How often you take Echocardiogram ultrasound test

[Carnelian]

Assuming you are years past your valve surgery (mine was mitral valve and double bipass over 5 years ago) how often do you take the test?
That is, when your cardiologist tells you to. Do you take it even with no symptoms and feeling fine? I understand its purpose and some patients
take no chances!

I went to my cardiologist for my 10 minutes. I have a shortness of breath for many years, even before surgery, probably asthma or allergy. He tells me to take the echo test-ultrasound.
My hunch is that his patients are mere pauses in the day or blips. Nothing to do.
I am cynical about these appointments because I dont care to pay 45. when my primary doctor can listen to a heart.. I asked him the likelihood of the test showing a problem for me and he would not answer. Well, time to find another guy. I've had 5 cardiologists so far and they are all tight-lipped.

 

[LondonAndy]

I'm in the UK, with an 8 year old mechanical aortic valve and am currently having annual echos. I suspect frequency partly depends on other health issues, eg monitoring of other valves, and a review of 93 studies of life expectancy concluded: "The long-term deterioration of the valves suggests a need for regular monitoring to identify people who may require a further valve replacement, especially after ten years."

 

[jeffp]

When I first had MVR and was over the acute healing phase, I had annual echoes for 3 or 4 years. Once things were known to be stable, we moved to every 3 years if there were no issues. My first cardiologist was one of those tight-lipped, “do as you’re told and don’t ask me a lot of questions” type. The 2nd was ‘meh’. Third (and current for a dozen years) is very thorough (he does general and interventional cardiology). You just gotta shop around until you find one that’ll work with you, vs. on you. It’s kind of a treasure hunt/crap shoot.
The value of the echocardiogram is much more than listening to your heart. They should be measuring flow velocity and volume, ejection fraction, various valve and chamber dimensions, etc and comparing prior readings to current to evaluate changes and future risk potential.

 

[pellicle]

Hi

Assuming you are years past your valve surgery (mine was mitral valve and double bipass over 5 years ago) how often do you take the test?

I normally have them about every 2 or 3 years, but I went through a period (while living a life of OS travel) ... I did this for about 10 years.

Then I went in because I felt "things weren't quite right" and they found a 5.6cm aneurysm. So if I hadn't gone in I'd be dead now.

..I understand its purpose and some patients take no chances!

do you?

I dont care to pay 45.

wow ... you mean fourty five dollars ...

ever eat out? Spend more than that on a dinner that you could have had at home?

... I asked him the likelihood of the test showing a problem for me and he would not answer.

I'd be tight lipped too ... do you wear a seatbelt? What are the chances you'll have an accident on this trip?

 

[skeptic49]

Every two or three years for me. I'm eight years out from surgery with a tissue valve. My lasst echo was two years ago. My cardio said we'll see how i feel in January but at this point i don't feel like i need an echo at this time.

 

[Paleowoman]

I see my cardiologist annually and have echos every year since surgery nearly 9 years ago.

 

[catwoman]

I am 19 1/2 years out from my MVR (St. Jude mechanical). I have had an echo every year since then.
I am on a 6-month recheck now so my cardiologist can keep an eye on my aortic valve. My first recheck is Jan. 10.
My cardiologist has been chief of cardiology and chief of staff at a hospital in Fort Worth TX (USA). He is now a professor at a medical school in Fort Worth, in addition to having a private practice. In addition to his bachelor's and medical degrees, he has a master's in biomedical engineering.

My late father-in-law had his first MVR (porcine) in 1979. He lived in a small town about 1 hour 20 minutes from Fort Worth, where he had his surgery. He got tired of driving to Fort Worth for annual checkups, so he quit going.
BAD DECISION!!!
By late 1989, it was very apparent something was wrong. He needed the mitral replaced again PLUS his aortic valve replaced, the ascending aorta rebuilt and 4 bypasses. He was in very bad shape. He was 74. His surgeon told him the odds of making it were very slim (I was present when he was told this).
It was a day-long surgery and he was in CICU for over a week. It was a long recovery. His wife had died of early-onset Alzheimer's 4 years prior, so he had to stay in Fort Worth for rehab afterwards.

We adapt our activities to health issues and often fail to see the big picture. I believe my FIL would have gotten into surgery much sooner had he not stopped going for annual rechecks and echoes. His recovery would have been shorter and much easier.

Just my 2 cents' worth.

 

[dornole]

Every year for 20 years. One of my husband’s colleagues had mitral valve replacement, stopped doing echos and by the time she got symptoms, she could not be saved and died at age 62. So I definitely follow dr instructions on this point. I do still have my native valve though- repaired. I feel like the cost and inconvenience of annual echos is minor compared to irreversible heart damage

 

[oo0My_Valve0oo]

Man I had it all typed out then cell battery went dead. Short answer I don't know when I am up for an echo. I was due a CT scan at 1 year but there was a shortage of iodine solution. After reviewing case said call in 6 months. I lined up one this Jan which will be 1.5 years after aortic valve replaced and area wall reinforced. It is a bio tissue valve. I do not have s cardiologist since he retired 8 months after my surgery. Said use PCP.

 

[Chuck C]

I feel like the cost and inconvenience of annual echos is minor compared to irreversible heart damage

That's exactly right.

 

[Timmay]

I support what Chuck just said … which is what someone else said.

I intend to get an echo every year. My next one is in January. I’m currently 6 months post op from receiving a mechanical AVR. Had my first post op echo at about 2 months.

 

[dornole]

Man I had it all typed out then cell battery went dead. Short answer I don't know when I am up for an echo. I was due a CT scan at 1 year but there was a shortage of iodine solution. After reviewing case said call in 6 months. I lined up one this Jan which will be 1.5 years after aortic valve replaced and area wall reinforced. It is a bio tissue valve. I do not have s cardiologist since he retired 8 months after my surgery. Said use PCP.

Wow I would not be cool with just seeing a pcp to follow my serious heart condition esp less than 2 years after surgery. That seems a bit cavalier of your cardiologist to say that.

 

[oo0My_Valve0oo]

Thank you. I am going to push for a cardiologist replacement.

 

[QuincyRunner]

I support what Timmay said about what Chuck said about what someone else said.

 

[pellicle]

I support what Chuck just said

I support what Timmay said about what Chuck said about what someone else said.

Gang members ...
¯\_(ツ)_/¯

 

[Woodcutter]

fyi - from the 2020 ACC Guidelines for the Management of Patients with Valvular Heart Disease

"In asymptomatic patients with any type of valve intervention, a baseline postprocedural TTE followed by periodic monitoring with TTE is recommended, depending on type of intervention, length of time after intervention, ventricular function, and concurrent cardiac conditions."

Then Table 12 spell out minimal imaging frequencies such as:

" baseline," for mechanical valve (surgical)

"baseline, 5 and 10 year after surgery, and then annually" for a bioprosthetic valve

" baseline, 1 yr, then every 2-3 years" for mitral valve repair (surgical)

etc. (there are several other categories in the table) with accompanying notes to adjust for changing symptoms, pregnancy, other cardiac issues.

To me, the basic points include:

- there are written guidelines (my reference is the American document so I bet most U.S. cardiologists and insurance providers utilize this to a high degree)
- there is considerable variability based on individual circumstances (just as you would expect)
- these guidelines change with time (I originally obtained the document last year when I was curious about my cardiologist wanting me to bridge for a colonoscopy when, 5 years earlier he and I looked up the recommendations together and the bridging was not the recommendation)

 

[Croooser]

You can shop for a cardiologist that is accepting new patients. I did that several years ago when my cardiologist tried to pass me off to a PA. The new one helped me decide when to see a surgeon and is monitoring me post op. I am on a 1X/year echo unless and until something changes for the worse (tissue valve). I would not want it any other way.

 

[dornole]

Gang members ...
¯\_(ツ)_/¯

Oh wow I got a gang

 

[pellicle]

Oh wow I got a gang

sure, when we do Dredd on stage you can play Ma-Ma

 

[pellicle]

fyi - from the 2020 ACC Guidelines for the Management of Patients with Valvular Heart Disease

for anyone who's interested but doesn't know how to get to that.

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923

I think it says a lot that imaging follow-up on Bioprosthetic is every 5 years then annually after the second inspection, while mechanical is just that one imaging after surgery (Baseline).

So if anyone thinks that all the discussions about mech over bio are not right or biased or whatever ... then take it up with the journal (written by the top specialists in the field) that informs the general population of specialists in the field.

Note: I'm not a doctor.