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New 2d Echo Form 2024

This document is a 2D echocardiogram report from the Veterans Memorial Medical Center, detailing various cardiac measurements and parameters for a patient. It includes data on left and right ventricle dimensions, blood flow velocities, and diastolic function, along with normal value ranges for comparison. The report concludes with sections for interpretation and conclusion, which are currently left blank.

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0% found this document useful (0 votes)
152 views3 pages

New 2d Echo Form 2024

This document is a 2D echocardiogram report from the Veterans Memorial Medical Center, detailing various cardiac measurements and parameters for a patient. It includes data on left and right ventricle dimensions, blood flow velocities, and diastolic function, along with normal value ranges for comparison. The report concludes with sections for interpretation and conclusion, which are currently left blank.

Uploaded by

drphen07
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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VETERANS MEMORIAL MEDICAL CENTER

North Ave., Diliman Quezon City

DEPARTMENT OF INTERNAL MEDICINE


CARDIOVASCULAR LABORATORY
2D ECHOCARDIOGRAM REPORT
Patient Name: Patient ID:
Room No.: Case No.:
Age/Sex: Rendered Date:
Birth Date: Release Date:
Physician:
Blood Pressure: Height: Weight: BSA:
HR:
2D /M-Mode measurements:
LEFT VENTRICLE RESULT NORMAL ATRIA AND GREAT RESULT NORMAL
VALUES VESSELS VALUES
LVEDD LA (M mode) 2.7-4.0cm
LVESD LA Vol. Index 16-34ml/m2
IVS(D) 0.6-1.0cm AORTA
IVS(S) AO ANNULUS (M:2.3-2.9cm
F:2.1-2.5cm)
PW(D) 0.6-1.0cm S. VALSALVA (M:3.1-3.7cm
F: 2.7-3.3cm)
PW(S) STJ (M:2.6-3.2cm
F: 2.3-2.9cm)
LVEDV 46-150ml Asc. AORTA (M: 2.6-3.4cm
F: 2.3-3.1cm)
LVESV 14-61ml Arch 2.0-3.6cm
SV >65ml MPA 1.5-2.5cm
CO >4.5 L/min/m2 IVC diameter 1.5-2.5cm
CI >2.5 L/min/m2 IVC collapse >50%
FS 27-43% Mitral Annulus 1.9-3.4cm
Tricuspid Annulus 1.3-2.8cm
EF M-mode (Teich) >55% Pulmonic Annulus 1.7-2.3cm

EF M-mode (Cubed) >55% RIGHT VENTRICLE


EF Simpson’s 54-72% RV mid 1.9-3.5cm
LV mass index (M:49-115 gm/m2 RV base 2.5-4.1cm
F:43-95 gm/m2)
LV RWT 0.22-0.42 RA 2.9-4.5cm
LVOT 1.7-2.4cm RA Vol. Index (M: 18-
32ml/m2
F: 15-
27ml/m2)
EPSS <0.7cm RVOT M: 1.7-2.7cm
F: 2.1-3.5cm
LV GLS -19 +/- 5% RVWT >0.5cm
DT RVFAC >35%
IVRT TAPSE >1.7cm
LVET 265 – 325 msec
DOPPLER: HEMODYNAMICS REGURGITATION
Peak Valve
Velocity Velocity Time Ratio Jet Area Gradient
Gradient Area
(m/sec) Integral (cm) (%) (cm2) (mmHg)
(mmHg) (cm2)
Mitral Valve
LVOT/AV
Tricuspid
Val.
RVOT/PA
PAT (m/s) MPAP (RVAT) mmHg SPAP (TR JET) mmHg
DOPPLER STUDY: (LV) DIASTOLIC FUNCTION
PUL. VENOUS VELOCITY MITRAL INFLOW MITRAL ANNULAR TDI
m/ Lateral cm/ E/E'
Systolic m/sec E wave DT
sec E' sec ratio
m/ cm/
Diastolic m/sec IVRT A'
sec sec
A Wave m/ cm/ E/E'
S/D ratio Medial E
dur sec sec ratio
m/ cm/
Ar Velocity m/sec Adur-Adur A'
sec sec
Tricuspi
d
Ar Duration m/sec Lateral (m/sec) 0.10 m/s
Annulus
S’

VETERANS MEMORIAL MEDICAL CENTER


North Ave., Diliman Quezon City

DEPARTMENT OF INTERNAL MEDICINE


CARDIOVASCULAR LABORATORY
2D ECHOCARDIOGRAM REPORT
Patient Name: Patient ID:
Room No.: Case No.:
Age/Sex: Rendered Date:
Birth Date: Release Date:
Physician:

INTERPRETATION:

CONCLUSION:

__________________________
_____________________,MD
Medical Technologist
Echocardiographer
VMMC-MR_DMD-CL Form 014A
Revised February 2024

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