Hello, I just wanted to reiterate that I totally agree with @sueinmn and add support to her suggestions. I, too, live in a rural area with limited medical resources but I travel to a larger metro city for second opinions or for some speciality services. I ensure that copies of all medical notes/tests, etc., are forwarded to my rural cardiologist so that they have all the clinical information available. I have learned that “the grass isn’t always greener” the hard way, and I know I that have to stay proactive on keeping my medical care team informed. Our overall healthcare system has become very fragmented post-COVID and requires our own due diligence of our health information. Sounds like you are on top of your health information too which I feel is so important these days. Best of luck to you and your wife in your health care journey.