I had my annual cardiac workup about a month ago. I'm a 49 year old male, still 50 lbs overweight but otherwise in good health. Don't smoke, don't drink, no family history, controlled cholesterol and blood pressure. In 2005 & 2006 I had a Thallium Stress test, Echo and blood work, all normal. This year when I went in for my initial check up, my cardiologist only ordered the Echo and blood work, no stress test. She based this on my low cholesterol level (TC 163 and LDL only 58), my exercise tolerence and weight loss ( I do 45 minutes and 500 calories every day on a treadmill with no symptoms and have lost 50 lbs this year), normal blood work and my normal test results the past two years. I have to agree that I have no heart related symptoms like chest pain or SOB so I guess she's right. When I got the Echo back, besides a slightly enlarged LA (blood pressure is controlled at 110/70), everything was fine, EF of 60%, all other chambers normal size, only trace reguritation in my tricuspid valve, all other valves good, no wall motion abnormalities. She told me that my only complaint, the occassional PVC was not an issue as my heart is structureally fine. When we were finished going over the report, she said I don't really need a cardiologist at this point and that my family doctor could manage me during my annual physicals and I should only need to see her if I started with new or changed symptoms, I guess that's a good thing.
My questions is how often should I have a stress test and echo? Should I just leave it up to my family doctor and let him know if anything changes?