Recent posts about echocardiograms prompt me to write about what has happened to me. I had an echocardiogram in February and the report arrived with my GP in April. As I won’t be able to see an NHS cardiologist until next February (! ), I decided to see a cardiologist privately two weeks ago.
He had a copy of the echocardiogram report which he had read very carefully and he also examined me at considerable length. Then he said he needed to see the echocardiogram images because something “didn’t sit right with him.”
What he observed on examination didn’t tally with the severity of what the echocardiogram was reporting and what it said about 2 of the valves would be highly unusual.
I’m not sure how these echocardiogram reports are generated. Are the images actually looked at by a specialist who then drafts the report? Or is the report generated by a computer from the images taken by the technician?
I shall be very interested to see what he has to say when he has seen the images together with the report.
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Classicfan49
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Reading your post, the first thing that struck me was that it took 2 months for the report to get to your GP. I just wonder whether there was a delay in preparing the report which affected the interpretation of the test.
I think your Cardiologist is wise to be referring back to the original images so that he can make his own judgment on the matter. I know waiting is the hardest thing to bear, but try not to worry about things. You were given a thorough examination, so had anything been urgent, I'm sure you would have been told.
I’m not particularly worried as the man I saw was so reassuring and it was good to actually sit down and talk to someone, face to face, who knows what he’s talking about! I’ve talked to various GPs about my condition but they don’t have the knowledge of the specifics and of course, this all has to be done over the phone, on one occasion when I was shopping in Aldi.
Hopefully it won't be long before the Cardiologist receives the images and can advise you further.
Hi, Is an Echo open to interpretation, in my experience, yes, but, that doesn't necessarily mean its being interpreted wrongly, just differently. I've had a lot of Echo's over a long period, and this has led me to being a firm believer that it is only as good as the technician carrying it out. I'm not saying some technicians aren't capable, far from it, but some are better than others, mainly through experience and knowledge accrued.
The Senior Tech at my local hospital has a very good rep, and when I get him, I'm always confident that he'll pick up on anything untoward, whereas, I've had them at a specialist heart hospital and the technicians have struggled to get the right images etc and had them re-done days later. I'm a complex echocardiographic subject and it's not unusual for a technician to seek help from someone else.
Again, in my experience, I've always been told by a technician that they'll write it up and the Consultant will be in touch, be it the same day or later at some point. My latest echo, which I posted about yesterday is a casing point. The technician thought I had Aortic Regurgitation, however on review of the images by my Cardiologist and Senior Technician they were of the view that it was in fact functioning well. That was down to interpretation and not having experience of having done an echo on me prior, whereas, they know my heart inside out.
It's not always easy to decipher the images and the sound, in my case, they're looking at both Mechanical Aortic and Mitral Valves, which are both leaking to some degree, along with a Shunt that is quite uncommon, again with leakage.
Most people on here are literally thrown into the system at the deep end, bewildered and in many cases in shock.
They can have an array of tests including an Echo, and then wham bam there being told, you have a problem, in some cases without seeing a Cardiologist.
If you see a Cardiologist, do you trust them to make the right calls that could be life changing. Do you see the same Cardiologist year after year, do you build up a relationship.
Being a long term patient from young, I've learned to trust Cardios and Surgeons etc, I've been under the care of the same Cardiologist for 25years or so and I trust him 100%, without question. My surgical hospital is the Freeman, Newcastle, so, I'm fortunate in that regard. These little things all help.
Definitely agree. My reasons for trusting the guy I saw are: we had a good rapport and he shared my sense of humour; he treated me as an intelligent human being; he gave me some concrete advice to use from day 1; he explained the next steps clearly; he didn’t sound anything like a politician, which is a definite plus! I left feeling reassured, as if someone had my back and would be looking to do the right thing by me.
I've had yearly echos for ages but last May it showed up that I had high pulmonary hypertension.My cardiologist called me in for an angiogram which showed 2 blocked arteries so I had to have stents fitted but I didn't have the high pulmonary hypertension the echo had shown
So they are not fool proof the radiologists who do the echos and interpret them my cardiologist read my echos himself I'm so thankfull he did
Hi I find this quite interesting . I too had an echo-scan recently after an X-ray showed an enlarged heart- and scan showed I have ‘mild diastolic impairment’ but was inconclusive as the report stated EF could not be assessed due to ‘all walls not visible’ - they took a long time doing scan and seemed to be having trouble getting the pictures they wanted. I have breathing problems on exertion, fatigue and I’m getting bloated despite on a very good low fat diet . My BNP was ok from blood tests. Seemed odd and interesting to me that they could not assess EF on echo scan - but the GP has ref to cardiologist anyway due to scan being inconclusive. The wait for cardiologist is 3 months min.
I’ve now had 4 different cardiologists look at 6 month spreads of echo, MRI and CT images and there is no consensus between them. Opinions range from me having a serious malignant heart condition requiring heavy medication on one extreme to ‘nothing to worry about’ simple, occasional PiP solution at the other end. The medical business cynic in me says that the private cardiologist might come back and say that they’ll need to do his own or additional separate tests. Not to be too critical, they do an excellent job and I understand the need for them to have test results that they know a little more about, however, when I’ve tried to pass on test results to another cardiologist for a different opinion the response is often ‘I can’t really tell you from someone else’s test and I’ll have to do my own’.
Hi all this was very interesting I assumed echo's were the rolls Royce of the tests and would tell the cardiologist everything, I have had loads and my consultant checks them before I leave the hospital as I have had a transplant, he never goes into detail just says it's fine even pre transplant I never seen any results just a worried look from the doc and once an "oh what a big heart" from the sonographer. I never realised that they could be interpreted differently, char
Any echo’s, both normal and Holt’s, are nutritiously unreliable. They are a good first indicator for a quick look. But then if there is more concerns they should step it up and do MRI’s. My cardiologist does not even bother with echo’s any more, and just checks me with MRI’s. But as mentioned they are good for first check as they are quick and easy, and normally faster waiting list to get it done.
Hi. That’s interesting. I had my last echo in March and I’m yet to see the report. The cardiac nurse told me over the phone that I was in heart failure and my heart muscle was damaged. No follow up by the cardiologist or letter or report etc. I was left thinking that my days were numbered and that the grim reaper was following me. Fortunately I recently saw a cardiologist (Ep) for atrial flutter who took the time to explain that Ive got borderline mild/moderate heart failure and not to worry too much. I’m pleased that your appointment with the cardiologist went well and I’m considering going for a private consultation myself. It shouldn’t have to be like this and I really feel for the people who have been left in limbo.
Do take the private option if you can and want to. It cost me £220 and the next visit will be £140. After that he says he can put me on his NHS list for continuity. No idea where you live but I asked on here for recommendations, which people private messaged me about.
Thanks for prompting this thread of conversation Classicfan. I too had no idea that interpretation of echocardiograms could vary so much. I had one last December and I know the technician was new on the job -- can't remember how I knew. Perhaps he told me. Then two months later had a very disagreeable talk with the hospital cardiologist who, based on the echo, was intent on persuading me I was in a rather bad way and needed to take more medication.
He refused to believe anything I said to the contrary, including that not long before the echo I'd been in hospital with covid which might have affected the results, and seemed to have the view that I was difficult patient who was refusing treatment -- although it was me who asked for the echo as I felt I hadn't had a check for a long time. My GP wasn't worried.
After seeking advice from my GP and a private GP I decided not to take the new medication. I shall consider a private cardiologist now.
Hello I was told echo cardiograms are a bit hit and miss a little guess work goes into the final report. My cardiologist has always said that the MRI result are what he goes on for accuracy. My last one was 39 % and cardio said in his opinion it was pretty accurate !I was once having an Echo and the technician called in a supervisor it went something like this " I think it's around 50% and the supervisor said maybe, she then asked me what my EF was I said last one was 44% surprise surprise on the report it said 44%. Her closing remark to the technician was if in doubt ask the patient they tend to know" I do believe on the operation of the valves it is more accurate method to ascertain valve leakage.
Reminds me of those foetal heart monitors they hitch you up to on the Labour Ward. When the alarm goes off they always say it’s because the machine is faulty.
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