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What Does The Cardiac Ultrasound Report Indicate?
Question: Hello. I'm a 31 year old male 6'3" 210 pounds with a history of "controlled" hypertension for about 6 years. I recently had an echo as a follow up from a previous one 2.5 years earlier. In the new report it shows a 3mm increase at the aortic root measuring 4.1cm (sinus of valsalva) I had a follow up since with my cardiologist who didn't have a lot to say on regards as to the seriousness of the situation and I was left very unsatisfied. I am however awaiting to schedule an mra. In the meantime I've been so stressed over this and am in need of much needed advice as I feel I was pushed aside from my cardiologist. Below I my echo reprt. 123 / 84 mmHg Height: 6 ft 3 in Weight: 210 lbs BSA:2.24M2 Sonographer:BS ImageQualityIndex:Adequate Amountofcontrastadministeredforendocardialenhancement0mL.perflutren Agitatedsalineinjectionperformed:no REASONFORECHOCARDIOGRAPHY:PVC,HTN,DilatedAorticRoot
LVID/d: 5.1 (3.9-5.9) cm
LVID/s: 3.6 (2.0-3.8) cm
IVS/d: 1.1 (0.6-1.0) cm
LVPW/d: 0.9 (0.6-1.0) cm
LEFT ATRIUM: 3.9 (2.7-40.) cm
LA volume/BSA: 28 (22 +/-6) mL/m2 AORTIC ROOT: 4.1 (2.1-3.5) cm
RVID/d: 2.9 (2.7-3.3) cm MVMAXPG:3(<4mmHg) MVMEANPG:1(<2mmHg)
MVAP1/2: 3.7 (4.0-6.0) cm2 AOMAXPG:5(<16 mmHg) AOMEANPG:3(<6mmHg)
AVA: 4.0 (>2.0) cm2
RVSP (TR): NA (16-35 mmHg)
EF:55%(>55%)
LEFT VENTRICLE: The left ventricle chamber is normal in size. Normal global and regional LV systolic function. The estimated ejection fraction is 55 %. Myocardial thickness is borderline increased. Normaldiastolicfunctionisnoted. RIGHT VENTRICLE: The right ventricle chamber is normal in size with normal global systolicfunction. LEFTATRIUM:Theleftatriumisnormalinsize. RIGHTATRIUM:Therightatriumisnormalinsize. MITRAL VALVE: The mitral valve is structurally normal, the valve opens well. No mitral stenosis is seen.Nomitralregurgitationisseen. TRICUSPID VALVE: The tricuspid valve is structurally normal, no tricuspid regurgitation isseen. AORTIC VALVE: The aortic valve is trileaflet and opens well. No aortic stenosis is seen. No aortic regurgitationisseen. PULMONIC VALVE: The pulmonic valve appears normal. No pulmonic regurgitation is seen. AORTICROOT:Theaortic root is mildly dilated at the Sinus of Valsalva. PERICARDIUM:Thepericardiumappearsnormal.Nopericardialeffusionisvisualized. OTHER: The interatrial septum appears normal; no aneurysmal formation is seen. No interatrial shunt isseen.Nointracardiacmass/thrombusisseen. PRESSURES: No significant tricuspid regurgitation is seen; therefore pulmonary artery pressures cannot be accurately obtained.
LVID/d: 5.1 (3.9-5.9) cm
LVID/s: 3.6 (2.0-3.8) cm
IVS/d: 1.1 (0.6-1.0) cm
LVPW/d: 0.9 (0.6-1.0) cm
LEFT ATRIUM: 3.9 (2.7-40.) cm
LA volume/BSA: 28 (22 +/-6) mL/m2 AORTIC ROOT: 4.1 (2.1-3.5) cm
RVID/d: 2.9 (2.7-3.3) cm MVMAXPG:3(<4mmHg) MVMEANPG:1(<2mmHg)
MVAP1/2: 3.7 (4.0-6.0) cm2 AOMAXPG:5(<16 mmHg) AOMEANPG:3(<6mmHg)
AVA: 4.0 (>2.0) cm2
RVSP (TR): NA (16-35 mmHg)
EF:55%(>55%)
LEFT VENTRICLE: The left ventricle chamber is normal in size. Normal global and regional LV systolic function. The estimated ejection fraction is 55 %. Myocardial thickness is borderline increased. Normaldiastolicfunctionisnoted. RIGHT VENTRICLE: The right ventricle chamber is normal in size with normal global systolicfunction. LEFTATRIUM:Theleftatriumisnormalinsize. RIGHTATRIUM:Therightatriumisnormalinsize. MITRAL VALVE: The mitral valve is structurally normal, the valve opens well. No mitral stenosis is seen.Nomitralregurgitationisseen. TRICUSPID VALVE: The tricuspid valve is structurally normal, no tricuspid regurgitation isseen. AORTIC VALVE: The aortic valve is trileaflet and opens well. No aortic stenosis is seen. No aortic regurgitationisseen. PULMONIC VALVE: The pulmonic valve appears normal. No pulmonic regurgitation is seen. AORTICROOT:Theaortic root is mildly dilated at the Sinus of Valsalva. PERICARDIUM:Thepericardiumappearsnormal.Nopericardialeffusionisvisualized. OTHER: The interatrial septum appears normal; no aneurysmal formation is seen. No interatrial shunt isseen.Nointracardiacmass/thrombusisseen. PRESSURES: No significant tricuspid regurgitation is seen; therefore pulmonary artery pressures cannot be accurately obtained.
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear XXXXXXX
I passed carefully through your cardiac ultrasound report, and would like to explain that your cardiac echo is normal and you shouldn't worry too much about your aortic root diameter. Even if the last aortic root diameter (at the level of Valsalva sinuses) be exactly measured, it is quite a mild dilation.
It is out of discussion we have not to do with an aortic aneurysm.
In general aortic root dilation should not exceed 40 mm in normal adults. And the rate of aortic growth averages around 0.9 mm for each decade of life.
Nevertheless, aortic root diameter is variably influenced by several factors including age, gender, body size [height, weight, body surface area (BSA)] and blood pressure.
Including the entire range of aortic diameter in normal individual (29 - 45 mm), if we account for the body surface area (BSA), then the normal range would be 19+/-1 mm/m2.
If we divide your aortic diameter of 41 mm to your BSA 2.24 m2, then it results 18.3 mm, which in fact results within normal ranges.
Absence of aortic valvular dysfunction (aortic regurgitation) which is frequently seen in abnormal aortic root dilation, supports the conclusion your aorta doesn't suffer any important disorder.
So, relax!
That's why you shouldn't worry about!
The only point to clear is if there has been a measurement inaccuracy on your last cardiac ultrasound exam, leading thus to an erroneously abnormal increase in aortic root diameter.
Coming to this point more appropriate imagine tests are necessary to correctly measure the aortic diameters.
Aortic angio-CT and MRI are the tests of choice for investigating possible aortic abnormalities.
A you have been scheduled for a MRI everything will be cleared after that.
I would like to review your MRI when the report comes out (after performing it).
Please let me know how things are going on.
Hope to have been helpful to you!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear XXXXXXX
I passed carefully through your cardiac ultrasound report, and would like to explain that your cardiac echo is normal and you shouldn't worry too much about your aortic root diameter. Even if the last aortic root diameter (at the level of Valsalva sinuses) be exactly measured, it is quite a mild dilation.
It is out of discussion we have not to do with an aortic aneurysm.
In general aortic root dilation should not exceed 40 mm in normal adults. And the rate of aortic growth averages around 0.9 mm for each decade of life.
Nevertheless, aortic root diameter is variably influenced by several factors including age, gender, body size [height, weight, body surface area (BSA)] and blood pressure.
Including the entire range of aortic diameter in normal individual (29 - 45 mm), if we account for the body surface area (BSA), then the normal range would be 19+/-1 mm/m2.
If we divide your aortic diameter of 41 mm to your BSA 2.24 m2, then it results 18.3 mm, which in fact results within normal ranges.
Absence of aortic valvular dysfunction (aortic regurgitation) which is frequently seen in abnormal aortic root dilation, supports the conclusion your aorta doesn't suffer any important disorder.
So, relax!
That's why you shouldn't worry about!
The only point to clear is if there has been a measurement inaccuracy on your last cardiac ultrasound exam, leading thus to an erroneously abnormal increase in aortic root diameter.
Coming to this point more appropriate imagine tests are necessary to correctly measure the aortic diameters.
Aortic angio-CT and MRI are the tests of choice for investigating possible aortic abnormalities.
A you have been scheduled for a MRI everything will be cleared after that.
I would like to review your MRI when the report comes out (after performing it).
Please let me know how things are going on.
Hope to have been helpful to you!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello. I wanted to follow up with my mra results
INDICATION:Dilatedaorticroot.Historyofhypertension. TECHNIQUE: Multiplanar unenhanced imaging followed by dynamic enhanced imaging through the chest following intravenous contrast. 20 mL Omniscan was administered intravenously. COMPARISON:5/5/2013radiographs.1/13/2010CTA chest. FINDINGS: Heart is nonenlarged. No pericardial thickening or effusion. No adenopathy. The aortic root measures 4.0 cm. The ascending aorta measures 3.1 cm and the descending thoracic aorta 2.0 cm. The great arch vessels are patent. The left vertebral artery arises directly from the aortic arch and is patent.No evidence of aortic dissection. Impression: Stable dilatation of the aortic root measuring 4.0 cm
INDICATION:Dilatedaorticroot.Historyofhypertension. TECHNIQUE: Multiplanar unenhanced imaging followed by dynamic enhanced imaging through the chest following intravenous contrast. 20 mL Omniscan was administered intravenously. COMPARISON:5/5/2013radiographs.1/13/2010CTA chest. FINDINGS: Heart is nonenlarged. No pericardial thickening or effusion. No adenopathy. The aortic root measures 4.0 cm. The ascending aorta measures 3.1 cm and the descending thoracic aorta 2.0 cm. The great arch vessels are patent. The left vertebral artery arises directly from the aortic arch and is patent.No evidence of aortic dissection. Impression: Stable dilatation of the aortic root measuring 4.0 cm
Brief Answer:
There is nothing to worry about.
Detailed Answer:
Hi again XXXXXXX
Seems that your MRA results are almost the same as those of cardiac echo. So overall cardiac structure is within normal ranges.
Regarding your aortic dimensions, the conclusion is the same (around 40mm) which is a borderline value, denoting a borderline dilation for a great proportions of individuals with an average weight and body size.
But, as I explained you above, when we divide the aortic diameter to the body surface area (BSA), providing thus the indexed aortic root dimension, we conclude to a within normal aortic root dimension: 17.85 mm/m2 (normal range 19+/-1 mm/m2).
This is due to your larger body surface area (BSA) than the average found in most of individuals.
So to conclude, I would like to assure you that there is nothing to worry too much about. Your aortic wall structure is quite normal (no evidence of aortic dissection, no visible atherosclerotic plaques, etc.).
The only advice would be to periodically follow up your aortic root dimensions, by performing cardiac ultrasound (and additional imaging tests if any abnormal progression is suspected).
Wishing a Happy New Year,
Dr. Iliri
There is nothing to worry about.
Detailed Answer:
Hi again XXXXXXX
Seems that your MRA results are almost the same as those of cardiac echo. So overall cardiac structure is within normal ranges.
Regarding your aortic dimensions, the conclusion is the same (around 40mm) which is a borderline value, denoting a borderline dilation for a great proportions of individuals with an average weight and body size.
But, as I explained you above, when we divide the aortic diameter to the body surface area (BSA), providing thus the indexed aortic root dimension, we conclude to a within normal aortic root dimension: 17.85 mm/m2 (normal range 19+/-1 mm/m2).
This is due to your larger body surface area (BSA) than the average found in most of individuals.
So to conclude, I would like to assure you that there is nothing to worry too much about. Your aortic wall structure is quite normal (no evidence of aortic dissection, no visible atherosclerotic plaques, etc.).
The only advice would be to periodically follow up your aortic root dimensions, by performing cardiac ultrasound (and additional imaging tests if any abnormal progression is suspected).
Wishing a Happy New Year,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reassurance. Can you tell me how a dilation differentiates from aneurysm?
Brief Answer:
Explanation as follows:
Detailed Answer:
Hi XXXXXXX
Generally speaking, an aortic aneurysm is defined as enlargement of aortic diameter at least 1.5 times the normal size.
As I explained you before, the normal aortic size is predicted by some factors, like body size (BSA), age, gender.
An aortic dilation is considered a smaller enlargement than the above.
Your actual aortic status represents only a borderline (upper normal) aortic dilation.
So, there is no reason to think about an aortic aneurysm.
Wishing you the best for this New Year!
Regards,
Dr. Iliri
Explanation as follows:
Detailed Answer:
Hi XXXXXXX
Generally speaking, an aortic aneurysm is defined as enlargement of aortic diameter at least 1.5 times the normal size.
As I explained you before, the normal aortic size is predicted by some factors, like body size (BSA), age, gender.
An aortic dilation is considered a smaller enlargement than the above.
Your actual aortic status represents only a borderline (upper normal) aortic dilation.
So, there is no reason to think about an aortic aneurysm.
Wishing you the best for this New Year!
Regards,
Dr. Iliri
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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