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ECG & 2D Echocardiogram Report Interpretation
Patient: Mr. Prateek Pathak | Age: 37 years, Male | Date: 23 June 2026
1. ECG Findings
| Parameter | Value | Normal Range | Status |
|---|---|---|---|
| Heart Rate | 94 bpm | 60-100 bpm | Normal |
| P duration | 106 ms | <120 ms | Normal |
| PR interval | 166 ms | 120-200 ms | Normal |
| QRS duration | 110 ms | <120 ms | Normal (upper limit) |
| QT interval | 320 ms | Variable | Normal |
| QTc interval | 379 ms | <440 ms (male) | Normal |
| P axis | 48° | 0-75° | Normal |
| QRS axis | 1° | -30° to +90° | Normal |
| T axis | 14° | Within normal range | Normal |
ECG Conclusion: Normal ECG - All intervals, axes, and durations are within normal limits. Heart rate of 94 bpm is normal sinus rhythm. The QRS duration of 110 ms is at the upper limit of normal but does not meet criteria for bundle branch block (<120 ms). The QTc of 379 ms is well within normal range, indicating no risk of arrhythmia from QT prolongation.
2. 2D Echocardiogram Findings
Chamber Dimensions
| Chamber | Measured Value | Normal Range | Status |
|---|---|---|---|
| Left Atrium (LA) | 39.5 mm | 19-40 mm | Normal (upper limit) |
| Left Ventricular Internal Diameter, diastole (LVIDd) | 48.4 mm | <57 mm | Normal |
| Left Ventricular Internal Diameter, systole (LVIDs) | 32.4 mm | <38 mm | Normal |
| Interventricular Septum, diastole (IVSd) | 12.9 mm | 9-11 mm | Thickened |
| LV Posterior Wall, diastole (LVPWd) | 12.9 mm | 9-11 mm | Thickened |
| Right Ventricle (RV) | 23 mm | 9-26 mm | Normal |
| Aortic Root | 31.4 mm | 20-37 mm | Normal |
| Pulmonary Artery | 18 mm | 15-25 mm | Normal |
LV Systolic Function
| Parameter | Value | Normal | Status |
|---|---|---|---|
| Ejection Fraction (EF) | 61% | ≥55% | Normal |
| Fractional Shortening (FS) | 32% | 25-45% | Normal |
| LV End-Diastolic Volume (LVEDV) | 109 ml | 70±9 ml/m² | Normal-high |
| LV End-Systolic Volume (LVESV) | 42 ml | - | Normal |
| Stroke Volume (SV) | 67 ml | 60-100 ml | Normal |
Valve Assessment
| Valve | Finding | Status |
|---|---|---|
| Mitral Valve | EF slope 130 mm/s, EPSS 4mm (<5), MVOA 3.92 cm², no MVP/SAM, no calcification | Normal |
| Aortic Valve | Opening 18.5 mm, tricuspid, central closure, Vmax 0.98 m/s | Normal |
| Tricuspid Valve | EF slope normal | Normal |
| Pulmonary Valve | EF slope normal, no mid-systolic notch | Normal |
Doppler Findings
| Flow | Velocity | Significance |
|---|---|---|
| Mitral E wave | 0.57 m/s | Reduced (E < A indicates impaired relaxation) |
| Mitral A wave | 0.65 m/s | Elevated (atrial kick compensating) |
| E/A ratio | 0.88 | <1 = Grade I diastolic dysfunction |
| Aortic Vmax | 0.98 m/s | Normal (no significant stenosis) |
| Pulmonary Vmax | 0.87 m/s | Normal |
3. Key Diagnoses Explained
A. Mild Concentric Left Ventricular Hypertrophy (LVH)
Both the IVS and LVPW measure 12.9 mm (normal 9-11 mm), meaning the walls are symmetrically thickened. This is called concentric LVH because both walls thicken equally without enlarging the cavity. In a 37-year-old male, the most common cause is systemic hypertension (high blood pressure). Other causes include athletic heart (though usually more pronounced) and certain cardiomyopathies.
B. Grade I (Stage I) Diastolic Dysfunction
The E/A ratio of 0.88 (<1.0) indicates the heart muscle is stiff and relaxes slowly in early diastole. Blood filling the ventricle now depends more on the atrial contraction (A wave dominant) rather than passive early filling (E wave). The left atrium at 39.5 mm (borderline high) reflects the extra pressure the atrium must generate to fill a stiff LV. Systolic function is completely normal - the problem is with relaxation, not contraction.
C. Normal LV Systolic Function (LVEF 61%)
Despite the wall thickening, the heart squeezes normally. An EF of 61% is in the normal range (normal ≥55%), confirming no systolic impairment.
4. What Was Not Found (Reassuring)
- No wall motion abnormality (no evidence of ischemia or prior infarction)
- No pericardial effusion
- No congenital defects (no ASD, VSD, PDA, PS)
- No thrombus, mass, or vegetation
- No significant valvular disease
- No aortic or pulmonary artery dilation
5. Clinical Significance & Next Steps
The combined picture points strongly toward hypertensive heart disease as the underlying etiology. For a 37-year-old:
- Blood pressure control is the priority - Concentric LVH with diastolic dysfunction at this age strongly suggests uncontrolled or undertreated hypertension. ACE inhibitors (e.g., Ramipril) or ARBs are preferred as they help reverse LVH.
- Serial echocardiography - To monitor whether LVH regresses with treatment.
- Lifestyle modifications - Salt restriction, weight management, aerobic exercise, and stress reduction.
- Diastolic dysfunction management - Rate control (avoid tachycardia), diuretics if symptomatic, and BP control.
- Symptoms to watch for - Exertional dyspnea, reduced exercise tolerance, and ankle swelling, which may signal progression to heart failure with preserved ejection fraction (HFpEF).
Important note: This interpretation is for educational purposes. The findings must be correlated with the patient's clinical history, blood pressure readings, symptoms, and other investigations as noted on the report itself. Management decisions should be made by the treating physician.
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