The Best Heart Checkup In Thailand Or Asia?

[advancebooking]

I've just had an Echo cardiogram done at a hospital here in KL and a few issues have been found. I want to get a second opinion.

If you have recently visited the heart dept of a hospital and can make recommendations, can you please let me know the details?

many thanks

[lopburi3]

In my case, a year ago, next step was stress test and if that shows some abnormalities MRI or CT scan or if major abnormalities direct to coronary angioplasty lab. In my case total time from start of cardiogram, stress test, to exit of lab with a number of balloon expansions and 2 stints was about 4 hours.

Stress test is treadmill walking until your pulse is very high or you can not do longer and a cool-down period with monitoring. Not invasive but if not use to fast walking or physical stress not really fun. But believe it can show a heart interventionist a lot and not that expensive. But suspect it would depend on what your echo cardiogram indicates what would be your next step.

If you need angioplasty mine was via wrist and every easy - took several hours but no pain - but it is expensive due to material prices and is not something every doctor could do. Overnight stay to remove pressure bandage and monitor as a bit long in the tooth but feeling good the whole time. My total cost was about 300,000 baht here in Bangkok at Vejthani Hospital.

[Sheryl]

Excellent cardiologists (including intervention cardiologosts e.g. ones who van place stents/do angioplasty) to be found at many hospitals here. A smaller range of choice -- but still several places -- if cardiothoracic surgery will be involved.

Would thus help to know the type of problem and whether or not you have insurance or financial constraints, and also whether there will be a time limit on how long you can stay in Thailand, as the least expensive options (government hospitals) can be very time consuming.

[Scott]

I had a heart attack on October 4 and was taken to Thainakarin Hospital where I underwent angioplasty to remove a blockage. In the process, they found two other blockages which will need to be corrected in the near future (tenatively Nov. 8). One doctor said I should have bypass surgery. The other older doctor said some people opt for angioplasty because they won't to be cut open.

I had an exam today and was told they will check the blockage that was opened and if it is OK, they will clear the other two, but if hasn't held, they will not be able to do anything with the other two and I will have to have bypass surgery.

I have enough money to go through another angioplasty, but not for bypass surgery.

Thoughts? Suggestions?

(By the way, the heart itself is in very good shape and they really can't find any damage--I was back to work on the following Monday and felt pretty good, physically).

Edited October 26, 2012 by Scott

[Sheryl]

Scott,

I suggest you take all tests resulkts (including the angio films) fior a seciond opinion.

Try Dr. Taworn at Bkk Chrisitan Hosp (only there once a week, I think Saturdays but check, and arrive early as it is first come first serve and he is in high demand). He is a senior Professor of Cardiology at Chula, trained at UCLA, and is top notch. If HE says bypass is the only option, then it is.

If another angioplasty is possible, he would do it at Chula, only does consults at Bkk Christian.

[Scott]

Thanks. BKK Christian is the hospital I usually go to and have gone to for many years. I'll call them to see if he will be in.

[MarkCyr]

I did the stress test at Bumrungrad Hospital on Soi 3 (up from Soi Nana) a few years back and they found a strange blip on the screen. So I was sent for a coronary MRI. Turns out I have no blockages and not even a trace of calcium buildup (yeah, me!! lol). So that was good news. With the original test and the MRI I paid about $800US. Not sure what it would cost now, but Bumrungrad is definitely getting pricier.

Anyway, as other posters say, get a second opinion or even a third for anything coronary. And go to the best hospitals you can afford if intervention is required.

[advancebooking]

Thanks for the replies. I should have stated what my heart issue was. During the treadmill stress test using the Echo cardiagram machine my blood pressure increased but when we got to the harder level on the treadmill my blood pressure started to drop. Then at the end of the echo the technician told me that my Ejection function (EF) was only 51%. The normal range for my age of early 40's is higher than this.

The consultant told me to give up booze, low salt / low fat diet and no high output exercise at all. He also said no stress in the coming months. Then all he said was that I should get it checked again in 4 to 6 months.

Im conscious of going to somewhere like bumrungrad that is a money oriented place and dont know if I should wait until I get back to oz in march to get it all checked out there.

I asked a family friend in oz (who is an echo technician!) who said that my results were a concern for my age and then she said I should be very careful getting any heart investigations done in asia. If I leave it to oz then Im on the public system with waiting times. If I go private there it will cost a bomb. I have travel insurance but it comes back to if the standard of care here is good enough at bumrungrad for example.

Any further opinions on my situation would be appreciated

many thanks

[Kalbo]

I had a heart attack on October 4 and was taken to Thainakarin Hospital where I underwent angioplasty to remove a blockage. In the process, they found two other blockages which will need to be corrected in the near future (tenatively Nov. 8). One doctor said I should have bypass surgery. The other older doctor said some people opt for angioplasty because they won't to be cut open.

I had an exam today and was told they will check the blockage that was opened and if it is OK, they will clear the other two, but if hasn't held, they will not be able to do anything with the other two and I will have to have bypass surgery.

I have enough money to go through another angioplasty, but not for bypass surgery.

Thoughts? Suggestions?

(By the way, the heart itself is in very good shape and they really can't find any damage--I was back to work on the following Monday and felt pretty good, physically).

Please forgive my impertinence, but may I ask your age ?

[Scott]

63 years 1 month. I saw the doctor and he was not as helpful as I wished--I wanted an answer and he said there isn't a definitive one. He has sent me on to a surgeon for a further review and wants me to come back after that for a further discussion.

He's a great doctor, by the way, I just have one of those situations that isn't quite so easy to answer.

By the way, if I am hijacking someone else's thread, just let me know and I'll post this stuff elsewhere.

Edited October 27, 2012 by Scott

[Sheryl]

Thanks for the replies. I should have stated what my heart issue was. During the treadmill stress test using the Echo cardiagram machine my blood pressure increased but when we got to the harder level on the treadmill my blood pressure started to drop. Then at the end of the echo the technician told me that my Ejection function (EF) was only 51%. The normal range for my age of early 40's is higher than this.

The consultant told me to give up booze, low salt / low fat diet and no high output exercise at all. He also said no stress in the coming months. Then all he said was that I should get it checked again in 4 to 6 months.

Im conscious of going to somewhere like bumrungrad that is a money oriented place and dont know if I should wait until I get back to oz in march to get it all checked out there.

I asked a family friend in oz (who is an echo technician!) who said that my results were a concern for my age and then she said I should be very careful getting any heart investigations done in asia. If I leave it to oz then Im on the public system with waiting times. If I go private there it will cost a bomb. I have travel insurance but it comes back to if the standard of care here is good enough at bumrungrad for example.

Any further opinions on my situation would be appreciated

many thanks

I take it no valve problems identified? (Often the reason for a low ejection fraction)?? And also no ischemic changes on the EKG? And why was the test done i nthe first place, i.e. were you symtomatic or was this a routine check up?

Plenty of places with good cardiologists/good standard of care in terms of investigations, whether or not youtr travel insurance will cover is a question though as they may say it was a pre existing problem (as it almost surely was).

Depending on answers to the above questions I might recommend same as i did for Scott (Dr. Taworn at Bkk Christian) however would not if there was indication of valve defect as he is not a surgeon.

[jrtmedic]

You should be aware that your reportedly lowish EF may, in fact be "normal" for you as an individual.

Normally a pathogenic low EF would be associated with a cardiomyopathy, a heart valve problem or damage caused by a myocardial infarction (heart attack). All of these possibilities (and some other much rarer ones) should have already been discounted as a cause of your lowish EF.

Was the Consultant you saw a cardiologist ? If not you may believe that a consultation with a Cardiologist is desirable.

Be aware that some cardiac investigations can be very expensive (ie 64 sllce CT scans) and some are invasive. Hospitals may attempt to "sell" these investigations to the "worried well" as a means of securing reassurance.

[rijb]

I would like to get a routine / preventative heart scan. Do any of the afore-mentioned places do the following? A location in Chiang Rai or Chiang Mai would be nice.

Multidetector Computed Tomography (MDCT) Scan

An upper torso scan (between the shoulders and hip bones) that detects buildup in the heart’s arteries. The scan also evaluates the lungs and abdominal organs.

Thank you!

[Scott]

Advancebooking, Dr. Tawon is very good. I think the consultation cost something like 600 baht (including the hospital fee). He explained the situation to me very clearly and what the upside and downside would be. I was very clear that I want somebody to tell me what I should do....we both laughed and he said he would send me to one of the best surgeons and to ask him if he thinks it should be surgery or not. He suggested we get together after that discussion if needed. He set up the appointment for today. I went and saw the surgeon, Dr. Kittichai, Cardiothoracic Surgeon, from Chulalongkorn (at BKK Christian Hospital).

He said angioplasty might work, but showed me a couple of rough places where it might not. Or he said, we can chop you open, redo the plumbing, and If I return to my wicked ways, my ticker should be good for about 15 years! And the bypass surgery is probably going to be less expensive that the angioplasty. 15 years or 100,000 miles--a pretty good guarantee as far as I am concerned!

Both Dr.'s are knowledgeable, helpful and easy to talk to.

As far as a time frame. This is what I was told that getting something done was not an emergency, but that it was urgent. The sooner I make a decision, the better. They also made it clear they would schedule me within days of letting them know.

Today is the first time since my fiasco started that I didn't feel like I had a big, black cloud hanging over my head.

(By the way, many years ago I had a broken neck and had surgery in BKK. I have never had even the slightest problem with that broken neck. I have a fair amount of faith in medical care here. Know your Dr. and know your hospital).

[lopburi3]

That sounds like good news (especially the price not being as high as expected). The angioplasty is very expensive for one use materials (and more so for each stint) and can be just a short term solution for some as they never know how fast blockage will return. The rough spots seems to indicate areas where this might be an issue (in my untrained mind) so if they feel new clean path is best choice I would put some weight on that. Do not believe there is any reason to push bypass over sale of angioplasty parts for profit reasons. My father had bypass at age 70 and died naturally 20 years later.