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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does this ECHO report indicate?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 6462 Questions

Posted on Fri, 6 Nov 2015 in Hypertension and Heart Disease
Question: Hi, Dr. Sharka, I greatly appreciate your follow up. You must be a very good doctor. I spoke to another cardiologist who said pretty much the same thing you did. More information is needed from the initial echo report before deciding next step or seeing if transesophagael is necessary. She said she wanted to see from initial echo report actual size of RV, estimated pulmonary pressure, and if they found any holes or defects in heart. She said all of these things should have been listed on initial echo report, which I believe is what you said as well. Do you agree? Anything else you can add to that?
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello dear XXXXXXX

Thank you for asking on HCM!

I reviewed carefully your last echo report and I would explain that it seems almost normal.

Your left heart (myocardium, aortic and mitral valves) seems quite perfect, only a mild left atrial dilation and diastolic dysfunction.

Regarding your right heart, it seems that the right ventricle has a normal function and the right atrium is not dilated.

I read that the right ventricle has a diameter of 2.95 and is considered mildly dilated.

I am not sure at what level is performed this measurement, as depending on the cardiac view RV diameter varies noticeably.

At the basal level is 3.3 +/- 0.5cm (at the apical four chamber view).

Roughly, a mid-right-ventricular diameter of 35 to 40 mm or 42 to 45 mm at the base indicates right ventricular dilatation.

It is also possible to measure the width of the RVOT (right ventricular outflow tract) on a parasternal short axis view at the base, and the upper limit of normal is 33 mm for the proximal aspect and 27 mm for the distal aspect at the level of the pulmonary valve.

So as I said I am not sure where that RV value has been measured.

Nevertheless, I would confirm you that it doesn't seem to be a clinically relevant dilation.

Regarding the other statement that pulmonary artery pressure was 10mm Hg, it doesn't seem clear, as pulmonary artery pressure is measured by utilizing tricuspid regurgitation on spectral Doppler analysis.

But from the other side, your doctor was not able to identify any tricuspid regurgitation at all.

So, how could be sure about the pulmonary artery pressure value?!

Coming to this point, I would suggest you to follow your doctors advise about the scheduled follow up echos time, and if RV diameter keeps changing (results larger), I would recommend you transesophageal echo and especially a cardiac MRI (which is a gold standard for right ventricular study).

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 22 minutes later
would you suggest visiting pulmonologist to get full pulmonary function test performed as precaution? Current cardiologist did not think that was a bad idea.
Answered by Dr. Ilir Sharka 11 hours later
Brief Answer:
I agree with your doctor about the pulmonologist consult.

Detailed Answer:
Hello again!

Although there is no clear evidence that those right heart changes may be due to any pulmonary function disorders, a pulmonologist consultation would be useful to rule out this possibility.

Meanwhile you should consider the above mentioned advises.

Hope to have been helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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