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My Cardiologist Doesn't Want To Give Me Another Echo. I Had One In February And I Want To Know If My Pressure Has Gone Down. Am I Being Unr
Doctors also use an echo to look for changes in the heart structure and not just to estimate the pulmonary pressure. For example: are the right atrium and ventricle enlarged, are the walls of them thickened or is their a pericardial effusion (swelling around the heart).
I would assume that some doctors order echos more often when they know the heart has issues and they want to monitor those changes. You might consider asking them, why they don’t feel one is necessary. Start a conversation with the doctor. It may put you and the doctor more at ease and remind everyone you are a team and you need to work together. While they know the science and the human body, you know yourself and have to live with the disease everyday.
It’s your health and it’s never unreasonable to advocate for yourself. If you are not completely comfortable and confident in your health care team, then it’s not unreasonable to seek out a new team that will make you comfortable and confident with your treatment plan.
My local cardiologist tells me that my PAH is so rare and she doesn’t have enough experience. She knows her job is just in case of emergencies. She lets my PH specialist take care of most of my care, but still sees me yearlly. I assume in an emergency, any doctors would be calling my PH center. That’s why the PH center oncall doctor’s phone number is on my wallet card, which is referenced on my medical ID bracelet.
You might consider a PH specialist. To find one look on the pulmonary hypertension association website. I’ve linked it:
https://phassociation.org/patients/doctorswhotr...
Good luck.
They tell me I need one every 6 months and a RHC 1 a year.
If you are controlled with meds and no severe or increased shortness of breath or BP changes, a lot of insurance companies will only cover an echo once a year.
Hi @A myPHteam Member it is kind off hard when you are not entirely sure what is going on. My first echo was 41 (May 2023), My cardiologist repeated it in July (I think) and it was down to 27 (he also started off label meds, Amlodipine, which did help). Then I had a TIA in September, so the hospital repeated it and it was 17, but showed a shunt, so they repeated it with my next TIA in Jan 2024, but this one did not show any pressure. It was negative for shunt, so they repeated 2 weeks later (to confirm negative for shunt - it was) and again it did not show any pressure. Then I had a stroke in June and they took it again at the hospital and the pressure was 25-30. But now my symptoms of shortness of breath improved significantly. They also had to stop the Amlodipine in June, because my BP when from high to very low, but I am doing a lot better... I do not fully understand where I am with PH, but I do trust my cardiologist and that he will order another echo or RHC if he feels it necessary. My cardiologist does have experience with PH, so I feel I can trust him. If you feel uncomfortable with your cardiologist, then it may be a good idea to get a second opinion. Also make sure your doctor knows about PH. It is very hard not to panic after the first echo, but it is a bit of a process to get diagnosed and it can still turn out to be technician error. Sometimes insurance dictate how often a provider can order an echo, so that may also be the reason why he is waiting. Hang in there and do not give up on getting clearer answers, just want to let you know, for me its a slow process and I am still unsure if I have PH at this stage, but it does appear to be mild if I have it.
Hi @A myPHteam Member it is kind off hard when you are not entirely sure what is going on. My first echo was 41 (May 2023), My cardiologist repeated it in July (I think) and it was down to 27 (he also started off label meds, Amlodipine, which did help). Then I had a TIA in September, so the hospital repeated it and it was 17, but showed a shunt, so they repeated it with my next TIA in Jan 2024, but this one did not show any pressure. It was negative for shunt, so they repeated 2 weeks later (to confirm negative for shunt - it was) and again it did not show any pressure. Then I had a stroke in June and they took it again at the hospital and the pressure was 25-30. But now my symptoms of shortness of breath improved significantly. They also had to stop the Amlodipine in June, because my BP when from high to very low, but I am doing a lot better... I do not fully understand where I am with PH, but I do trust my cardiologist and that he will order another echo or RHC if he feels it necessary. My cardiologist does have experience with PH, so I feel I can trust him. If you feel uncomfortable with your cardiologist, then it may be a good idea to get a second opinion. Also make sure your doctor knows about PH. It is very hard not to panic after the first echo, but it is a bit of a process to get diagnosed and it can still turn out to be technician error. Sometimes insurance dictate how often a provider can order an echo, so that may also be the reason why he is waiting. Hang in there and do not give up on getting clearer answers, just want to let you know, for me its a slow process and I am still unsure if I have PH at this stage, but it does appear to be mild if I have it.
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