2DEcho || How to READ 2DEcho report || Echocardiography • Daily Cardiology

Summary

This educational script delves into the interpretation of echocardiogram (ECHO) reports, detailing the significance of various heart components like mitro and aortic valves, and their abnormalities. It explains terms like MVP, mitro anular calcification, and the implications of valve regurgitation and stenosis. The script also covers chamber sizes, wall motion abnormalities, and pressure gradients, concluding with the assessment of heart function and potential conditions like hypertrophic cardiopathy and heart failure. It emphasizes consulting a cardiologist for accurate diagnosis.

Takeaways

• 🔍 An echocardiogram report provides detailed information about the heart's structure and function.
• 🌟 The mitral valve (MV) is crucial, and its normal functioning means it is anatomically normal without issues like mitral valve prolapse (MVP).
• ⚠️ Mitral valve regurgitation occurs when the valve doesn't close properly, causing blood to leak backward.
• 👴 Mitral annular calcification (MAC) is common in the elderly and involves the fibrous ring of the mitral valve.
• 📏 Mitral valve area (MVA) is measured; values below 2 cm indicate mitral stenosis, which may require repair or replacement.
• 🚀 The aortic valve (AV) is vital, and abnormalities can lead to aortic stenosis, affecting blood flow from the left ventricle to the aorta.
• 💔 Valve replacement surgery is indicated by the presence of a prosthetic valve, which is noted in the report.
• 🌡 The aorta's (AO) width is crucial; widths over 3 cm may indicate a life-threatening aortic aneurysm.
• 🏠 The left atrium (LA) size is noted, with dilations of over 4 cm² considered abnormal.
• 🧱 The interatrial septum (IAS) and intraventricular septum (IVS) are assessed for integrity, with defects like ASD and VSD noted.
• 💓 Left ventricular function is gauged by the ejection fraction (LVEF), with ranges indicating normal, hyperfunctioning, low functioning, or possible heart failure.

Q & A

What is the purpose of a transducer in a chest examination?

A transducer is a device used in chest examinations to capture images of the heart and its function, which are then printed on paper for further analysis.

What does MV stand for in a heart examination report?

MV stands for Mitro Valve, also known as the bicuspid valve, which is located between the left atrium and left ventricle.

What is mitro valve prolapse (MVP)?

Mitro valve prolapse (MVP) is a condition where the valve flaps do not fit and close properly, potentially causing blood to leak backward through the valve into the left atrium, a condition known as mitro valve regurgitation.

What does mitro anular calcification (Mac) refer to?

Mitro anular calcification (Mac) is a chronic, progressive condition involving the fibrous ring of the mitro valve, typically seen in elderly patients.

What is the significance of MVA in a heart report?

MVA stands for mitro valve area, which indicates the size of the mitro valve orifice. If the area goes below 2 cm, it can cause an impediment to blood flow, leading to mitro stenosis.

What does AV refer to in the context of a heart examination report?

AV refers to the Aortic Valve, which is situated between the aorta and left ventricle. Abnormalities in the aortic valve can lead to a condition called aortic stenosis.

What is the normal width of the aorta according to the script?

The normal width of the aorta is less than 3 cm. A width greater than 3 cm may lead to life-threatening conditions such as aortic aneurysm.

What is the significance of the left atrium (La) size in heart health?

The normal size of the left atrium is less than 4 cm squared. A size greater than this is considered dilated, which is not normal and may indicate a health concern.

What does IAS stand for and what does its integrity signify?

IAS stands for Inter-atrial Septum, which is the wall between the left and right atria. An intact IAS means the wall is normal, while an abnormality could indicate an atrial septal defect (ASD).

What is the normal width of the intraventricular septum (IVs)?

The normal width of the intraventricular septum (IVs) should be less than 1 cm squared. An increase in the size of the IVs may lead to conditions such as left ventricular hypertrophy (LVH).

What does the term 'hypokinesia' refer to in the context of heart motion?

Hypokinesia refers to a decrease in the movement of the heart walls, indicating a reduction in the heart's pumping efficiency.

What does LVF represent and what is the normal range for it?

LVF represents the left ventricular ejection fraction, which indicates the heart's pumping capacity. The normal range for LVF is between 55% to 70%.

What does a normal 2D ECHO report conclusion look like?

A normal 2D ECHO report conclusion would state something like 'Normal LV and RV function, no RWMA, normal size chambers, normal valves, no MR, AR, TR, and PH.'

What is the difference between mild, moderate, and severe pulmonary artery hypertension according to the script?

Mild pulmonary artery hypertension is indicated by an RVP between 29 to 40, moderate by an RVP between 41 to 50, and severe by an RVP greater than 50.

What is the significance of the inferior vena cava (IVC) size?

The normal size of the inferior vena cava is between 1 to 2 cm. An increase in size suggests too much fluid in the body, which can occur in conditions like heart failure, while a collapsed IVC suggests dehydration.

What does the term 'vegetation' refer to in the context of heart health?

Vegetation refers to masses composed of fibrin, platelets, and infecting organisms held together by antibodies, which are generally seen on heart valves in conditions like endocarditis.

Outlines

00:00

🩺 Understanding Echocardiogram Reports

This paragraph delves into the details of an echocardiogram report, a document generated after a doctor examines the heart using a transducer. It explains various heart valves, such as the mitral valve (MV), and their potential abnormalities like mitral valve prolapse (MVP) and mitral annular calcification (Mac). The report also discusses the importance of the mitral valve area (MVA) and conditions like mitral stenosis that may necessitate valve repair or replacement. Additionally, it covers the aortic valve (AV), tricuspid and pulmonary valves, and the implications of valve replacement surgery. The paragraph concludes with the significance of the aorta (AO), left atrium (La), interatrial septum (IAS), and intraventricular septum (IVS), highlighting their normal conditions and potential abnormalities such as atrial septal defect (ASD) and ventricular septal defect (VSD).

05:00

🏥 Echocardiogram: Heart Wall Motion and Chamber Dimensions

This section of the script focuses on the analysis of heart wall motion and chamber dimensions as revealed by an echocardiogram. It introduces terms like hypokinesia and akinesia, which describe reduced and absent movement of the heart walls, respectively. The walls mentioned include the anterior, posterior, lateral, inferior walls, apex, and IVS. The script then discusses the left ventricular internal diameter (LVID and LVIDs), explaining what constitutes a normal range and the implications of dilation. It also explains the left ventricular ejection fraction (LVEF), which indicates the heart's pumping capacity, and categorizes it into normal, hyperfunctioning, low functioning, and possible heart failure based on percentage values. The paragraph also touches on the right atrium and ventricle (R and RV), tricuspid annular plane systolic excursion (TAP), and pulmonary artery dimensions, concluding with the significance of pressure gradients and velocities in diagnosing valve stenosis.

10:01

🛑 Echocardiogram Conclusions and Additional Findings

The final paragraph of the script outlines how to interpret the conclusions of an echocardiogram report. It describes the conditions under which the report would indicate normal left and right ventricular function, the absence of wall motion abnormalities, and normal chamber and valve conditions. The paragraph also addresses additional findings that may be present in an echo report, such as pericardial effusion, pleural effusion, vegetation, and thrombus, which can indicate various cardiac conditions. The severity of regurgitation and right ventricular systolic pressure (RVSP) are also discussed, with ranges provided for normal, mild, moderate, and severe conditions. The script emphasizes that the echo report is for educational purposes and advises consulting a cardiologist for accurate diagnosis.

Keywords

💡Mitro Valve

The mitro valve, also known as the bicuspid valve, is a critical component of the heart situated between the left atrium and left ventricle. It has two leaflets and is responsible for preventing the backflow of blood. In the script, the mitro valve's normal functioning and potential abnormalities such as mitro valve prolapse and mitro valve regurgitation are discussed, which are central to understanding heart health.

💡Mitro Valve Prolapse (MVP)

Mitro valve prolapse refers to a condition where the valve's flaps do not fit and close properly, potentially causing blood to leak backward. This is a key concept in the script as it illustrates a common heart abnormality that can be detected through an echocardiogram, a diagnostic tool mentioned in the video.

💡Mitro Annular Calcification (MAC)

Mitro annular calcification is a chronic condition affecting the fibrous ring of the mitro valve, typically seen in elderly patients. The script explains this condition as part of the detailed examination of the mitro valve, emphasizing its importance in diagnosing heart abnormalities.

💡Mitro Valve Area (MVA)

The mitro valve area (MVA) is the size of the mitro valve orifice. The script specifies that a normal MVA is about 4 to 6 cm^2, and if it goes below 2 cm^2, it can cause mitro stenosis, which is a significant finding in heart function assessment.

💡Aortic Valve (AV)

The aortic valve is located between the aorta and the left ventricle and plays a crucial role in preventing backflow of blood into the heart. The script discusses aortic stenosis, a condition resulting from an abnormal aortic valve, which is an important aspect of heart health.

💡Tricuspid Valve

The tricuspid valve, with its three leaflets, is situated between the right atrium and right ventricle. The script mentions that this valve is usually normal in most cases, but understanding its function is essential for a comprehensive heart examination.

💡Pulmonary Valve

Located between the right ventricle and the pulmonary artery, the pulmonary valve is another critical component of the heart. The script notes that like the tricuspid valve, it is typically normal, but its assessment is part of a complete heart evaluation.

💡Left Ventricle

The left ventricle is a key chamber of the heart responsible for pumping oxygenated blood to the body. The script discusses the left ventricular internal diameter (LVID) and left ventricular ejection fraction (LVEF), which are vital measurements for assessing the heart's pumping capacity.

💡Left Ventricular Hypertrophy (LVH)

LVH refers to the thickening of the heart muscle, particularly the left ventricle, which can be a consequence of conditions like high blood pressure. The script uses LVH as an example of a condition that can be identified through the evaluation of the posterior wall thickness.

💡Regional Wall Motion Abnormality (RWMA)

RWMA pertains to the movement or motion of the heart walls, which is crucial for understanding how efficiently the heart is pumping blood. The script explains hypokinesia and akinesia as types of RWMA, which are significant in diagnosing heart function issues.

💡Pulmonary Artery

The pulmonary artery carries blood from the heart to the lungs. The script discusses the normal diameter of the pulmonary artery and conditions such as dilation, which can indicate heart-related issues like pulmonary hypertension.

💡Inferior Vena Cava (IVC)

The inferior vena cava is responsible for bringing blood from the lower half of the body back to the heart. The script explains that the size of the IVC can indicate conditions like heart failure or dehydration, making it a vital component in a heart examination.

Highlights

Introduction to the process of receiving and interpreting a transthoracic echocardiogram (TTE) report.

Explanation of the mitral valve (MV) and its normal function.

Description of mitral valve prolapse (MVP) and its implications.

Mitral annular calcification (Mac) as a chronic condition affecting the mitral valve.

Details on mitral valve leaflets and their potential abnormalities.

Mitral valve area (MVA) and its importance in blood flow.

Mitral stenosis as a condition requiring valve repair or replacement.

Aortic valve (AV) and its role in aortic stenosis.

Information on tricuspid and pulmonary valves, their normalcy, and potential for replacement.

Aorta (AO) measurements and the risk of aortic aneurysm.

Left atrium (La) size and its dilation implications.

Interatrial septum (IAS) and atrial septal defect (ASD).

Intraventricular septum (IVs) and its role in ventricular septal defect (VSD).

Posterior wall (PW) and its relation to left ventricular hypertrophy (LVH).

Regional wall motion abnormality (WMA) and its impact on heart pumping efficiency.

Left ventricular internal diameter (LVID) and its dilation.

Left ventricular ejection fraction (LVEF) and its significance in heart health.

Classification of LVEF into normal, hyperfunctioning, low functioning, and possible heart failure.

Right atrium (RA) and right ventricle (RV) conditions and their dilation.

Tissue Doppler imaging (TDI) and its use in assessing right ventricular function.

Pulmonary artery (Pa) and its dilation as an indicator of pulmonary hypertension.

Inferior vena cava (IVC) size and its implications for fluid status in the body.

Pressure gradient (PG) and mean pressure gradient (MPG) in valve stenosis assessment.

Velocity measurements in mitral and aortic valves for stenosis severity.

Regurgitation and its classification based on severity in different heart valves.

Right ventricular systolic pressure (RVSP) and its relation to pulmonary artery pressure.

Other findings such as effusion, vegetation, and thrombus in echocardiogram reports.

Conclusion writing in echocardiogram reports based on normal or abnormal findings.

Transcripts

you will receive a piece of paper like

this after doctor examine your chest for

a couple of minutes with a device called

transducer and then it will be typed and

printed on paper this paper consists of

many information about heart and its

function n

abnormality there are many different

types of format for todco report but we

are choosing this one so it will be easy

for us to understand although they all

have the same

information let's start one by one at

first we have MV MV means mitro valve

mitro valve is also known as bicuspid

valve because it has to leaflets and it

is situated between left atrium and left

ventricle normal means mitro valve is

anatomically normal and well

functioning let's see

abnormality MVP means mitro valve

prolapse a prolapsed mitro valve means

that the valves flaps do not always fit

and close properly between each bead of

the heart which may cause the valve to

leak blood backward through the valve

back to the left atrium this condition

is called mitro valve

regurgitation Mac means mitrol anular

calcification mitro anular calcification

is a chronic progressive condition

involving the fibrous analy of the mitro

valve and it is generally seen in

elderly

patients to Deo also givs detailed

information about the leaflets of mitro

valve which are anterior mitro leaflet

and posterior mitro leaflet which can be

normal thicken or calcify MVA means

mitro valve area the normal area of the

mitro valve orifice is about 4 to 6 cm

and the mitro valve area goes below 2 cm

the valve causes an impediment to the

flow of blood into the left ventricle

creating a pressure gradient across the

mitro valve this condition is called

mitro stenosis that may require mitro

valve repair or

replacement next is Av AV means aortic

valve this valve is situated between

aorta and left ventricle an abnormal

aortic valve can be scerotic or calcific

and it leads to condition called aortic

stenosis the other two valves are

tricuspid valve fan pulmonary valve

tricuspid valve has three leaflets and

is situated between right atrium and

right ventricle and pulmonary valve is

situated between right ventricle and

pulmonary

artery these both valves are normal in

most of the

cases if patient had a valve replacement

surgery then there will be written

prosthetic valve in situ which means

prosthetic valve is present in heart

situ means

present next Is AO AO means aorta aorta

sends blood to all parts of the body

normal width of aorta is less than 3 cm

more than 3 cm aorta may lead to

life-threatening condition like aortic

aneurysm that may lead to aortic

rupture next is La La Means left

atrium the normal size of left atrium is

less than for cm square more than for

cenm square consider as dilated left

atrium which is not normal

next is

Ias IAS means in atrium

septum it is a wall between oper to

chambers of heart left and right

atrium intact means the wall is normal

and the abnormality is

ASD ASD means atrial sepal defect

commonly known as whole in a

heart next is

IVs IVs means intraventricular septum it

is a wall between the lower to chambers

of heart left and right

ventricles intact means the IVs is

normal and the abnormality is vssd

ventricular septile

defect between ASD and vssd ASD is more

commonly

seen the normal width of IVs should be

less than 1 cm

square next is

PW PW means posterior wall the normal

width to posterior wall is less than 1

cm increase in a WID to posterior wall

and intraventricular septum may lead to

condition called

LVH left ventricular hypertrophy which

is one of the cause of high blood

pressure next is our

WMA in full form it is regional wall

motion

abnormality it is about the movement or

motion of heart in other words it is

about how fluidly the heart is pumping

with help of all

walls most common words are here is

hypokinesia and

ainio hypo means less or decrease and

kinesia means movement so hypokinesia

means decrease movement and akinesia

means no movement at

all and the walls are anterior wall

posterior wall lateral wall inferior

wall Apex and

IVs next is LV ID and

lvids lvid means left ventricular

internal diameter and

diast an lvids means left ventricular

internal diameter and

syy the normal range for lvid is 3.5 to

5.6

cm and the normal range for lvids is 2.0

to 4.0

CM increase in a size of these are

called dilated left ventricle next is

lvf left ventricular ejection fraction

lvf represents the pumping capacity of

heart and in common words it represents

the heart

health lvef presented in

percentages lvef between 55 to 70%

consider as normal functioning heart

more than 70% tell the F consider as

hyperfunctioning heart which is not

normal this may lead to the condition

called hypertrophic

cardiopathy lvf between 40 to 55%

considered as low functioning heart ant

lvf less than 40% considered as possible

heart failure the Ino lvf is classified

as normal LV function f LV function mild

LV dysfunction moderate LV dysfunction

and severe LV dysfunction 60 to 70% lvf

is considered as normal LV function 51

to 60% LV f is considered as feral the

function 41 to 50% LV f is considered as

mild LV dysfunction 31 to 40% tvf is

considered as moderate LV dysfunction an

alv F less than 30% considered as severe

LV

dysfunction next is r and RV right

atrium and right ventricle these

Chambers are either normal or dilated

dilated ra and RV scene in right

ventricular

dysfunction next is

tapay tapay means TripIt annular plane

systolic Excursion it is study to

determine the right ventricular systolic

function tap say less than 1. for

CM considered as right ventricular

dysfunction next is Pa Pa means

pulmonary

artery pulmonary artery carries blood

from heart to lungs

and the normal diameter of pulmonary

artery is between 20 to to 28 mm

increase in a size of pulmonary artery

consider as dilated pulmonary artery

next is

IVC inferior venina Cava inferior venova

brings blood from the lower half a body

to Heart the normal size of inferior

venova is between 1 to 2

cm increase in a size of inferior venne

Cava is is called dilated IVC which

suggests too much fluid in body which

happens in a condition like heart

failure collapsed IVC suggests

dehydration and patient needs fluid

replacement next is PPG and Dam PG teak

pressure gradient and mean pressure

gradient the gradient study is to

determine the severity of valve

stenosis which happens in heart valve

disease the normal gradient value for

mitro valve is zero and for aortic valve

it is less than

five in mild stenosis the MPG for mitro

valve is between 1 to 5 and for aortic

valve it's between 6 to

25 in moderate stenosis dmpg for mitro

valets between 6 to 10 and for aortic

valet between 26 to

50 and in severe stenosis the mpg for

mitro valve is more than 25 and moric

valve it's more than

50 next is

velocity in mitro valve the velocity

during e wave should be greater than the

velocity during a wave it means the

ratio of peak velocity blood flow from

left ventricular relaxation in early

diast which is ewave to Peak velocity

flow and late diast caus biotrial

contraction which is a wave and for

aortic valve the normal velocity is one

in mild stenosis it's between 2.5 to 2.9

in moderate stenosis it's between 3 to 4

and in severe stenosis it's more than

four next is

regurgitation valve

regurgitation is a condition in which

the heart's valve doesn't close tightly

which allows blood to flow backward in

the

heart regurgitation can happen in mitro

valve aortic valve and tricuspid

valve severity of rigur itation can

classifi in Trivial mild moderate and

severe next is our

VSP our VSP means right ventricular

systolic

pressure our VSP helps to assess the

pulmonary artery pressure or pulmonary

artery

hypertension are vssp less than 28

consider as normal pulmonary artery

pressure

our VSP between 29 to 40 considered as

mild pulmonary artery

hypertension our VSP between 41 to 50

considered as moderate pulmonary artery

hypertension and our vssp more than 50

considered as severe pulmonary artery

hypertension axillary other important

information from

too first we have a fusion it means

collection of too much fluid in outer

area of organ if a fusion happens in

heart's outer area it's called

pericardial diffusion and if a fusion

happens in lung's outer area it's called

plural

effusion next is

vegetation vegetation or masses composed

the fibron plets and infecting organisms

held together by aguena antibodies

produced by the bacteria and generally

seen on heart's valve which is seen in

condition like

endocarditis

and last is

thrombus thrombus is a clot of blood

cells which can present in any chamber

of

heart conclusion if the 2D EO report is

normal then conclusion will be look like

this normal LV and RV function no R WMA

normal size Chambers normal valves no Mr

a r TR and

pH and if to De Echo is not normal then

conclusion will be written according to

report please note that this video is

only made for educational purposes

kindly consult a cardiologist before

jumping into any

conclusion for many such informative

video please like And subscribe to daily

Cardiology and please comment your views

and questions regarding the

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