Our cardiologist does echocardiograms once every year as indicated as follow up to valve diseases, aortic stenosis surveillance. In some cases, pulmonary hypertension surveillance is done once or twice a year. In my experience, unless you are specifically checking for ejection fraction changes, checking for medication response, insurances frown upon a monthly echocardiogram. If we perform echocardiograms within a year, we only do a limited echo for the subsequent one.