Echocardiographic monitoring
Hello Director: I would like to ask for your assistance in reviewing the follow-up echocardiogram report.
108/08/28 MEASUREMENTS AND SCREENING
Ao Diameter (MM) 32
LA / Ao 1.5
AV Cusp (MM) 19
IVSd (MM) 14
LVIDd (MM) 57
LVPWd (MM) 9
IVSs (MM) 15
LVIDs (MM) 35
LVPWs (MM) 18
MV DecT (ms) 195
MV Dec Slope (mm/s²) 6866
EF (Teich) (%) 66
%FS (%) 37
AORTIC VALVE: AV Vmax 1.48 m/s.
MITRAL VALVE: Chordae rupture (+) multiple, anterior leaflet.
DOPPLER: E/A 1.34/0.75 m/s.
E/E’ 13.7, 7.4.
Reversal flow in PV (+).
MISCELLANEOUS: Ao 3.29, LA 4.94, IVSd 1.49, LVIDd 5.71, LVPWd 0.99 cm, FS = 109/08/05
MEASUREMENTS AND SCREENING
Ao Diameter (MM) 30
LA / Ao 1.7
AV Cusp (MM) 17
IVSd (MM) 10
LVIDd (MM) 58
LVPWd (MM) 11
IVSs (MM) 14
LVIDs (MM) 35
LVPWs (MM) 18
MV DecT (ms) 181
MV Dec Slope (mm/s²) 8690
EF (Teich) (%) 72
%FS (%) 39
AORTIC VALVE: AV Vmax 1.65 m/s.
MITRAL VALVE: MR VCW 0.94 cm.
Chordae rupture (+) multiple, anterior & posterior leaflets.
TRICUSPID VALVE: TAPSE 23.1 mm.
DOPPLER: E/A 1.58/0.73 m/s.
E/E’ 14.2, 10.7.
Systolic reversal flow in PV (+).
MISCELLANEOUS: 110/08/11 MEASUREMENTS AND SCREENING
Ao Diameter (MM) 30
LA / Ao 1.9
AV Cusp (MM) 18
IVSd (MM) 10
LVIDd (MM) 64
LVPWd (MM) 9
IVSs (MM) 14
LVIDs (MM) 38
LVPWs (MM) 18
MV DecT (ms) 181
MV Dec Slope (mm/s²) 7460
EF (Teich) (%) 71
%FS (%) 40
MITRAL VALVE: MR EROA 0.29 cm².
Chordae rupture (+) multiple, anterior & posterior leaflets.
TRICUSPID VALVE: RV S’ 15 cm/s.
DOPPLER: E/A 1.36/0.59 m/s.
E/E’ 15.4, 9.6.
MISCELLANEOUS: Ao 3.01, LA 5.59, IVSd 1.09, LVIDd 6.46, LVPWd 0.93 cm.
Since the follow-up appointment is scheduled for the end of September, I have uploaded the health records for your review.
If possible, could you please describe the condition? Thank you.
Best wishes, Shiqi.
aben, 60~69 year old female. Ask Date: 2021/08/19
Dr. He Dongjin reply Cardiology
Hello, your mitral valve has issues causing regurgitation, which has led to the continuous enlargement of the left atrium and ventricle.
Please return for a follow-up visit to discuss with your attending physician.
Based on your symptoms, we will discuss when intervention for mitral valve repair surgery is necessary.
Changhua Hospital cares about your well-being.
Reply Date: 2021/08/19
More Info
The echocardiogram reports you provided indicate a series of measurements and findings that are crucial for assessing your heart health. Let's break down the key components of the reports and what they suggest about your cardiac condition.
Overview of the Reports
1. Chamber Sizes and Function:
- The left atrium (LA) and left ventricle (LV) sizes are measured, with values indicating normal dimensions in most instances. For example, the LA/AO ratio and the left ventricular internal dimensions (LVID) suggest that the heart chambers are not significantly dilated, which is a positive sign.
- The ejection fraction (EF) is a critical measure of how well the heart pumps blood. Your EF values range from 66% to 72%, which are within the normal range (typically above 55% is considered normal). This indicates that your heart is functioning well in terms of pumping efficiency.
2. Valvular Assessment:
- The reports indicate the presence of mitral valve prolapse (MVP) with chordal rupture, which can lead to mitral regurgitation (MR). The degree of MR varies across the reports, with some indicating trivial to moderate levels. This means that while there is some backflow of blood through the mitral valve, it is not severe enough to cause significant symptoms or complications at this time.
- The aortic valve (AV) measurements and velocities are also noted, with values indicating normal function. However, the presence of aortic stenosis (AS) or regurgitation (AR) is not mentioned, which is a good sign.
3. Doppler Studies:
- The Doppler measurements provide insight into the flow of blood through the heart valves. The E/A ratios and E/E’ values help assess diastolic function, which is how well the heart fills with blood. Your E/A ratios are within acceptable ranges, suggesting that diastolic function is preserved.
- The presence of reversal flow in the pulmonary veins (PV) is noted in some reports, which can indicate elevated pressures in the left atrium, often associated with mitral valve issues.
4. Right Heart Function:
- The tricuspid valve (TV) function is assessed, with TAPSE (tricuspid annular plane systolic excursion) values indicating normal right ventricular function. However, the presence of tricuspid regurgitation (TR) is noted, which is common and often not clinically significant unless severe.
Clinical Implications
Based on the findings from your echocardiogram reports, here are some clinical implications:
- Mitral Valve Prolapse: While MVP can sometimes lead to complications, many individuals live with this condition without significant issues. Regular monitoring is essential, especially if you experience symptoms such as palpitations or shortness of breath.
- Mitral Regurgitation: The degree of MR should be monitored over time. If it progresses to moderate or severe, further evaluation and potential intervention may be necessary.
- Heart Function: Your heart function appears to be well-preserved, with normal ejection fractions and no significant wall motion abnormalities. This is reassuring and suggests that your heart is effectively pumping blood.
- Follow-Up: Given the presence of chordal ruptures and the varying degrees of MR, it is advisable to have regular follow-ups with your cardiologist. They may recommend periodic echocardiograms to monitor any changes in your heart's structure and function.
Conclusion
In summary, your echocardiogram reports indicate that while there are some concerns, particularly regarding the mitral valve, your overall heart function appears to be stable and within normal limits. It is essential to maintain regular follow-ups with your healthcare provider to monitor your condition and address any emerging symptoms or changes in your heart health. Lifestyle modifications, such as maintaining a healthy diet, regular exercise, and managing stress, can also contribute positively to your heart health.
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