Had my echo and have questions

[twinmaker]

Hey you all! I had my echo today with the new cardiologist here in Charlotte. I have a couple of questions. It's been a year since my last echo, and I read the report on it, and is said that my aortic valve was mildly stenotic. This is the reason why my cardio. in Tampa put me on Lipitor. Anyway, the technician today said that the aortic valve looked moderately stenotic now. He showed me where the blood was leaking back through. My mitral valve has been replaced (almost 25 years old), and since he didn't have any of the info from the last echo on that valve, he couldn't tell me anything about it. Can you all tell me how accurate the techs are when they are doing these things and telling me about them? I certainly didn't have to pry any info out of him. And he certainly seemed very sure about the aortic valve being moderately stenotic. Should I be concerned about a moderately stenotic valve? Any info would be appreciated. LINDA

 

[pfsinger]

Hi Linda-
I would wait to worry until you have your cardiologist's interpretation of the echo. Yes, techs do this all the time and can understand and explain what they see, but technically they are not supposed to give you a diagnosis or interpret your echo for you. This is done by your cardiologist.

If I were you, I'd talk to my cardio and not freak out about anything the tech said. Your cardio will give you a more accurate interpretation of your echo.

 

[MikeHeim]

I totally agree with pfsinger's answer. It is irresponsible for a tech to play Cardiologist and start diagnosing you on the spot. Wait for the Cardiologist's interpretation.

 

[RandyL]

I wouldn't worry to much moderate is not severe. I am surprised your cardio didn't talk to you afterwards and explain the situation. Was the echo not performed in his office?Every cardio I have been to had his own echo technician.

 

[bvdr]

Hey you all! I had my echo today with the new cardiologist here in Charlotte. I have a couple of questions. It's been a year since my last echo, and I read the report on it, and is said that my aortic valve was mildly stenotic. This is the reason why my cardio. in Tampa put me on Lipitor. Anyway, the technician today said that the aortic valve looked moderately stenotic now. He showed me where the blood was leaking back through. My mitral valve has been replaced (almost 25 years old), and since he didn't have any of the info from the last echo on that valve, he couldn't tell me anything about it. Can you all tell me how accurate the techs are when they are doing these things and telling me about them? I certainly didn't have to pry any info out of him. And he certainly seemed very sure about the aortic valve being moderately stenotic. Should I be concerned about a moderately stenotic valve? Any info would be appreciated. LINDA

Hi Linda,

Here is a link you might want to look at for a good overview of aortic valve stenosis including the use of statins in hopes of slowing the progress. It is the same reason I was put on Lipitor after my MVR. My cholesterol was fine but it was to hopefully hinder the progress of the aortic stenosis.

I had one other question for you. Is the valve both stenotic and regurgitant? If so, I believe the net result is worse than if just one or another is present. In other words, in stenosis, there is the reduced area that the blood is pumped through and if part of that area is being used for the backflow then the functional area left for forward flow is technically lessened. So a mild stenosis may actually behave more like a moderate stenosis. I had my mitral valve replaced when it was moderately stenosed but the moderate regurgitation made it function as if it was severe.

Anyway here is the link: http://heart.bmjjournals.com/cgi/content/full/92/6/729

 

[twinmaker]

Hey Betty, I believe it is regurgitating. He showed me on the color doppler where the blood was leaking back through. That's regurgitation, right? Randy, this office has thirty cardios. The tech that was doing mine told me he had three echos scheduled for 11 this morning (my appt. time). I'm not even sure my cardio was in the office today. I guess I was also a little stunned when he said the stenosis was definitely moderate. I know I should wait for the cardio to read the results, but I'm sure these techs know something about this stuff. My concern is the fact that my mechanical mitral valve is almost 25 years old, and who knows when it will need to be replaced. If they have to operate on the aortic valve (whenever), will they go ahead and replace the mitral again also. I just don't want to face two more OHS at my age. I know I'm getting ahead of myself, but I'm sure you all know where I'm coming from. LINDA

 

[tobagotwo]

Mild or moderate isn't divination, and cardiologists aren't making Karnak-like predictions based on hidden evidence that the technician can't see. It's a finite range of numbers that the tech, not the cardiologist, usually dopes out. The question is largely only whether the technician is a good echocardiogrammer (echocardiogramist?). Echo tech.

Generally the techs are discouraged from showing the clients too much (scares the customers). You may have inadvertently made him feel you were knowledgeable and interested while talking to him during the exam. (Well, you are interested and you are knowledgeable. It may well have shown.) He probably thought you would appreciate him sharing the data.

Obviously, there are other factors involved with your heart's health that your cardiologist will want to balance with that when he presents it to you. It's an isolated number, and should be in context with other findings. But this specific item itself is numerical more than interpretive, as are the other numbers in the report (which you will get a copy of). I don't see how the cardiologist could change the numbers.

Yes, if he showed you blood leaking back, it's regurgitation (sometimes called insufficiency), just as Betty said. That doesn't mean it's a lot, though. If you've got some calcification going there, a little back-leakage isn't surprising.

Moderate's a large range. Don't be discouraged.

Best wishes,

 

[ALCapshaw2]

Linda,

My cardio group is also quite large. Echo's are scheduled immediately before regular checkups with the cardio who goes over the results. IF a tech were to give his/her 'opinion' on the results I expect they would be either reprimanded or be looking for another job.

Here is a list of terms describing medical hierarchy by degrees of seriousness:

NO / NONE
Trace
Mild
Moderate (usually warrants regular monitoring / checkups)
Severe
Critical

'AL Capshaw'

 

[twinmaker]

Al, I don't have another checkup with my cardio until August. I guess I could call and ask about the results of the echo (like I haven't been told anything by the tech). I really don't want to get him in trouble. I'm sure because of the fact that I told him that I had had two OHS and a defibrillator implanted and possibly because of the terminology that I knew and I DID ask how things looked, that's probably the reason he was so forthcoming. Of course, I've always asked "how things look" while having echos done, and I usually don't get any answers. I'm certainly not one to stick my head in the sand, but I wonder if no news is good news if I don't hear anything from the cardio before August. Knowing myself though, I'll probably call in a few days and ask about the echo. What do you all think? Would you call? LINDA

 

[Mary]

I'd get the results from the echo, and then judge for yourself whether you should call.

 

[pfsinger]

Linda-
I had an echo done in December of 2004 (my first in 10 years - long story). I never received the results and figured everything was fine since I hadn't heard anything. Come to find out this year that my echo showed moderately severe pulmonic insufficiency. I then went to Mayo and had my appointment with my new cardio after having tests, including an echo. Nothing much had changed on my echo, which I take to mean that my heart has stayed the same, basically.
I need my pulmonary valve replaced and am having it done in July. If I had received those echo results last year and someone had actually followed up with me, I know I would have had a PVR last year. I'm hoping that there's no irreversible damage done.

My point is, no news isn't necessarily good news. I'd call you cardio to get the results.