Download Echocardiography Report

Cardiovascular Imaging Laboratory
Transthoracic Echocardiographic Study Report
Name:
Patient ID:
Exam Date:
Ht:
Sonographer:
DOB:
Study Location:
Previous Study:
Reading Physician:
Primary Care Physician:
Referring Physician:
Copy To:
in
Wt:
lb
Age:
Yrs
BSA:
m
2
Gender:
Medications:
Indications:
Risk Factors and Assessment:
Procedure:
Sonographer Comments:
Ejection fraction is
%. Please modify this number if necessary.
*These comments will remove from the final report.
Observations
Left Ventricle:
Normal chamber size. Normal wall thickness. Normal global systolic function. Normal diastolic
function. No resting wall motion abnormalities noted.
Right Ventricle:
Chamber size is normal. Global systolic function is normal.
Left Atrium:
Left atrium is normal in size.
Right Atrium:
Right atrium is normal in size.
Mitral Valve:
Valve appears structurally normal. No evidence of stenosis. No significant regurgitation visualized.
Aortic Valve:
Valve appears structurally normal. No evidence of stenosis. No significant regurgitation visualized.
Tricuspid Valve:
Valve appears structurally normal. No evidence of stenosis. No significant regurgitation visualized.
Pulmonic Valve:
Valve appears structurally normal. No evidence of stenosis. No significant regurgitation visualized.
Pericardium:
Pericardium appears normal. There is no pericardial effusion visualized.
Aorta:
Aortic root is normal in size.
Pressures:
Pulmonary artery systolic pressure is normal.
Venous:
The inferior vena cava is not dilated and shows more than 50% respiratory variation.
Other:
There is no pleural effusion present.
Conclusions
 Normal echocardiogram.
Yes
Electronically Signed
Patient:
Patient ID #:
M-Mode Dimensions
RVDd
IVSd
IVSs
LVIDd
LVIDs
LVPWd
LVPWs
Ao Root Diam
Ao Ascend Diam
Ao Cusp Sep
LA Diameter
% Fractional Short
% EF M-Mode
EPSS
Adult Values
cm
cm
cm
cm
cm
cm
cm
cm
cm
cm
cm
%
%
cm
Normal Range
0.7 – 2.3 cm
0.6 – 1.1 cm
2D Dimensions
RVDd
IVSd
IVSs
LVIDd
LVIDs
LVPWd
LVPWs
Ao Root Diam
Ao Ascend Diam
Ao Cusp Sep
LA Diameter
LA Area (ESV A4C)
LA Area (EDV A4C)
% FS
% EF 2D
EPSS
Adult Values
cm
cm
cm
cm
cm
cm
cm
cm
cm
cm
cm
cm2
cm2
%
%
cm
Normal Range
0.7 – 2.3 cm
0.6 – 1.1 cm
Simpson’s Values
LVEDV-4ch
LVESV-4ch
%EF 4ch
LVEDV-2ch
LVESV-2ch
%EF 2 ch
% EF Simpson’s
Stroke Vol (BP)
Cardiac Output
Stroke Index (A4C)
Stroke Index (A2C)
Adult Values
ml
ml
%
ml
ml
%
%
ml
ml/min
ml/m2
ml/m2
Normal Range
56 – 155 ml
19 – 58 ml
55 – 85%
56 – 155 ml
19 – 58 ml
55 – 85%
50 – 85%
Other Values
Heart Rate
LVOT Diam
RVOT Diam
RVOT VTI
IVRT
LV Mass
LV Mass Index
LA Volume
LA Volume Index
Qp:Qs
Adult Values
bpm
cm
cm
cm
msec
g
g/m2
ml
ml/m2
Normal Range
3.5 – 5.6 cm
2.0 – 4.0 cm
0.6 – 1.1 cm
0.9 – 1.8 cm
2.0 – 4.0 cm
< 3.4 cm
1.5 – 2.6 cm
2.0 – 4.0 cm
30 – 45%
1.0 cm
3.5 – 5.6 cm
2.0 – 4.0 cm
0.6 – 1.1 cm
0.9 – 1.8 cm
2.0 – 4.0 cm
< 3.4 cm
1.5 – 2.6 cm
2.0 – 4.0 cm
30 – 45%
50 – 85%
1.0 cm
Exam Date:
Doppler Measurements
Mitral Valve
Peak Velocity
Mean Velocity
Peak PG
Mean PG
MV VTI
MVA
Press Half Time
Decel Slope
Decel Time
Peak E
Peak A
E to A Ratio
E' Medial
E' Lateral
E / E' Medial
E / E' Lateral
ERO
PISA Rad
MR VTI
Aliasing Vel
MR Vmax
MR Flow
MR Vol
MR PISA
Tricuspid
Peak Velocity
Mean Velocity
Peak PG
Mean PG
RA Pressure
RVSP
Pulmonary
Peak PG
Mean PG
Velocity
PAT
LVOT
Peak Velocity
Mean Velocity
LV Peak PG
LV Mean PG
LV VTI
Aortic Valve
Peak Velocity
Mean Velocity
Peak PG
Mean PG
AVA
Ao VTI
Press Half Time
Adult Values
m/s
m/s
mmHg
mmHg
cm
cm2
msec
cm/s2
msec
m/s
m/s
Normal Range
4.0 – 6.0 cm2
160 – 240 msec
0.60 – 1.30 m/s
0.30 – 0.60 m/s
0.8 – 2.5
m/s
m/s
mm2
cm
cm
cm/s
m/s
ml/s
ml
cm2
m/s
m/s
mmHg
mmHg
mmHg
mmHg
mmHg
mmHg
m/s
msec
0.3 – 0.7 m/s
0.5 – 1.0 m/s
m/s
m/s
mmHg
mmHg
cm
0.7 – 1.1 m/s
m/s
m/s
mmHg
mmHg
cm2
cm
msec
0.9 – 1.7 m/s
<10 mmHg
<10 mmHg
2.5 – 3.5 cm2
Resting Wall Motion Rest Score: 1.0
1 – Normal
1 – Normal
1 – Normal
2 – Hypokinetic
2 – Hypokinetic
2 – Hypokinetic
1 – Hyperkinetic
1 – Hyperkinetic
1 – Hyperkinetic
3 – Akinetic
3 – Akinetic
3 – Akinetic
4 – Dyskinetic
4 – Dyskinetic
4 – Dyskinetic
X
X –– Not
Not
X Visualized
–Visualized
Not
X Visualized
– Not Visualized
5 – Dilated
5 – Dilated
and
5 – Dilated
Thinned
Thinned
and Thinned
and Thinned