When does the control ECHO examination is not needed?

Don't order follow up or serial echocardiograms for surveillance after a finding of trace valvular regurgitation on an initial echocardiogram.
Trace mitral, tricuspid and pulmonic regurgitation can be detected in 70% to 90% of normal individuals and has no adverse clinical implications. The clinical significance of a small amount of aortic regurgitation with an otherwise normal echocardiographic study is unknown.
Don't repeat echocardiograms in stable, asymptomatic patients with a murmur/click, where a previous exam revealed no significant pathology.
Repeat imaging to address the same question, when no pathology has been previously found and there has been no clinical change in the patient's condition, is not indicated.
Avoid echocardiograms for preoperative/perioperative assessment of patients with no history or symptoms of heart disease.
Perioperative echocardiography is used to clarify signs or symptoms of cardiovascular disease, or to investigate abnormal heart tests. Resting left ventricular (LV) function is not a consistent predictor of perioperative ischemic events; even reduced LV systolic function has poor predictive value for perioperative cardiac events.
Avoid using stress echocardiograms on asymptomatic patients who meet "low risk" scoring criteria for coronary disease.
Stress echocardiography is mostly used in symptomatic patients to assist in the diagnosis of obstructive coronary artery disease. There is very little information on using stress echocardiography in asymptomatic individuals for the purposes of cardiovascular risk assessment, as a stand-alone test or in addition to conventional risk factors.
Avoid transesophageal echocardiography (TEE) to detect cardiac sources of embolization if a source has been identified and patient management will not change.
Tests whose results will not alter management should not be ordered. Protocol-driven testing can be useful if it serves as a reminder not to omit a test or procedure, but should always be individualized to the particular patient. While TEE is safe, even the small degree of risk associated with a procedure is not justified if there is no expected clinical benefit.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

As the largest global organization for cardiovascular ultrasound imaging, the American Society of Echocardiography (ASE) is the leader and advocate, setting clinical standards and guidelines with a commitment to improving the practice for better patient outcomes. ASE is devoted to ensuring patient access to excellence in the practice of Echocardiography around the world. Echocardiography provides an exceptional view of the cardiovascular system to safely and cost-effectively enhance patient care. Full text of ASE's guidelines is available at www.asecho.org/guidelines.

For more information about ASE, visit www.asecho.org. For patient-specific information on the practice of echocardiography, visit www.SeeMyHeart.org.

Sources

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