Transthoracic Echo Report

Name:SMITH, IDA Sex: F Exam Loc: OP Referring Physician: Michelle D Miller, MD MRN:1000547354 DOB: 11/18/1942 Age: 73 Reading Physician: Farhat Khairallah, MD FIN:6613303590 Exam Date: 05/25/2016 09:49 Ordering Physician: Miller, Michelle Ht (in):62 Wt (lb): 170 BSA: 1.8 Prior Study Date: Sonographer: Lacy Ward, RCS Ordered: Routine Dr. Notified:No Notify Date/Time:

Procedure CPT: 93306 Indications: Cardiac murmur, unspecified

ICD Codes: R011

Procedure Performed: E-2D MM Dop.

BP:148 / 81 HR: 72 Rhythm: Other Technical Quality: Fair

FINDINGS Left Ventricle Left ventricular cavity size normal. Normal left ventricular ejection fraction. Left ventricular ejection fraction is 60-65%. Left ventricular wall thickness mildly increased. Abnormal relaxation filling pattern of the left ventricle for age (stage 1 diastolic dysfunction).

Right Ventricle Mild right ventricular dilatation. Normal right ventricular global systolic function.

Left Atrium Normal left atrial size.

Right Atrium Normal right atrial size.

Mitral Valve Mitral valve structurally/functionally normal. No significant MR

Aortic Valve Diffuse thickening of the aortic valve cusps with reduced excursion. Mild calcific aortic stenosis.

Tricuspid Valve Normally structured tricuspid valve. Mild tricuspid regurgitation (normal variant). Right ventricular systolic pressure estimated to be 34 mm Hg.

Pulmonary Valve Structurally normal pulmonic valve. Minimal pulmonic regurgitation (normal variant).

Pericardium No pericardial effusion.

CONCLUSIONS Normal left ventricular size and systolic function. The estimated ejection fraction of the left ventricle is 60-65%. Dilated right ventricle with preserved function. Mild calcific aortic stenosis. Grade 1 diastolic dysfunction.

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MEASUREMENTS (Male / Female) Normal Values 2D ECHO LV Diastolic Diameter PLAX 4.2 cm 4.2 - 5.9 / 3.9 - 5.3 cm LV Systolic Volume 2D Cubed16.2 ml LV Systolic Diameter PLAX 2.5 cm LV Diastolic Volume 2D Cubed 71.5 ml IVS Diastolic Thickness 1.2 cm 0.6 - 1.0 / 0.6 - 0.9 cm LV Ejection Fraction 2D Cubed 77.3 % LVPW Diastolic Thickness 1.2 cm 0.6 - 1.0 / 0.6 - 0.9 cm LV Ejection Fraction 2D Teich69.9 % LV Relative Wall Thickness 0.6 LV Ejection Fraction MOD BP 62.5 % >= 55 % RV Internal Dim ED PLAX 3.3 cm LV Cardiac Index MOD BP 964.8 cm³/min·m² LVOT Diameter 1.9 cm LV Ejection Fraction MOD 4C62.7 % Aortic Root Diameter 2.9 cm LV Cardiac Index MOD 4C 1234.9 cm³/min·m² LA Systolic Diameter LX 3.3 cm 3.0 - 4.0 / 2.7 - 3.8 cm LV Ejection Fraction 4C AL 64.6 % LV Stroke Volume 2D Teich 53.4 ml LV Cardiac Index 4C AL 1282.5 cm³/min·m² LV Stroke Index 2D Teich 30.0 ml/m² LV Ejection Fraction MOD 2C63.0 % LV Stroke Volume 2D Cubed 55.3 ml LV Ejection Fraction 2C AL 66.2 % LV Stroke Index 2D Cubed 31.1 ml/m² LV Cardiac Index 2C AL 746.8 cm³/min·m² LV Systolic Volume 2D Teich 23.0 ml LA Volume Index 14.6 cm³/m² 16 - 28 cm³/m² LV Diastolic Volume 2D Teich 76.4 ml

M-MODE Aortic Root Diameter MM 2.5 cm LA Ao Ratio MM 1.4 LA Systolic Diameter MM 3.4 cm AV Cusp Separation MM 1.5 cm

DOPPLER AV Peak Velocity 2.3 m/s Isovolumic Relaxation Time 77.0 ms AV Peak Gradient 21.2 mmHg LV E' Lateral Velocity 0.1 m/s AV Mean Gradient 10.0 mmHg Mitral E to LV E' Lateral Ratio13.0 AV Velocity Time Integral 47.8 cm LV E' Septal Velocity 0.1 m/s LVOT Peak Velocity 1.2 m/s Mitral E to LV E' Septal Ratio 9.0 LVOT Peak Gradient 5.6 mmHg TV Peak Velocity 0.5 m/s LVOT Velocity Time Integral 25.3 cm TR Peak Velocity 2.7 m/s LVOT Cardiac Index 2768.2 cm³/min·m² TR Peak Gradient28.5 mmHg AV Area Cont Eq vti 1.5 cm² Right Atrial Pressure 10.0 mmHg AV Area Cont Eq pk 1.5 cm² Pulmonary Artery Systolic Pressure 38.5 mmHg Mitral E Point Velocity 0.8 m/s Right Ventricular Systolic Pressure 38.5 mmHg Mitral A Point Velocity 1.1 m/s PV Peak Velocity 1.1 m/s Mitral E to A Ratio 0.7 PV Peak Gradient 4.4 mmHg

Farhat Khairallah MD (Electronically Signed) Final Date: 25 May 2016 11:09

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