Is it necessary to take an ECG when BNP value is high?

Hello doctor,

My 72- year- old wife was diagnosed with permanent atrial fibrillation about eight years back. She had one echocardiogram four years ago, which showed mild chamber enlargement with normal ventricular function. I hope doctors will catch CHF or indications of remodeling or valvular issues while she is asymptomatic. Her BNP, three weeks ago, was 167 pg/mL. Would it be reasonable, medically necessary, or imperative for an echocardiogram to be ordered now? She is being rate controlled with 360 mg Diltiazem ER every day. In addition, she takes Sinemet, Levothyroxine, Quetiapine, Rasagiline, Apixaban, and Donepezil. Thank you.

Hello doctor,

Thank you for the reply. We finally got a new echocardiogram. The most urgent query is who (what subspecialty of doctor) should I take my wife to now that we see LVEF 41%, PH>33 mm HG, and LA volume of about 130 ml? Does that seem to be HFrEF? Is the 41% any less significant than if we saw 41% HFpEF? The image quality of the report taken three years back is not good, so please let me know if you can read it. I will upload that first. They found one from a five-year report, but it does not have data, just conclusions. There are three images done six years back. Thank. you.

Hi,

Thank you for the reply. Your understanding of the meaning of permanent AF provides me with a new and beneficial perspective. More studies have been done on percutaneous ablation in the last two years, so that I will revisit the issue. My query was prematurely sent before I had a chance to complete my communication or upload the echo image files I have. May I, please, submit the three echo reports and expand the inquiry to you? Thank you.