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Questionable Echocardiogram report - Ever have this something like this???

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slipkid

Well-known member
Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
My medical history is in 2014 I had major heart attack, emergency open heart surgery, double bypass, AVR replacement (mechanical On-X), + last Fall my prior cardiologist detected a blockage in routine nuclear stress test, did a cardiac cath, & put a stent in to open another artery.

I got a new cardiologist this year (long story with what happened with the last one which I will not bore you with at this point).

My first visit with new cardio Dr was over the phone earlier this year as an introductory visit, then had an in person visit 1st week in July.

New cardio Dr. wanted to do an echocardiogram to check on my heart after the stent (had not had that done yet, sounded like a good idea). I was going to get it done around here closer to where I live/more convenient but he recommended that they do it in his office instead because that way he said will read the results himself rather than have to rely on a different Dr to interpret the data.

So I hung out (went to lunch actually & came back) and had it done in his office, they squeezed me in that afternoon. Dr told me that regardless of the echo result he wanted to see me again in October, and probably have a nuclear stress test as further followup after that visit.

Next morning someone in his office called and told me that the result was "no change since last echo in 2015". Good news I guess but was not sure.

I was not given a copy of the report or any other details. I was curious if my ejection fraction had improved because prior to the stent last Fall it had dropped from 55% down to around 45%. Wondered if it had recovered any after the blockage was lessened.

I had to see my PCP the very next day so I mentioned to him then that I just had an echo done but was not given any details other than "no change since 2015" etc etc. So he pulled up the report & printed me out a copy, and we went over that ourselves. First thing was good news, according to that my ejection fraction went up to 60%!!! WOW! Did not think that was even possible,

But then I noticed multiple things that had me scratching my head which I pointed out to the PCP. It appears that this report may not even be for me or at very least has incorrect data in it from God knows where!

In the section of the report with the heading of AORTIC VALVE it says this:

- The aortic valve is tri-leaflet
- The valve is calcified with restriction of motion
- The aortic valve has moderate stenosis and mild regurgitation
- The peak gradient is 44mm HG and the mean gradient is 24mm

It then goes on to say other things etc etc etc etc.

Right away I spotted that the first 3 points above make no sense, at least not to me.:

- My aortic valve is most certainly NOT "tril-leaflet". It is a mechanical valve with 2 swinging doors. And my original valve which I do not even have any more was only bicuspid in the first place. Why does the report say it is tricuspid???

- My aortic valve is mechanical. I asked my PCP - can it even GET cholesterol deposits (isn't it engineered NOT TO?) and if it can how can it calcify in ONLY 5 YEARS (to which he had no answer)?

- Plus - how could the valve have STENOSIS (not open properly)????? WOULDN'T THAT BE BIG DEAL FOR A MECHANICAL VALVE??? That would mean the valve itself has some kind of defect, maybe it is friggin' BROKEN????

The PCP agreed with me that things in the report did not add up and said I should discuss it with the cardiologist. I asked him to please bring it up with him as a Dr instead of me because of all the bad past experiences I have had with Drs who do not like patients pointing out problems/errors/etc to them. So he said he would do that.

Additionally I noticed that the name of the Dr who read the echo and produced the report is someone I never heard of; it was NOT the cardiologist who told me to have it done at his office because that way HE will be the one to read it! Instead it is probably just someone on staff in radiology (??). So that to me is a strike against this new cardiologist right there (he told me to have the test there since that way he will be the one to read the data, yet he doesn't).

Fast fwd to about 2 weeks ago, I had to see the PCP again, without all the details why will just say that the PCP is suspecting some new heart probs, wants me to get nuclear stress test NOW rather than wait and wants me to see the new cardio Dr now rather than wait until my appt in October. I asked him what happened when he talked to my new cardiologist about the questionable echo test as per our last visit. He gave me a blank stare. He completely 4got about the echo report problems that we talked about the previous month. And this is a Dr I actually like and have faith in. Sigh. So I explained it to him again, we talked about it etc. He said he would look into it and I said I was going to do some research as well, and bring it up to the cardiologist myself in case he didn't have time.

So I reached out to On-X for some answers. In the past they helped me greatly clear up and clarify some things which my previous cardiologist & his staff were clueless about. I spoke with someone there very knowledgeable and helpful and he confirmed that my suspicions about the report being fishy were correct, the valve is NOT trileaflet, it cannot get cholesterol deposits or calcify (it is inert), makes no sense to say the valve has stenosis etc etc. Additionally he also pointed out that the info in the last point I cited above (peak gradient 44 and mean gradient 24) did not sound right either (my particular valve should have around a 14mm pressure gradient).

So I contacted my PCP and let him know what On-X said and he reacted in a way which I very much appreciated, which was something like "What utter garbage!!! I am going to contact Dr X (cardiologist) right away and bring all this to his attention, and tell him that they owe you a new echo at their expense!!!". Over a week later I asked how that went (I am seeing the cardio Dr next week) and the PCP told me that he left emails for him but he never responded! But that he would try calling him. I asked him to let me know what the result is. Of course I have heard nothing back though.

I understand that Drs are busy. Stretched beyond what they should be expected to do with insurance companies, big healthcare conglomerates making them see 5 patients more an hour than they have time for, get caught up in emergencies/whatever. But that is NOT MY PROBLEM. I've been through all kinds of things like this in the past as well,& this is nothing (heck one Dr KILLED my best friend because they didn't know what they were doing). So this pales in comparison. But sheesh, I find this whole thing so wrong; and cannot trust ANYTHING now in this report at all.....what am I paying the DRs for? How can I trust them to make life/death decisions when they can't even get an echo report right??

Anyone have something like this happen to them? What did you do, or would you do, in this situation?? Sorry to ramble on, I actually left out some things, but thought if nothing else some of you might find this entertaining.
 

Warrick

Well-known member
Joined
Dec 27, 2015
Messages
612
Location
New Zealand
Really sounds like the report they gave you belongs to someone else (perhaps they got your report and are scratching their head wondering how they’ve got a bileaflet mechanical valve...).
Here in NZ an echo is free under the public health system, but if I want one in between my 4 year checkups I can pay myself which I have done before and cost around $450 NZD,
Certainly amusing but not in a good way.
 

carolinemc

Well-known member
Joined
May 31, 2010
Messages
820
Location
kansas city, mo
My medical history is in 2014 I had major heart attack, emergency open heart surgery, double bypass, AVR replacement (mechanical On-X), + last Fall my prior cardiologist detected a blockage in routine nuclear stress test, did a cardiac cath, & put a stent in to open another artery.

I got a new cardiologist this year (long story with what happened with the last one which I will not bore you with at this point).

My first visit with new cardio Dr was over the phone earlier this year as an introductory visit, then had an in person visit 1st week in July.

New cardio Dr. wanted to do an echocardiogram to check on my heart after the stent (had not had that done yet, sounded like a good idea). I was going to get it done around here closer to where I live/more convenient but he recommended that they do it in his office instead because that way he said will read the results himself rather than have to rely on a different Dr to interpret the data.

So I hung out (went to lunch actually & came back) and had it done in his office, they squeezed me in that afternoon. Dr told me that regardless of the echo result he wanted to see me again in October, and probably have a nuclear stress test as further followup after that visit.

Next morning someone in his office called and told me that the result was "no change since last echo in 2015". Good news I guess but was not sure.

I was not given a copy of the report or any other details. I was curious if my ejection fraction had improved because prior to the stent last Fall it had dropped from 55% down to around 45%. Wondered if it had recovered any after the blockage was lessened.

I had to see my PCP the very next day so I mentioned to him then that I just had an echo done but was not given any details other than "no change since 2015" etc etc. So he pulled up the report & printed me out a copy, and we went over that ourselves. First thing was good news, according to that my ejection fraction went up to 60%!!! WOW! Did not think that was even possible,

But then I noticed multiple things that had me scratching my head which I pointed out to the PCP. It appears that this report may not even be for me or at very least has incorrect data in it from God knows where!

In the section of the report with the heading of AORTIC VALVE it says this:

- The aortic valve is tri-leaflet
- The valve is calcified with restriction of motion
- The aortic valve has moderate stenosis and mild regurgitation
- The peak gradient is 44mm HG and the mean gradient is 24mm

It then goes on to say other things etc etc etc etc.

Right away I spotted that the first 3 points above make no sense, at least not to me.:

- My aortic valve is most certainly NOT "tril-leaflet". It is a mechanical valve with 2 swinging doors. And my original valve which I do not even have any more was only bicuspid in the first place. Why does the report say it is tricuspid???

- My aortic valve is mechanical. I asked my PCP - can it even GET cholesterol deposits (isn't it engineered NOT TO?) and if it can how can it calcify in ONLY 5 YEARS (to which he had no answer)?

- Plus - how could the valve have STENOSIS (not open properly)????? WOULDN'T THAT BE BIG DEAL FOR A MECHANICAL VALVE??? That would mean the valve itself has some kind of defect, maybe it is friggin' BROKEN????

The PCP agreed with me that things in the report did not add up and said I should discuss it with the cardiologist. I asked him to please bring it up with him as a Dr instead of me because of all the bad past experiences I have had with Drs who do not like patients pointing out problems/errors/etc to them. So he said he would do that.

Additionally I noticed that the name of the Dr who read the echo and produced the report is someone I never heard of; it was NOT the cardiologist who told me to have it done at his office because that way HE will be the one to read it! Instead it is probably just someone on staff in radiology (??). So that to me is a strike against this new cardiologist right there (he told me to have the test there since that way he will be the one to read the data, yet he doesn't).

Fast fwd to about 2 weeks ago, I had to see the PCP again, without all the details why will just say that the PCP is suspecting some new heart probs, wants me to get nuclear stress test NOW rather than wait and wants me to see the new cardio Dr now rather than wait until my appt in October. I asked him what happened when he talked to my new cardiologist about the questionable echo test as per our last visit. He gave me a blank stare. He completely 4got about the echo report problems that we talked about the previous month. And this is a Dr I actually like and have faith in. Sigh. So I explained it to him again, we talked about it etc. He said he would look into it and I said I was going to do some research as well, and bring it up to the cardiologist myself in case he didn't have time.

So I reached out to On-X for some answers. In the past they helped me greatly clear up and clarify some things which my previous cardiologist & his staff were clueless about. I spoke with someone there very knowledgeable and helpful and he confirmed that my suspicions about the report being fishy were correct, the valve is NOT trileaflet, it cannot get cholesterol deposits or calcify (it is inert), makes no sense to say the valve has stenosis etc etc. Additionally he also pointed out that the info in the last point I cited above (peak gradient 44 and mean gradient 24) did not sound right either (my particular valve should have around a 14mm pressure gradient).

So I contacted my PCP and let him know what On-X said and he reacted in a way which I very much appreciated, which was something like "What utter garbage!!! I am going to contact Dr X (cardiologist) right away and bring all this to his attention, and tell him that they owe you a new echo at their expense!!!". Over a week later I asked how that went (I am seeing the cardio Dr next week) and the PCP told me that he left emails for him but he never responded! But that he would try calling him. I asked him to let me know what the result is. Of course I have heard nothing back though.

I understand that Drs are busy. Stretched beyond what they should be expected to do with insurance companies, big healthcare conglomerates making them see 5 patients more an hour than they have time for, get caught up in emergencies/whatever. But that is NOT MY PROBLEM. I've been through all kinds of things like this in the past as well,& this is nothing (heck one Dr KILLED my best friend because they didn't know what they were doing). So this pales in comparison. But sheesh, I find this whole thing so wrong; and cannot trust ANYTHING now in this report at all.....what am I paying the DRs for? How can I trust them to make life/death decisions when they can't even get an echo report right??

Anyone have something like this happen to them? What did you do, or would you do, in this situation?? Sorry to ramble on, I actually left out some things, but thought if nothing else some of you might find this entertaining.
A tri leaflet is the type of valve they put in, mine is different than your leaflet, it is a St. Judes' leaflet. And that calcification does sound strange, for the types you and I have do not calcify at all. Thank goodness you have a great GP to know what to look for and is informed on the Cardiac side. Sounds like you have a Osteopathic doctor, for they get schooling on everything known to man and then some.
Let me tell you what happened to me. A so called Heart Specialist told me, as he was taking my blood pressure and not knowing how to read the BP, told me that my BP was extremely high. Well he prescribed BP meds and said my BP was 500? I thought 500 over what, as my BP was rising as he talking utter nonsense. I have never had a Cardio take my BP. Called my CP and we had me going to her office a few times and was not taking the BP meds yet. GP said my BP was normal and to trash the BP meds. So we all have had weird experiences. And nope, I never went back to that quack fake Cardio.
 

charlottekaye

Well-known member
Joined
Apr 4, 2012
Messages
46
Location
georgia
A tri leaflet is the type of valve they put in, mine is different than your leaflet, it is a St. Judes' leaflet. And that calcification does sound strange, for the types you and I have do not calcify at all. Thank goodness you have a great GP to know what to look for and is informed on the Cardiac side. Sounds like you have a Osteopathic doctor, for they get schooling on everything known to man and then some.
Let me tell you what happened to me. A so called Heart Specialist told me, as he was taking my blood pressure and not knowing how to read the BP, told me that my BP was extremely high. Well he prescribed BP meds and said my BP was 500? I thought 500 over what, as my BP was rising as he talking utter nonsense. I have never had a Cardio take my BP. Called my CP and we had me going to her office a few times and was not taking the BP meds yet. GP said my BP was normal and to trash the BP meds. So we all have had weird experiences. And nope, I never went back to that quack fake Cardio.
Did you report the quack fake cardio?
 

AZ Don

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Joined
Apr 23, 2013
Messages
697
Location
Phoenix, AZ
I would call the Dr's office, ask to speak to the Dr or assistant and ask the Dr to call you back because the echo does not make sense. If they can't/won't fix this quickly I would look for another Cardio. If you can't have an open and honest discussion with this Dr, then he is not the right Dr for you.

I have not had anything like that happen to me, but three Dr's read the report that first identified my aortic aneurysm, and they all said there were no significant issues. I actually read the report, found an appropriate Dr and had surgery 2 months later.
 

dornole

Well-known member
Joined
Jan 5, 2014
Messages
713
Location
Minnesota, US
Errors do occur, it definitely sounds like your PCP got the wrong report. Whether or not that is the same one your cardiologist looked at doesn’t seem clear. I would start over and directly call the cardio office and ask for your echo results (you don’t have an electronic health record you can access?) and if they are for a trileaflet valve still, follow up with the nurse and say these can’t be my results.
 

slipkid

Well-known member
Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
4got to say that my NAME, birthdate, all that stuff IS on my report, and it even mentions my history with AVR on the first page.

Yet the actual data makes no sense.

I have had other issues in the past with nonsensical reports, for instance with both of the nuclear stress tests that I have had each of them had a final line in them of something like "study terminated because patient was unable to continue", even though both times I did every single thing they asked and the tests continued to until THEY said they were done. It's like whoever writes these things uses some kind of template and 4gets to change the appropriate parts.

Anyways, thx for the comments, guess I will find out more about the garbage echo when I see the cardiologist on Wednesday this week. Am hoping he is a decent Dr that actually listens to patients and is willing to correct wrongs on his part, as opposed to the numerous full of themselves Drs I have encountered several times in the past who feel that patients should be seen and not heard, and resent any questions whatsoever etc.
 

slipkid

Well-known member
Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
Errors do occur, it definitely sounds like your PCP got the wrong report. Whether or not that is the same one your cardiologist looked at doesn’t seem clear. I would start over and directly call the cardio office and ask for your echo results (you don’t have an electronic health record you can access?) and if they are for a trileaflet valve still, follow up with the nurse and say these can’t be my results.
The report was for me, had my name & info on it along with all the other data, and came from the cardiologist office. So the cardiologist had to have seen all this - assuming he even looked at it all that is.

I have no electronic access to any reports from this cardiologist's office btw.
 

carolinemc

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Joined
May 31, 2010
Messages
820
Location
kansas city, mo
The report was for me, had my name & info on it along with all the other data, and came from the cardiologist office. So the cardiologist had to have seen all this - assuming he even looked at it all that is.

I have no electronic access to any reports from this cardiologist's office btw.
Do you have a home computer or laptop? That is your access, just ask for a link, if you have a computer. Even a smart phone has internet access. I pray that you will see about getting another Cardio. Seems they are not very forthcoming with information. And report them also, for you have the right to medical reports, Patient rights.
 

slipkid

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Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
Do you have a home computer or laptop? That is your access, just ask for a link, if you have a computer. Even a smart phone has internet access. I pray that you will see about getting another Cardio. Seems they are not very forthcoming with information. And report them also, for you have the right to medical reports, Patient rights.
Of course I have a home computer. This cardio group has not yet mentioned anything to me about having any sort of electronic system available to their patients. My PCP has that but honestly it is missing much info & far from perfect. My previous cardiologist group had a system which they supposedly setup an account for me but it didn't even work so I gave up btw....

This is already my 2nd cardiologist & only just started with his practice. I need to try to work with him b4 trying a third or I will lose my PCP as well & be branded as a major pain in the ass. Will find out more tomorrow in my visit with him (other things are going on, just had a nuclear stress test today),

Btw, yet another weird record issue came up today. Way more to this story making it even worse which I will not go into, but I showed up for the test and one of the first things that happened is the two nurses there are going over my history etc and according to their printed report I just had an ECHO STRESS TEST done last month. I had to tell them that was WRONG, it was a REGULAR ECHO (and that there was much in that that did not even make sense). They acted at first like I was just a confused dumb patient. I had to try to EXPLAIN/PROVE to them that their record was wrong. Also according to the info they had they did not even know that I am on plavix as well as warfarin. Yeah, like I said above I need to try to work with this cardio group but seems like they do not have a clue what they are doing, but that has been 100% par for the course with almost any Dr's office I have ever had experience with,
 

tom in MO

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Joined
Jan 17, 2012
Messages
1,442
Location
MO USA
I've had errors in my medical records, but none as severe as yours. You may want to check with your medical insurance company to make sure that someone isn't using your identity or social security number to perpetrate insurance fraud.
 

slipkid

Well-known member
Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
I've had errors in my medical records, but none as severe as yours. You may want to check with your medical insurance company to make sure that someone isn't using your identity or social security number to perpetrate insurance fraud.
It was just a lazy bogus report, with sections from a template that were either not updated like they should have been (or copied in by mistake). Discussed with the (new) cardiologist today. He said he had not even read it himself, that he had only looked over the raw data with his own eyes. He promised to have a word with the Dr that created the report but in judging from a few other things that happened both yesterday at my stress test and today in his office I doubt that will happen, seems like they are seeing way too many patients to keep things straight or have the time to deal with this sort of thing. Not good in my eyes but am stuck with him at the moment.
 

slipkid

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Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
It's like we need to keep our own personal med records & have a PCP in the room with us if we are in the hospital or @specialist...
More than that even. Anyone that just takes Drs at their word is a fool. You need to constantly stay on top of your care and take an active roll, try to understand what they are saying and ask intelligent questions. Everytime I haven't I have been burned in one way or another. Of course to some Drs that just makes you a "problem patient" which they feel is a license to then treat you with disdain and ignore anything you say or ask. Don't get me started, I could go on and on and on and on and on....
 

slipkid

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Joined
Jun 12, 2014
Messages
186
Location
Schwenksville, PA, USA
You need to constantly stay on top of your care and take an active roll...
Just happened to reread my post above and that line made me laugh. Of course I meant the word "role" but must have had a brainfart while typing and wrote "roll" instead.

Although bread can be yummy I don't think you need to bring any with you when seeing the doctors. :)
 

charlottekaye

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Joined
Apr 4, 2012
Messages
46
Location
georgia
Of course I have a home computer. This cardio group has not yet mentioned anything to me about having any sort of electronic system available to their patients. My PCP has that but honestly it is missing much info & far from perfect. My previous cardiologist group had a system which they supposedly setup an account for me but it didn't even work so I gave up btw....

This is already my 2nd cardiologist & only just started with his practice. I need to try to work with him b4 trying a third or I will lose my PCP as well & be branded as a major pain in the ass. Will find out more tomorrow in my visit with him (other things are going on, just had a nuclear stress test today),

Btw, yet another weird record issue came up today. Way more to this story making it even worse which I will not go into, but I showed up for the test and one of the first things that happened is the two nurses there are going over my history etc and according to their printed report I just had an ECHO STRESS TEST done last month. I had to tell them that was WRONG, it was a REGULAR ECHO (and that there was much in that that did not even make sense). They acted at first like I was just a confused dumb patient. I had to try to EXPLAIN/PROVE to them that their record was wrong. Also according to the info they had they did not even know that I am on plavix as well as warfarin. Yeah, like I said above I need to try to work with this cardio group but seems like they do not have a clue what they are doing, but that has been 100% par for the course with almost any Dr's office I have ever had experience with,
Could it be they want to charge for the more expensive test?
 

Warrick

Well-known member
Joined
Dec 27, 2015
Messages
612
Location
New Zealand
“ Anyone that just takes Drs at their word is a fool.”
Hear hear!!
I was with my father at his doctors today and he asked him wether he had a tissue or mechanical valve.. hes only been his doctor for the last 20yrs...
 

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