If your aortic valve stenosis is severe, as determined by an echocardiogram, your primary care physician or general cardiologist should refer you for a structural heart evaluation, says Gilbert Hin-Lung Tang, MD, the surgical and academic director of the structural heart program at the Mount Sinai Health System in New York City. “The issue is that severity can be underestimated or overestimated, because echo reports vary widely depending on how the images are acquired and measurements are made,” he says, adding that you may have severe disease even if an echocardiogram suggests otherwise.
In this case, you may want to ask for a second opinion. “And if a patient is having symptoms, it should also be evaluated by a structural heart specialist,” Dr. Eleid says. “I think patients should advocate for themselves.” Know that seeking a second opinion or requesting a consultation with a specialist is common, and your healthcare provider may even encourage you to do so.
Before requesting a referral, prepare a timeline of your symptoms if you’re experiencing any, noting when they started, how they’ve changed, and what makes them better or worse. Be ready to explain what prompted the visit and why you’re seeking specialized care.
If the idea of bringing this topic up with your provider feels uncomfortable, consider sending a message through your patient portal first, explaining your concerns and noting that you’d like to discuss a referral or second opinion. They will likely ask to set up an in-person or telehealth visit to answer your questions before giving you a referral. For this visit, consider bringing a loved one with you to provide emotional support.
There are other ways to find a specialist on your own, such as asking family or friends for recommendations, connecting with patient advocacy groups, searching through online directories, contacting nearby medical centers or hospitals, or checking with your insurance provider. Also note that depending on your specific insurance plan, you may be able to reach out to a specialist directly, without a referral.
“Nowadays, most people have a lot of information available on the internet and can research on their own, so they have the freedom to do that,” Dr. Tang says. “If they want a second opinion, especially in a more underserved or remote area, there are always options to do a telehealth visit or other means to get more information.”
