Had my echo today...

[Midpack]

Hi:

Today i had my echo (i am being followed because of moderate mitral valve regurgitation). Tomorrow i will see my cardiologist. I dont have the report yet.
There is a peculiar situation happening during my echos. Because my cardiologist want them to be performed by the chief of the echocardiography department, there is allways besides him a younger cardiologist receiving training. And, of course, they talk about what they are seeing on the screen and the values they are measuring. A normal person would not have the slightest idea about what they are talking about, but that is not my case (and not yours, probably). I understand 90% of what they are saying (i have read a lot about valve issues, and i know what are the key parameters to consider in order to decide surgery or not). I am not sure if it is good to know what are they talking about. Personally, i become more anxious. Can you beleive that my RHR is 60 beats per minute and during my echo i was at 90 bpm?

Anyway, from what i heard, some of my values have worsened. A bad sign. My EF is still pretty good (70%), but both my LA and LV show some enlargement from previous echo 6 months ago. I guess my cardiologist will still suggest a monitoring approach, but i beleive my seat in the waiting room is closer to the door labeled "surgery".

 

[DebbyA]

I like the echo tech I have now because she tells me what she is seeing, and what has changed. Always before the techs fended off any question with "the doctor will interpret for you". Still, I can understand that trying to decipher what you're partly hearing must be unnerving. Do you have any symptoms?

Let us know what your cardiologist tells you.

 

[Midpack]

Hi DebbyA:
I visited my cardiologist yesterday, with my last echo report in hand. He said that nothing has significantly changed. And that i should continue my life, not worry about this, and have another checkup in 6 months. And less Dr. Google, of course. As i see, cardiologists take into account the overall picture (including clinical examination), not focusing on single echo values. For instance, i was worried because my LA area increased from 22cm2 to 28 cm2. But this is still considered a mild dilatation, and being the systolic function od the LV preserved (EF estimated at 70%), he did not worry about it. Regurgitation is still evaluated as moderate. And he said that surgery is not considered until it reaches severe (or you have annoying symptoms). In my case, i am symptomless.
To sum it up, still in the waiting room for some time...

 

[DebbyA]

I hope you're at peace with this. It sounds like you have a good cardiologist. It also sounds like you have a lot of knowledge, so you can be helpful to the other worriers in the waiting room. See you there!

 

[tom in MO]

In my experience in the US, echos are not given by cardiologists, but technicians. In the US, from what I've been told by people who do this work, due to the need for the interpretation of test results, it is not considered proffessional for any technician, lab, radiology, echo, etc. to supply details of an exam to a patient other than the exam was completed successfuly or not. Only the attending or referring physician or their cohorts (e.g. nurse) should supply the information related to a diagnosis. So in the US, we wouldn't have the cardiologist doing the echo, but interpreting it after it was done. But, since the person giving the narrative is your attending physician, it would be considered ethically correct.

In my case I had the same technician over a number of years. At my last one before surgery, halfway through she asked me if I was having any problems with fainting as part of her exam. The exam took longer as well. I correctly inferred from this that the gig was up and surgery was due. However she was just gathering data for her test, so it was no lapse in judgement.