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What Do The Following Echocardiogram Reports Indicate?

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Posted on Thu, 2 Mar 2017
Question: Can I get help understanding the results of my echocardiogram (specifically the items highlighted).
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

I passed carefully through your echocardiogram report and would explain that generally speaking the performed measurements seem to be OK.

The ventricular dimensions (the ventricular wall thickness in diastole are not described). aortic root, trans-aortic valve flow, systolic pulmonary artery pressure and mitral valve flow seem to be normal.

Regarding the highlighted items I would explain that left atrial diameter is slightly above the upper limit of normal, but it is highly influenced on the accuracy the examiner shows while positioning the investigation plane during measurements.

I would not rely only on just a simple diameter for concluding a dilated left atrium.

It is necessary to quantify the LA area and LA volume and indexing them (divide by your body surface area).

Also the deceleration time of the early mitral diastolic wave E seems highly increased, while the ratio of the two waves E/A is within normal wave.

For properly interpreting this finding it is necessary to perform additional measurements like IVRT (isovolumic relaxation time) and E/E' ratio. If these two latter parameters are abnormally increased, then left ventricular diastolic dysfunction could be concluded (the left ventricle is shown stiffer during diastolic phase of the cardiac cycle).

But, meanwhile these values are not quantified; no definite conclusion could be drawn by the uploaded echo report.

It is necessary also the qualitative estimation when performing the echo test.

In conclusion, no any serious abnormality is seen on this echo report.

Just a suspicion of a mild diastolic dysfunction (mildly increased LA, increased DTE) is raised.

I would recommend to carefully and frequently check your blood pressure values for excluding possible high BP trends (which could explain these finding).

The most rationale approach would be to discuss with your doctor for the possibility of performing another echo test including also the other parameters of diastolic function, as well as a comprehensive evaluation of left atrium dimension.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
Thank you very much for the very detailed and insightful response Dr. Iliri, it's much appreciated. I do have a follow up question - you may or may not recall that last week I asked about a finding of a significantly elevated peak systolic velocity in my internal carotid arteries (no other abnormal findings). My question is could diastolic dysfunction possibly be related to an elevated PSV in carotid arteries?

I do have an appointment with a cardiologist in 2 weeks, just trying to gather as much information as possible (which HCM has helped immensely with).

Thanks again.
doctor
Answered by Dr. Ilir Sharka (26 minutes later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

No direct correlation exists between diastolic dysfunction and an increased PSV in carotid arteries.

But, elevated blood pressure values (if present) during carotid doppler ultrasound could have influenced to some degree the results.

When reviewing the results of carotid ultrasound, it is necessary to consider both doppler findings and visualization of arterial anatomy for coming to the right conclusions.

Regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9312 Questions

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What Do The Following Echocardiogram Reports Indicate?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome back on HCM! I passed carefully through your echocardiogram report and would explain that generally speaking the performed measurements seem to be OK. The ventricular dimensions (the ventricular wall thickness in diastole are not described). aortic root, trans-aortic valve flow, systolic pulmonary artery pressure and mitral valve flow seem to be normal. Regarding the highlighted items I would explain that left atrial diameter is slightly above the upper limit of normal, but it is highly influenced on the accuracy the examiner shows while positioning the investigation plane during measurements. I would not rely only on just a simple diameter for concluding a dilated left atrium. It is necessary to quantify the LA area and LA volume and indexing them (divide by your body surface area). Also the deceleration time of the early mitral diastolic wave E seems highly increased, while the ratio of the two waves E/A is within normal wave. For properly interpreting this finding it is necessary to perform additional measurements like IVRT (isovolumic relaxation time) and E/E' ratio. If these two latter parameters are abnormally increased, then left ventricular diastolic dysfunction could be concluded (the left ventricle is shown stiffer during diastolic phase of the cardiac cycle). But, meanwhile these values are not quantified; no definite conclusion could be drawn by the uploaded echo report. It is necessary also the qualitative estimation when performing the echo test. In conclusion, no any serious abnormality is seen on this echo report. Just a suspicion of a mild diastolic dysfunction (mildly increased LA, increased DTE) is raised. I would recommend to carefully and frequently check your blood pressure values for excluding possible high BP trends (which could explain these finding). The most rationale approach would be to discuss with your doctor for the possibility of performing another echo test including also the other parameters of diastolic function, as well as a comprehensive evaluation of left atrium dimension. Hope to have been helpful to you! In case of any further uncertainties, feel free to ask me again! Kind regards, Dr. Iliri