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Q. Please interpret my echo report to rule out PH.

Answered by
Dr. Mohammad Rajja
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 05, 2020

Hello doctor,

I recently had an echo done for my heart, and the results are:

Nondilated aortic root: sinus of Valsalva 3.5 cm, sinotubular junction 2.4 cm. Ascending aorta not imaged. Normal arch appearance normal flow and proximal descending aorta.

Tricuspid, normally functioning aortic valve.

Main pulmonary artery and pulmonary valve appear normal. Normal trans pulmonary Dopplers.

Both AV valves appear morphologically normal with good leaflet excursion.

No regurgitation identified.

Nondilated left atrium: minor axis 3.2 cm, left atrial volume 52 ml.

There is evidence of mild diastolic dysfunction: E velocity 0.72, E DT 454 milliseconds, A velocity I, ratio 0.7, E/E prime (averaged) 7.58.

No internal measurements or volumetric assessment of the left ventricle re-suboptimal images and off axis parasternal view.

The ventricle appears nondilated.

There is good left ventricular function: VT 1 27.3 cm, ejection fraction (visual) 60%.

No regional wall abnormality identified.

Normal longitudinal function: Lateral S wave 14 cm/sec, septal S wave 12 cm second, inferior S wave 11 cm second, anterior S wave 18 cm/sec.

Nondilated, reactive IVC.

Normal right heart appearance.

There is good right ventricular systolic function: TAPSE 18 mm, lateral S wave 15 cm/sec.

No flow identified across the inter-atrial septum in the short axis and subcostal views.

Does this report rule out PH? And how worried should I be?

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#

Hello,

Welcome to icliniq.com.

Nondilated aortic root: Sinus of Valsalva 3.5 cm, sinotubular junction 2.4 cm. Ascending aorta not imaged. Normal arch appearance normal flow and proximal descending aorta. Tricuspid, normally functioning aortic valve. Main pulmonary artery and pulmonary valve appear normal. Normal trans pulmonary Dopplers. All these indicate normal finding.

Both AV valves appear morphologically normal with good leaflet excursion. No regurgitation identified. Nondilated left atrium: Minor axis 3.2 cm, left atrial volume 52 ml. There is evidence of mild diastolic dysfunction: E velocity 0.72, E DT 454 milliseconds, A velocity I, ratio 0.7, E/E prime (averaged) 7.58, indicate mild diastolic dysfunction when heart is taking blood in the ventricle there is a little dysfunction in the heart while blood come in the ventricles. It is mild and will not create any problem.

No internal measurements or volumetric assessment of the left ventricle re suboptimal images and off axis parasternal view. Shows that it is normal and good.

There is good left ventricular function: VT 1 27.3 cm, ejection fraction (visual) 60%. No regional wall abnormality identified. This is anormal finding and good. Normal longitudinal function: lateral S wave 14 cm/sec, septal S wave 12 cm second, inferior S wave 11 cm second, anterior S wave 18 cm/sec. Nondilated, reactive IVC. Normal right heart appearance. There is good right ventricular systolic function: TAPSE 18 mm, lateral S wave 15 cm/sec. Normal is 15 to 25 mm and this is normal. No flow identified across the inter-atrial septum in the short axis and subcostal views. This a normal finding.

Regarding ruling out PH, the invasive measurement of pulmonary artery pressure during right heart cardiac catheterization is required to confirm or refuse a diagnosis of PH.

The first step in assessing the echocardiography probability of PH being present is to measure the peak TRV. If this is a good-quality signal and is greater than 3.4 m/s, there is a high probability of PH being present. If the peak TRV is below 3.4 m/s, the probability of PH is assessed in combination with other echocardiographic markers. Pulmonary Hypertension PH is a rare but life-threatening disease that affects the pulmonary arteries, which are the vessels responsible for carrying blood from the heart to the lungs. The disease is characterized by high blood pressure in the lungs. Do not worry. Keep in regular follow up.

Thank you doctor,

I am worried. Is there anything on the results that would indicate PH?

#

Hello,

Welcome back to icliniq.com.

Your reports are normal. As the report is fit and fine for now, you are also fit and fine. If you have other reports, then kindly send me the attachments.

Thank you doctor,

Is my level of diastolic dysfunction reversible? I have read with exercise and a good diet it can be.

#

Hello,

Welcome back to icliniq.com.

Well, exercise is always an excellent option to keep heart diastolic dysfunction correct.

Have a low-fat diet. Eat healthy fruits.

To put your cholesterol level low tablet Rosuvastatin 20 mg 1 tablet at night for one month. Much you will run or do exercise much it will be in the correct form.

Diastolic dysfunctions are also reversible with cardiac remodeling medicine. Eg. Losartan or Telmisartan. Or you can use ACE inhibitors also like Enalapril, Ramipril, etc.

I hope I will know your blood pressure so that I can also inform you the correct dose of medicine.

Thank you doctor,

Normally my blood pressure has always been slightly elevated or in the normal range. However, in the last few days it has been rather low. This morning it was 102/59. I have recently been taking many more supplements and wonder if that can cause low blood pressure?

I am on multivitamin, Vitamin D 3000 IU, Omega-3 1000 mg, Bio Kult probitoics, and Black Garlic 2400 mg. And I have just started taking Magnesium.

#

Hello,

Welcome back to icliniq.com.

Magnesium can cause low blood pressure. Please reduce the intake of Magnesium. Other medicines are good for your health.

As your blood pressure is low, you cannot start cardiac remodeling drugs like Telmisartan, Losartan or Enalapril because these drugs are antihypertensive as well as cardiac remodeling drugs.


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