What GP checks should I have post AVR?

[Coper10]

I had an AVR 2 years ago and get an annual CT scan to check that all is well. Medication wise - I am on bisoprolol, eplenerone, losartan, furosemide, colecalciferol and warfarin. My INR is monitored re the latter.

My query is what involvement, if any should I get from the GP? I have an annual telephone medication review but this seems to be a check that I know what the medication is for. I am not asked about my blood pressure and don't get any blood tests. Is there anything I should be aware of?

[Beta70]

You sound as though you are really doing well since your operation. Prior to lockdown I used to get annual MOTs from my GP where they took my blood pressure, did blood tests and weighed me. Not sure if this was because I was over 60 though. As I am on statins for high cholesterol and clopidogrel I ask for a blood test annually and they also test for vitamin deficiency and liver and kidney function and diabetes. But I have to ask for these to be done, they don't automatically send for me. They usually take my blood pressure too while I am there. If having these test would reassure you, then I would ask if they will do them explaining the reasons. You can now get your blood pressure checked in some ranches of Boots chemist if you make an appointment . Best wishes.

[Rosie1066]

I had an AVR some years ago. Do you get your Warfarin checked by your GP surgery or hospital? All I have is routine annual bloods at surgery and Warfarin checks almost weekly at my local hospital. I don’t get an annual check up or CT scan on the heart valve and I don’t routinely have any follow up by my GP but he is always there for me if I had any real problems, which I don’t.

[Coper10 in reply to Rosie1066]

My warfarin is checked at GP surgery. I also had my ascending aorta and root replaced along with the valve - think CT is to check all that is stable. I don't get offered any annual blood test but had read about the need to check bloods when on certain medication - so I wondered about other people's experience. Thanks for replying.

[Anon2023]

hi. I get called up once a year for “a long term condition” check with the nurse at my GP surgery. If I want blood tests I have to ask them and be assertive. I’m meant to have my kidney function monitored but if I didn’t ask, it wouldn’t happen. I would just look up the NICE. guidelines for your condition and medications and start reminding your GP of when you need tests. These days we really do need to advocate for ourselves as I fear the NHS is just too overwhelmed.

[Coper10 in reply to Anon2023]

Thanks for that, I hadn't thought of NICE guidelines. I am a little sceptical with my surgery - on my first medication review I was asked why I was taking Warfarin rather than a newer anti-coagulant. When I replied it was due to my mechanical valve the Gp said 'oh I didn't know you had a new heart valve'. He then asked why I was taking such a high level of Warfarin, to which I replied that the dose was determined by my INR! It didn't fill me with confidence. I had a feeling that with certain medications potassium levels etc should be checked but this has never been offered. Being proactive regarding my health is something I've learnt to be. I was curious about others' experiences. Thanks for your input 🙂

[Anon2023 in reply to Coper10]

sorry, I didn’t mean to sound like I was saying that you weren’t proactive. Like you, I’ve learnt the hard way that it’s easy to get forgotten by your GP if you aren’t persistent. X

[Jocastina]

My GP says I need annual kidney function tests (includes potassium level) because I'm on Candesartan (similar to Losartan) and Spironolactone, with additional tests if the dose is changed. They also say I need annual cholesterol tests because I'm on Atorvastatin too. I think with Losartan/Candesartan and Bisoprolol they're supposed to check blood pressure now and then too as both lower it. As well as Candesartan and Spironolactone I'm also on Bisoprolol, Lansoprazole, Aspirin, Atorvastatin and Warfarin (I have a mechanical mitral valve). My INR is monitored at the local hospital where I had my valve replaced, and I test it at home too. I also have an annual echo and check up at the valve clinic at the hospital. I contact the GP as needed and they are supposed to do the medication related checks as they are the ones managing my many prescriptions. I always contact them to arrange the tests - whether they would invite me if I didn't, I don't know, but like you, my experience over the years tells me that I always need to be in the driving seat with health admin and make sure that these things happen.

[Coper10 in reply to Jocastina]

Thank you so much. I had seen something about blood tests being needed when on certain medications but my GP has never offered. I will follow it up 🙂