Factors to consider when referring for echocardiography

Echocardiography is a vital diagnostic tool for the investigation of cardiac disease.

Research Authors

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Summary

Echocardiography is a vital diagnostic tool for the investigation of cardiac disease. Essential information is gained from this non-invasive imaging modality about the size, shape and dynamic function of cardiac structures. The skill required to obtain appropriate scan data is immense. The scan is limited by the skill and experience level of the person obtaining the images and also the quality of the ultrasound machine used.

In the human medical field, the vast majority of echocardiograms are performed by cardiologists, as opposed to radiologists. At ARC we are lucky to have Dr Joon Seo, our cardiologist, on hand to perform our echocardiogram studies. The value that Dr Joon can add to an echo is not solely on how he positions the probe to perform the scan itself, but factors peripheral to the image attainment.

For example, whenever he does an echo he will first auscultate the patient, and he will run a concurrent ECG trace while scanning (a single lead ECG- not a full diagnostic one with multiple leads). His auscultation and ECG will help tune him in to the overall disease picture and may adjust how he goes about the scan and the images he obtains for measurements. To maximise the value of an echocardiogram as a tool, it is useful to have a cardiologist perform the scan. Combine echo with a cardiologist consultation, and you are giving the patient and client the best value by maximising leverage of a specialist’s experience, knowledge and skills when taking a history and performing a full physical examination.

We still offer outpatient echo scans at ARC (ie without a consultation), though at the discretion of our team, to ensure that the animal is sufficiently stable to be returned to the referring clinic. In case cost is a consideration when requesting an outpatient echo, it might be useful to highlight that the cost of the echo scan is reduced when done in conjunction with a cardiologist consult.

And that follow-up revisit scans, for evaluation of the same disease when under our cardiologist’s care, are done at a further reduced rate. This means that if 2 scans are performed (an initial scan and then a follow-up), then the cost for two outpatient echos is about the same as cardiology consultation and 2 cardiologist-performed scans. But think of all the added value that the cardiologist input represents?! Something to consider when thinking of the bigger picture for the patient and total treatment cost for an owner.

 

Echocardiography

Citation Reference

Cardiovascular imaging: who does it and how important is it to the practice of radiology? – PubMed (nih.gov)

A comparison of cardiologist and noncardiologist use of echocardiograms: implications for containing health care costs – PubMed (nih.gov)