A cardiologist in Colombia who has never met you can only judge what you send. If the packet holds a one-line discharge summary and a stent card, the consult turns into a list of tests to repeat. If it holds the actual images, the reports, an accurate medication list and a letter from your own cardiologist, the same consult can answer the real question: is this procedure right for you, and is it safe to travel for it?
This guide lists exactly what to gather, how to request it from US providers under the HIPAA right of access, which file formats to ask for, and how to share and translate it without losing control of your data.
Why images matter more than reports
A report is someone's summary of a test. An image is the test itself. A cardiologist reviewing you for a valve repair, a bypass or a stent will want to see the echo loops, the angiogram runs and the CT slices, because measurements and judgment calls (how tight a narrowing looks, how a valve moves, how calcified a vessel is) can be read differently by different specialists.
Your right to copies covers images, not only paperwork. US federal guidance says the records you can request include x-rays and other images held in your record set.3 That is the single most useful fact in this guide: ask for the images by name, every time.
Every test that has a picture should arrive twice: once as a signed report (PDF) and once as the full image study (DICOM). A stills-only printout of an echo or a cath is not enough for a serious second look.
The cardiac records checklist
Gather these before you request any consult. Not everyone will have every item; send what exists and say clearly what has never been done.
- Cardiologist's letter. A short referral or summary from your treating cardiologist: diagnosis, what was recommended, why, and any concerns about travel.
- ECGs. The most recent 12-lead ECG plus any older one that shows a change. Rhythm strips or monitor (Holter, event monitor) reports if you have had them.
- Echocardiogram report and images. The signed report and the full study with moving clips, not just still frames. Include transesophageal echo (TEE) if done.
- Stress test. Report and, for nuclear or stress-echo tests, the images.
- Cardiac catheterization. The cath report and the angiogram films as DICOM. If you had pressure-wire measurements (FFR or iFR), make sure they are in the report.
- Cardiac CT or MRI. Calcium score, coronary CT angiography, or cardiac MRI: report and images.
- Recent labs. Kidney function, blood count, lipid panel, HbA1c if you have diabetes, clotting tests if you take a blood thinner. Ask the clinic how recent they need to be.
- Medication list with doses. Generic name, strength, how often, and why you take it. Include supplements and anything you stopped recently.
- Allergy list. Drug, contrast dye, latex, and what the reaction was.
- Prior procedure reports. Earlier stents (with stent type and location if listed), bypass operative notes, valve procedures, pacemaker or ICD details, ablations.
- Other conditions. A short problem list: diabetes, kidney disease, lung disease, prior stroke, bleeding problems.
| Item | Ask for | Usually held by | Format |
|---|---|---|---|
| ECG | Tracing, not only the interpretation line | Cardiology office or hospital | |
| Echo | Signed report plus full study with clips | Echo lab or hospital imaging | PDF plus DICOM |
| Stress test | Report; images if nuclear or stress echo | Cardiology or nuclear medicine | PDF plus DICOM |
| Cath / angiogram | Cath report plus all angiogram runs | Hospital cath lab | PDF plus DICOM |
| CT or MRI | Report plus full image series | Radiology or imaging center | PDF plus DICOM |
| Labs | Results with reference ranges and dates | Lab, portal or doctor's office | |
| Medications and allergies | Your own typed list, checked against the pharmacy | You | PDF or document |
| Prior procedures | Operative or procedure notes, device details | Hospital records department |
How to request records under the HIPAA right of access
US patients have a federal right to see and get copies of their medical and billing records from HIPAA-covered providers and health plans, with few exceptions.1 The steps below keep the request clean and hard to stall.
- Check your patient portal first. Reports, labs and visit notes are often downloadable there today. Download them as PDFs. Images are rarely on the portal, so plan to request those separately.
- Make a list of every place that holds something. Your cardiology practice, the hospital where you had the cath, the imaging center that did your CT, the lab. Each one is a separate request.
- Write to the records (health information management) department. Use the provider's own form if it has one. Name each item and its date, and say you want the images, not only the reports.
- Name the format. Ask for reports as PDF and images as DICOM on a disc, a USB drive or a secure download. Providers must give you copies in the form and format you ask for if they can readily produce it.3
- Note the date and follow up. A provider must act on your request no later than 30 calendar days after receiving it. It can take one further 30-day extension only if it tells you in writing, within the first 30 days, why and when it will finish.2
- Ask about fees up front. Providers can charge reasonable copying and mailing costs but not for searching for or retrieving your records, and they cannot refuse copies because you owe them money for care.1
HHS calls those deadlines outer limits and expects many providers to answer well before them.2 In practice, request everything at least six weeks before you want a consult, so one slow department does not hold up the whole packet.
Patients in Canada
HIPAA does not apply to Canadian providers. Access rules, timelines and fees are set province by province, so ask the health records department of each hospital or clinic how to request copies, and ask for the same items in the same formats.
Formats, discs and file sharing
Reports: PDF, one file per test
Save each report as its own PDF and name it so a stranger can understand it at a glance: 2026-08-14_Echo_Report.pdf, 2026-09-02_Cath_Report.pdf. Put a one-page index at the front of the packet listing every file, its date and what it is.
Images: DICOM, the full study
DICOM is the standard format medical imaging systems use to store and exchange images, and discs from hospitals are normally written in it, often with a basic viewer included.5 Image files are usually stored at the facility where you had the exam, so request them there; radiology societies also advise keeping your own copy on a disc or flash drive even when images can be sent electronically.4
- Ask for the full study, not key images. For echo and cath, the moving loops are what a reviewing cardiologist needs.
- Check the disc before you leave. Open it on a computer if you can. Discs are sometimes blank, partial or locked to one viewer.
- Keep the original disc. Upload copies; never mail your only copy abroad.
- Ask for DICOM if you get a proprietary disc. Some systems write formats others cannot read; the originating hospital can supply a DICOM replacement disc on request.5
Because image files are large, the format you agree on with the provider has to be able to carry them. HHS guidance notes that file size can shape how access is provided.3 A secure download link or a USB drive is often easier than several discs.
Getting it to the clinic
Ask the Colombian clinic how it wants to receive images, such as an image-sharing portal or a secure upload link. Send the original DICOM files, not screenshots or JPEG exports: converted images may display, but they can lose information needed for diagnostic quality.5 Use messaging apps to arrange the transfer, not to send the study itself.
Translation: what to translate and what to leave
Images need no translation. Numbers in reports (ejection fraction, valve gradients, percent stenosis) are read the same way everywhere. What benefits most from Spanish is the narrative: your cardiologist's letter, your problem list and your medication list.
- Ask first. Ask the clinic whether the reviewing cardiologist reads English medical reports. If yes, you may not need translation at all.
- Use generic drug names. Brand names often differ between countries; generic names do not. Write "metoprolol succinate 50 mg once daily", not only the brand on your bottle.
- Translate the summary, not the whole chart. A translated one- or two-page summary is more useful than hundreds of pages of machine-translated notes.
- Have a person check medical translations. If you use a translation tool, ask a bilingual clinician or certified medical translator to check doses, allergies and diagnoses, where a mistranslation can cause harm.
The medication list is the item most often wrong. Compare it against your pharmacy's records and your pill bottles, including blood thinners, diabetes medicines and anything stopped in the last three months.
Privacy: sending health records across a border
Once records leave a US provider and reach you, HIPAA no longer governs what you do with them. You decide who gets them, and the receiving clinic's local rules and its own policies govern how it handles them.
- Send only what the consult needs. Psychotherapy notes and unrelated history usually do not belong in a cardiac packet.
- Ask the clinic who will see the files, where they are stored and how long they keep them.
- Prefer the clinic's secure upload over email attachments. If you ask a US provider to send records to you by unencrypted email, it may do so, but it should warn you about the risk first.6
- If you share a cloud folder, use a link that expires and that only the named recipient can open. Do not post a public link.
- Keep a master copy of everything you send, with the date you sent it.
If you want a provider to send records straight to the Colombian clinic, that is a disclosure you authorize. US providers may share with another provider for treatment or with your permission, but the Privacy Rule does not require them to.1 It is often simpler to get the copies yourself and forward them.
Common gaps that delay a consult
| Gap | Why it slows things down | Fix |
|---|---|---|
| Cath report without films | Anatomy cannot be independently reviewed | Request the angiogram as DICOM from the cath lab |
| Echo stills only | Valve motion and function need moving clips | Ask the echo lab for the complete study |
| Brand-name-only medication list | Drug may be unknown or named differently abroad | Add generic names, doses and frequency |
| Undated files | Reviewer cannot tell old from current | Date every file name and the index |
| No letter from your cardiologist | The reason for the recommendation is missing | Ask for a short summary letter |
| Old labs | Kidney function and blood counts change | Ask the clinic what it needs and repeat if required |
A complete packet does more than speed things up. It lets the clinic tell you early if you are a poor candidate for travel. Our guide on who should not travel for heart surgery covers the situations where staying home is the safer choice, and our overview of heart surgery in Colombia explains how the planning fits together.
What to do with the packet next
Once the packet is ready, send the same complete set to every hospital you are comparing, so their answers are based on the same facts. Ask each one, in writing, which tests it would repeat on arrival and why; repeated tests change both cost and length of stay. Our list of accredited cardiac hospitals in Colombia is a starting point for who to ask.
If you want help turning the packet into comparable written quotes, you can request a quote and attach your cardiologist's recommendation. Your own cardiologist should stay involved: they know your history, and they decide whether you are fit to travel.