Echo reprting of left ventricle parameters
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The document outlines parameters for reporting on the left ventricle based on echocardiography findings. It describes assessing and reporting on cavity size, wall thickness, ventricular mass, shape, systolic and diastolic function, thrombus, mass, and ventricular septal defects. Measurement of ejection fraction and fractional shortening are outlined for evaluating systolic function, and diastolic filling patterns are described for assessing diastolic function. The document provides detailed guidelines for documenting the presence, size, location and characteristics of any abnormalities found.
Echo reprting of left ventricle parameters
- 1. Echocardiography Reporting of Left Ventricular Parameters Dr. Md.Toufiqur Rahman MBBS, FCPS, MD, FACC, FESC, FRCPE, FSCAI, FAPSC, FAPSIC, FAHA, FRCPG, FCCP Associate Professor of Cardiology National Institute of Cardiovascular Diseases Sher-e-Bangla Nagar, Dhaka-1207 Consultant, Medinova, Malibagh branch. Honorary Consulant, Apollo Hospital, Dhaka and Consultant , STS Life Care Centre, Dhanmondi drtoufiq19711@yahoo.com
- 2. LEFT VENTRICLE: A. Cavity Size (Dimensions or Volumes) 1. Normal 2. Increased a. Mild b. Moderate c. Severe 3. Decreased B. Wall Thickness 1. Normal 2. Increased a. Mild b. Moderate c. Severe 3 Decreased 4. Relative Wall Thickness C. Ventricular Mass 1. Normal 2. Borderline 3. Increase 4. LV mass (or LV mass index) Summary
- 3. D. Ventricular Shape 1. Normal 2. Concentric Hypertrophy a. Mild b. Moderate c. Severe 3. Asymmetric Hypertrophy a. Absent b. Present 1) Anterior 2) Posterior 3) Septal 4) Lateral 5) Apical 6) Basal 4. Eccentric Hypertrophy a. Absent b. Present Summary
- 4. 5. Aneurysm a. Absent b. Present 1) Anterior 2) Posterior 3) Inferior 4) Septal 5) Lateral 6) Apical 7) Other (Specify) 6. Pseudoaneurysm a. Absent b. Present 1. Anterior 2. Posterior 3. Inferior 4. Septal 5. Lateral 6. Apical 7. Basal Summary
- 5. E. Systolic Function 1. Global a. Ejection Fraction 1) Normal 2) Borderline 3) Low normal 4) Decreased-a) Mild b) Mild-to-Moderate c) Moderate d) Moderate-to- Severe e) Severe 5) Increased (Hyperdynamic) b. Fractional Shortening (Basal) 1) Normal 2) Decreased 3) Increased Summary
- 6. c. Fractional Area Change 1) Normal 2) Decreased 3) Increased d. Dilated (Congestive) 1) Mild 2) Mild-to-moderate 3) Moderate 4) Moderate-to-severe 5) Severe Summary
- 7. 2. Regional a. Normal b. Hypokinetic 16 or 17 segment c. Akinetic ASE model d. Dyskinetic List score for each segment e. Scar/Thinning f. Not Seen In the case of abnormal septal motion, may code 1) Abnormal (paradoxical) motion consistent with right ventricular volume overload and/or elevated RV end-diastolic pressure 2) Abnormal (paradoxical) motion consistent with post-operative status 3) Abnormal (paradoxical) motion consistent with left bundle branch block 4) Abnormal (paradoxical) motion consistent with RV pacemaker 5) Abnormal (paradoxical) motion due to pre-excitation 6) Flattened in diastole (“D” shaped left ventricle) consistent with right ventricular volume overload 7) Flattened in systole consistent with right ventricular pressure overload 8) Flattened in systole and diastole consistent with right ventricular pressure and volume overload 9) Septal “bounce” consistent with constrictive physiology 10) Excessive respiratory change – consider tamponade, ventilationrelated, etc 11) Other (Specify) Summary
- 8. 3. Myocardial Infarction a. Anterior-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large b. Posterior-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large c. Inferior-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large d. Lateral-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large e. Anteroseptal-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large f. Apical-1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large Summary
- 9. g. Antero-apical 1) Small 2) Small-to-moderate 3) Moderate 4) Moderate-to-large 5) Large h. Postero-lateral 1) Small 2) Small-to-moderate 3) Moderate 4 ) Moderate-to-large 5) Large F. Diastolic Filling 1. Normal 2. Abnormal -a. Pattern :1) Impaired relaxation 2) “Pseudonormal” 3) Restrictive b. Elevated LV Filling Pressure :1) Absent 2) Present a) Elevated mean left atrial pressure (LAP) b) Elevated LV end-diastolic pressure (LVEDP) c) Both elevated LAP and LVEDP G. Thrombus 1. Absent 2. Present a. Size-1) Small 2) Moderate 3) Large b. Location- 1) Apical 2) Basal 3) Lateral 4) Septal c. Shape-1) Flat (mural) 2) Protruding 3) Pedunculated 4) Spherical 5) Regular 6)Irregular 7) Multilobular 8) Other (specify) d. Texture -1) Solid 2) Layered 3) Hypoechoic interior (Cystic) 4) Hyperechoic 5) Calcified e. Mobility-1) Mobile 2) Fixed (Sessile) f. Dimensions Summary
- 10. H. Mass (Tumor) 1. Absent 2. Present a. Size-1) Small 2) Moderate 3) Large b. Location-1) Apical 2) Basal 3) Septal 4) Lateral 5) Intra myocardial 6) Intracavitary c. Shape-1) Flat (mural) 2) Protruding 3) Pedunculated 4) Papillary 5) Spherical 6) Regular 7) Irregular 8) Multi lobular 9) Frond like 10) Infiltrating d. Texture -1) Solid 2) Layered 3) Hypoechoic interior (Cystic) 4) Echogenic 5) Calcified e. Mobility-1) Mobile 2) Fixed (Sessile) f. Dimensions Summary
- 11. Ventricular Septal Defect 1. Absent 2. Present a. Location-1) Membranous (infracristal) 2) Infundibular (supracristal) 3) Inlet 4) Muscular 5) Multiple b. Size- 1) Small 2) Moderate 3) Large 4) Dimensions c. Shunt-1) Left-to-right 2) Right-to-left 3) Bidirectional 4) Qp:Qs ratio Summary