Interpret
Reading File
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Based on all findings from the textbooks and the echo report in the image, here is a thorough interpretation:
Echocardiography Report Interpretation
Patient: Mariyumma P P K | 76-year-old Female | Government Medical College Hospital Kannur
Date: 29 May 2026 | Report No: 33214
Measurements at a Glance
| Parameter | Patient Value | Normal Range | Status |
|---|---|---|---|
| Aortic Root (AO) | 30 mm | 20-35 mm | Normal |
| Left Atrium (LA) | 41 mm | 19-40 mm | Mildly enlarged |
| Ejection Fraction (EF) | 60% | >50% | Normal (preserved) |
| LV Internal Diam. Diastole (LVIDd) | 40 mm | 36-52 mm | Normal |
| LV Internal Diam. Systole (LVIDs) | 27 mm | 23-39 mm | Normal |
| IVS (Interventricular Septum) | 13 mm | 6-11 mm | Thickened |
| PWD (Posterior Wall Diastole) | 12 mm | 6-11 mm | Thickened |
Valves
- Mitral Valve: Annular calcification - This is a degenerative finding common in elderly patients. In this 76-year-old, it is associated with longstanding hypertension and/or aging. It can impair normal annular sphincter function and contribute to mitral regurgitation (confirmed here as mild MR on Doppler). As noted in Harrison's 22E, mitral annular calcification can cause mixed primary and secondary MR.
- Aortic, Tricuspid, Pulmonary Valves: Normal
Chambers
- Left Atrium: 41 mm - Mildly dilated (normal upper limit 40 mm). This is a marker of chronically elevated left-sided filling pressures, often from diastolic dysfunction or long-standing hypertension.
- Right Atrium: Normal
- Left Ventricle: Hypertrophied - IVS at 13 mm and posterior wall at 12 mm are both above the 6-11 mm normal range. This pattern of concentric LV hypertrophy in an elderly female is classic for longstanding hypertensive heart disease.
- Right Ventricle: Normal
Septae
- IVS: 13 mm (thickened, confirming LV hypertrophy)
- IAS (Interatrial Septum): Intact - no ASD
Great Arteries
- Aorta: Normal
- Pulmonary Artery: Mild pulmonary arterial hypertension - PASP 48 mmHg (normal <35 mmHg). This constitutes mild-to-borderline pulmonary hypertension by echocardiographic criteria. It is likely secondary (Group 2 PH) to the elevated left-sided filling pressures from diastolic dysfunction, rather than primary pulmonary vascular disease.
Doppler Data
| Valve | Finding | Significance |
|---|---|---|
| Mitral | E=0.5 m/s, A=0.7 m/s, E/A=0.7 | E/A <1 indicates diastolic dysfunction (Grade 1 - impaired relaxation) |
| Aortic | Velocity 1.3 m/s | Normal (<2.0 m/s) |
| Tricuspid | Trivial TR | Physiological, not significant |
| Pulmonary | Velocity 1.0 m/s | Normal |
| LVOT | Normal | No obstruction |
The E/A ratio of 0.7 (E < A) reflects impaired left ventricular relaxation - the ventricle is stiff (due to hypertrophy) and relies more on atrial kick (A wave) for filling. This is Grade I diastolic dysfunction, consistent with the LV hypertrophy seen.
The mild MR on mitral Doppler is consistent with mitral annular calcification distorting the annular geometry.
Wall Motion & Pericardium
- Wall Motion Abnormalities: Nil - no regional wall motion abnormalities, so no evidence of ischemia or prior myocardial infarction
- Pericardium: Normal - no effusion
Overall Summary / Clinical Interpretation
This echo is consistent with hypertensive heart disease in an elderly woman. The key findings cluster around a single pathophysiological mechanism:
- LV concentric hypertrophy (IVS 13 mm, PW 12 mm) from longstanding systemic hypertension
- Preserved systolic function (EF 60%) - this is Heart Failure with Preserved EF (HFpEF) pattern
- Grade I diastolic dysfunction (E/A 0.7) - stiff, non-compliant LV
- Mildly dilated LA (41 mm) - marker of chronically elevated filling pressures
- Mitral annular calcification with mild MR - a degenerative complication of hypertension/aging
- Mild pulmonary hypertension (PASP 48 mmHg) - secondary to elevated left-heart filling pressures (Group 2 PH)
Clinical note: The absence of wall motion abnormalities makes significant coronary artery disease less likely as the primary driver. The echo pattern strongly favors systemic hypertension as the underlying etiology. Blood pressure control, rate control if symptomatic, and evaluation for heart failure symptoms (dyspnea, edema) would be the next clinical steps.
Sources: Textbook of Clinical Echocardiography; Harrison's Principles of Internal Medicine 22E; Braunwald's Heart Disease; Murray & Nadel's Textbook of Respiratory Medicine
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