suggest requesting copies of your last few echos from their office. In the US, they are required by law to give you the reports upon request.

Also, symptoms should never be ignored. They may or may not be related to your heart valves. But, if heart valve symptoms are ignored for too long, it can lead to permanent damage to your heart. So, they should be running tests until they can figure our the cause of your symptoms. If your current cardiologist is not concerned about your symptoms, I would get a second opinion and perhaps move on to find another cardio who a) takes your symptoms seriously and is determined to reveal the cause and b) is a better communicator

Best of luck.

 

[QuincyRunner]

I agree with the previous poster about the TEE (transesophageal echocardiogram) being the gold standard, at least compared to a regular echocardiogram. When I developed endocarditis of the mitral valve it went undiagnosed for several weeks during which time I underwent multiple tests, including several echocardiograms that failed to provide the doctors with an explanation for my increasing inability to breathe. Finally they resorted to a TEE (which sends a flexible tube down your esophagus) which instantly identified the infected and disintegrating mitral valve which apparently was occurring on the back side of the valve which the TEE could see but the echocardiogram could not. At least that was the explanation given by the doctors (probably to avoid a potential malpractice suit) before they rushed me into emergency open heart surgery just hours later. I was told that I had come very close to death which leaves me thinking that the TEE saved my life. I don't know whether or not possible stenosis or leakages can also be better seen with a TEE versus a regular echocardiogram but I know that for infections and blood clots in the heart it is definitely the gold standard.

 

[pellicle]

Hi

By issues I meant if the echo fails to pick up something like valve stenosis or leakage

stenosis and its changes will be less accurate a measurement (because of the nature of an echo), however leakage will be apparent in the Doppler jets

or if a degree of stenosis/leakage is not correctly measured (worse in reality but shows up ok on an echo, for example)

I'm not sure (can't comment) about how well distinguished leakage is from stenosis. They are as I understand it different things. I thought stenosis was more "The valve ... is narrowed and doesn't open fully. "

leakage was I thought it not fully closing

 

[tom in MO]

You state your problem is: However, I've been having symptom of fatigue from exertion and low energy for a few months now. The symptoms are similar to ones I had when my heart valve was leaking severely. Those symptoms can have a variety of causes. If your heart team says it's not the ticker, I'd suggest you go back to your general practitioner..

 

[rich01]

Maybe a stress test. Do you have sleep apnea? Have you been getting regular exercise?

 

[dornole]

My personal experience is that the echo can be variable by one level. For example I have both mitral stenosis and mitral regurgitation (one repair, done 20 years ago). A year ago I had mod-severe stenosis and moderate regurgitation. A couple weeks ago it came back as moderate stenosis and mod-mild regurgitation. So I am not a miracle or anything, it’s not spontaneously healing, it’s just the test. In the past when the TTE has given results that could be actionable they have given TEE and found it’s not time for surgery.

 

[dornole]

Also I am still confused on your conditions - how bad is stenosis? You said tiny leak but that would be regurgitation - and you had regurgitation before the repair? What were your actual echo results?

 

[Linkpad]

Interestingly enough I am in the same boat, I have had my TR valve repaired (annuloplasty) 9 years ago had 2 echos come back as normal although show mildly dilated RV, I feel similar symptoms to the Severe Regurgitation before the repair. My cardiologist has booked me in for a Cardiac MRI stress test which I think is a lot more detailed than a standard echo.

 

[msdizzydolores]

I didn't read your post yet, but I just had an issue with my latest echo report...one part contradicts the Summary and I'm just over it.