Do you take the full echocardiogram test with imaging, treadmill?

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Carnelian

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Jul 29, 2017
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55
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midwest US
Four years after my double bipass and valve replacement, my doctor ordered this "deluxe" echo test. I have no symptoms of new
heart trouble. With my BlueCross, it is $250. or 10% of total. I wonder, why did I need this?
(It was normal.) Usually tests are $50.00.
I don't want to take unnecessary tests. Do you still do them? I might not take any more.
 

Chuck C

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Joined
Dec 5, 2020
Messages
1,149
Four years after my double bipass and valve replacement, my doctor ordered this "deluxe" echo test. I have no symptoms of new
heart trouble. With my BlueCross, it is $250. or 10% of total. I wonder, why did I need this?
(It was normal.) Usually tests are $50.00.
I don't want to take unnecessary tests. Do you still do them? I might not take any more.
Hi Carnelian.

Most of my echos have been standard echos, but when my aortic stenosis was first diagnosed with a normal echo, my cardiologist ordered a stress echo, which involved a Bruce Protocal treadmill stress test and an echo.
So, I did ask some questions and this is what I was told for my own situation. He indicated that he was specifically looking for my blood pressure response to exercise. Blood pressure is supposed to rise gradually with increasing exercise. But with aortic stenosis, particularly advanced, blood pressure will sometimes drop with exercise, which can lead to syncope (fainting), which might be an indication for surgery. As it turned out, my blood pressure rose gradually with increasing stress, as it is supposed to.

Also, the tech who conducted the echo explained to me that with the increased work load on the heart with exertion, they are better able to evaluate diastolic function- does the heart show the flexibility with expansion(during filling) and contraction as expected, or is there rigidity, which could be an indicator of diastolic dysfunction. I had mild left ventricular hypertrophy, and as this progresses, often the ventricular walls do not have the flexibility with expansion that they should have.
 

cldlhd

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Joined
Apr 9, 2014
Messages
1,686
Location
Levittown ,Pa 19054
Four years after my double bipass and valve replacement, my doctor ordered this "deluxe" echo test. I have no symptoms of new
heart trouble. With my BlueCross, it is $250. or 10% of total. I wonder, why did I need this?
(It was normal.) Usually tests are $50.00.
I don't want to take unnecessary tests. Do you still do them? I might not take any more.
The last echo I had was a stress test echo and I've never had a bypass or stent or any signs of stenosis. I have a BAV and I had an ascending aortic aneurysm until 2015 when I had it replaced with a graft. I was glad to get it because apparently you get a better indication of what's going on with it and the results came back well regarding my blood pressure and with exercise my heart rate never got as high as predicted so I guess that means it was working well. I guess also with my insurance it then it cost me any more than a regular echo so there is that. If it was me depending on your financial situation I would ask a cardiologist why and I would be okay with paying the extra money if it was a better test.
 

carolinemc

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Joined
May 31, 2010
Messages
964
Location
kansas city, mo
Four years after my double bipass and valve replacement, my doctor ordered this "deluxe" echo test. I have no symptoms of new
heart trouble. With my BlueCross, it is $250. or 10% of total. I wonder, why did I need this?
(It was normal.) Usually tests are $50.00.
I don't want to take unnecessary tests. Do you still do them? I might not take any more.
It is to get a better picture of your heart and valves by doing this. It is easier than going through cardiac cath. it is to see if surgery is warranted. I would do it to make sure everything is fine. Medical Tech is better than it was 20 years ago. Medical tech has much improved over time, which has taken years to make it better for us patients. Pay the extra to use caution. Better than just having surgery and may have many more unneeded bypasses.
 

carolinemc

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Joined
May 31, 2010
Messages
964
Location
kansas city, mo
Hi Carnelian.

Most of my echos have been standard echos, but when my aortic stenosis was first diagnosed with a normal echo, my cardiologist ordered a stress echo, which involved a Bruce Protocal treadmill stress test and an echo.
So, I did ask some questions and this is what I was told for my own situation. He indicated that he was specifically looking for my blood pressure response to exercise. Blood pressure is supposed to rise gradually with increasing exercise. But with aortic stenosis, particularly advanced, blood pressure will sometimes drop with exercise, which can lead to syncope (fainting), which might be an indication for surgery. As it turned out, my blood pressure rose gradually with increasing stress, as it is supposed to.

Also, the tech who conducted the echo explained to me that with the increased work load on the heart with exertion, they are better able to evaluate diastolic function- does the heart show the flexibility with expansion(during filling) and contraction as expected, or is there rigidity, which could be an indicator of diastolic dysfunction. I had mild left ventricular hypertrophy, and as this progresses, often the ventricular walls do not have the flexibility with expansion that they should have.
You would not believe the stress echo was given, no tread mill, just laying on the table while given the med to stimulate CHF(Congestive Heart Failure) I liked this one much better. I was told I was having a irregular heartbeat and they needed a closer look. Found out they decided to just monitor the heartbeat. WOW!
 

cldlhd

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Joined
Apr 9, 2014
Messages
1,686
Location
Levittown ,Pa 19054
You would not believe the stress echo was given, no tread mill, just laying on the table while given the med to stimulate CHF(Congestive Heart Failure) I liked this one much better. I was told I was having a irregular heartbeat and they needed a closer look. Found out they decided to just monitor the heartbeat. WOW!
I had that one before it also, I believe it's called a nuclear stress test? I had that back before I had my surgery but I prefer the treadmill on that I had a year and a half ago. I also had a cardiac cath before the surgery and everything came back clear so I was happy about that of course. My cardiologist told me that the stress echo was a kind of roundabout way of figuring out how well the arteries were flowing blood to different areas of the heart.
 

carolinemc

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Joined
May 31, 2010
Messages
964
Location
kansas city, mo
I had that one before it also, I believe it's called a nuclear stress test? I had that back before I had my surgery but I prefer the treadmill on that I had a year and a half ago. I also had a cardiac cath before the surgery and everything came back clear so I was happy about that of course. My cardiologist told me that the stress echo was a kind of roundabout way of figuring out how well the arteries were flowing blood to different areas of the heart.
I had that twice, hated it both time. especially when they got to the med to stimulate CHF. Hated it. But what I got recently was not Nuclear Stress Test. I was not sitting, I was on the table and they did an echo with the med. I had the Cath and made everyone laugh when they said the arteries were clear.
 

dwhist

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Joined
Dec 30, 2011
Messages
149
Location
Elmhurst, IL
I think I have had 4 Nuclear Stress tests. I believe it works by getting a picture of heart at rest and then when you reach peak heart rate, they inject with a dye. Next pictures taken show any areas of heart not getting blood flow.

Last one I had was in 2018. At end of test 2 nurses left and came back a few minutes later. Was told they needed to confirm with cardiologist it was ok for me to leave. Next morning got a call from my cardiologist's nurse, he was out of town but received report and I was to stop all exercise and head to hospital if any chest pain. Next week we talked and he said it showed blockage and I was scheduled for a cardiac cath. He told me to bring an overnight bag as at minimum I was getting a stent with possibility of bypass surgery. Had the cath with them go in both the wrist and groin. Doc who did the procedure came into room when I woke up and said my arteries were better than the last cath 8 years ago and I was not in danger of any heart attack. Glad I had insurance that paid for all of it.
 

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