Echo Case 1

ECHO COMPLETE (From 3 months prior to admission)

Measurements and Calculations

Diast Nl Syst Nl

RV 3.31 cm 2.0 – 3.8 LA Diam 5.10 cm 3.0-4.0

IVS 1.26 cm 0.6 – 1.0 LA Area 26.55cm² <=20

LVID 6.72 cm 4.2 – 5.9 4.87 cm LA Vol 96.51 ml 18-58

LVPW 1.16 cm 0.6 – 1.0 LA Vol/BSA 41.06ml/m² 22+ / -6

RA Diam 4.86cm 2.9-4.5

Ao at the sinuses 3.48 cm Ao Ascending 3.78 cm Ao Descending 2.20cm

LVEF  48 % (biplane method of discs)

LV FS 27.5 LV SV 132.7 ml LV SI 56.5 ml/m²

Aov Cusp Sep 2.30 cm(Systole)

Aov VTI 0.305 m LVOT VTI 0.261 m LVOT diameter 2.78 cm

Aov VMax 1.38 m/s LVOT Vmax 1.12 m/s Dimensionless Index 0.81

Aov Pk Pressure 7.6 mmHg Aov Mn 4.1 mmHg Gradient Pressure Gradient

Aov Area (VTI) 5.20 cm² Aov Area Index 2.21 cm²/m² (VTI)

AI DT 2101 msec

MV VTI MV DT 215 msec

MV E Vmax 0.80 m/s MV A Vmax 0.86 m/s E/A 0.93

MV Area press 1/2 Time 3.53 IVRT E/E ‘ 8.02

Septal E ‘ 0.040 m/s Prop Velocity

Lateral E ‘ 0.10 m/s LA Pressure 16.10 mmHg

Average E’ 0.070 m/s MV Average E/E’ 11.45

TR Vmax 2.53 m/s TR Pk Grad 25.6 mmHg RA Pressure 3 mmHg RVSP 28.6 mmHg

TV E Max TV Mn Grad mmHg PHT 62.28 msec TV VTI

PV Vmax 0.91 m/s PV Pk Grad 3.3 mmHg PV Mn Grad RVEDP

 

Left Ventricle – Structure and Systolic Function: The left

ventricular cavity size is moderately increased. Ventricular wall

thickness is mildly increased. The relative wall thickness is normal

(0.36). Global left ventricular systolic function is mildly reduced.

The ejection fraction is 48% by biplane method of discs. Left

ventricular basal fractional shortening is decreased.

Left Ventricle – Diastole:The overall diastolic function is mildly

impaired (grade I, impaired relaxation pattern) with normal left

ventricular filling pressures.

Left Atrium: The left atrium is severely dilated in size.

Right Atrium: The right atrium is mildly dilated in size.

Atrial Septum: Atrial septum is not well visualized. Atrial septum is

structurally normal and intact on 2D and color Doppler interrogation.

Right Ventricle: The right ventricle is not well seen. The right

ventricular size is normal. Global right ventricular systolic

function is normal. The right ventricular fractional area change is

37.11% which is normal. The tricuspid annular plane systolic

excursion is 3.28 cm consistent with normal right ventricular

systolic function. The right ventricular systolic pressure, as

estimated using the tricuspid regurgitation velocity, is 28.6 mmHg.

Aortic Valve: The aortic valve is trileaflet and is calcified with

normal excursion. Mild aortic valve insufficiency is present. The

pressure half-time of the aortic insufficiency jet is 609 msec.

Mitral Valve: The mitral valve is structurally normal. Prolapse of

the mitral valve is not seen. No evidence of mitral stenosis is seen.

Mild mitral regurgitation is present.

Tricuspid Valve: The tricuspid valve is structurally normal. Trace

tricuspid regurgitation is present.

Pulmonic Valve: The pulmonic valve is not well visualized.

Aorta: The aorta at the level of the sinuses of Valsalva is normal in

diameter at 3.48 cm. The ascending aorta is normal at 3.78 cm. The

descending aorta is normal in size at 2.20 cm.

Pulmonary Artery: The tricuspid regurgitant velocity is 2.53 m/s, and

with an assumed right atrial pressure of 3 mmHg, the estimated

pulmonary artery systolic pressure is normal at 28.6 mmHg.

Pericardium: Normal

Summary:

1. Moderately increased left ventricular cavity size.

2. Severely dilated left atrial size.

3. Mildly increased left ventricular wall thickness.

4. Mildly reduced global left ventricular systolic function.

5. Mildly dilated right atrial size.

6. Mild diastolic dysfunction with normal left ventricular filling pressures.

7. Normal right ventricular systolic function.

8. Trileaflet aortic valve and aortic sclerosis.

9. Mild aortic insufficiency.

10. Mild mitral regurgitation.

11. Trace tricuspid regurgitation.

12. Normal aortic root diameter for body size.

13. Normal atrial septum by 2D and color Doppler.