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2D Echo Report Format

The document is a patient assessment form detailing various cardiac measurements and evaluations including chamber dimensions, left ventricular function, valvular assessment, pulmonary artery pressure, pericardium and IVC status, and other observations. It includes sections for recording specific measurements and interpretations, such as ejection fraction and valve conditions. The final impression section is left blank for the physician to fill in after analysis.

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130 views3 pages

2D Echo Report Format

The document is a patient assessment form detailing various cardiac measurements and evaluations including chamber dimensions, left ventricular function, valvular assessment, pulmonary artery pressure, pericardium and IVC status, and other observations. It includes sections for recording specific measurements and interpretations, such as ejection fraction and valve conditions. The final impression section is left blank for the physician to fill in after analysis.

Uploaded by

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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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PATIENT DETAILS:

Name : _________________________________ Age/ Gender : ____/____ Date : ______________

Patient ID: ____________ Referred By : ___________________________

I. CHAMBER DIMENSIONS
Structure Measurement Interpretation
Left Atrium (LA) ______ mm Normal / Enlarged / Thickened
LV Diastole ______ mm Normal / Enlarged / Thickened
LV Systole ______ mm Normal / Enlarged / Thickened
Right Atrium (RA) ______ mm Normal / Enlarged / Thickened
Right Ventricle (RV) ______ mm Normal / Enlarged / Thickened
IV Septum Thickness (IVS) ______ mm Normal / Enlarged / Thickened
Posterior Wall Thickness ______ mm Normal / Enlarged / Thickened
(PWT)

II. LEFT VENTRICULAR (LV) FUNCTION


- Ejection Fraction (EF): __________ %

☐ Normal ☐ Mildly Reduced ☐ Moderately Reduced ☐ Severely Reduced

- Global Wall Motion: ☐ Normal ☐ RWMA Present

- Diastolic Function: ☐ Normal ☐ Grade I ☐ Grade II ☐ Grade III

III. VALVULAR ASSESSMENT


Valve Morphology Motion Regurgitation Stenosis
Mitral Valve Normal / Normal / None / Mild / None / Mild /
Thickened Restricted / Moderate / Moderate /
Prolapse Severe Severe
Aortic Valve Normal / Normal / None / Mild / None / Mild /
Thickened Restricted / Moderate / Moderate /
Prolapse Severe Severe
Tricuspid Valve Normal / Normal / None / Mild / None / Mild /
Thickened Restricted / Moderate / Moderate /
Prolapse Severe Severe
Pulmonary Normal / Normal / None / Mild / None / Mild /
Valve Thickened Restricted / Moderate / Moderate /
Prolapse Severe Severe

IV. PULMONARY ARTERY PRESSURE (Estimated PASP)


- TR Jet Velocity: ______ m/s - Estimated PASP: ______ mmHg

☐ Normal (<30) ☐ Mild (30–40) ☐ Moderate (41–55) ☐ Severe (>55)


V. PERICARDIUM & IVC
- Pericardial Effusion: ☐ None ☐ Mild ☐ Moderate ☐ Severe

- Tamponade Features: ☐ Present ☐ Absent

- IVC Diameter: ______ mm - Collapsibility: ☐ Present ☐


Absent

- Estimated RA Pressure: ______ mmHg

VI. OTHER OBSERVATIONS


- Septal Defect (ASD / VSD): ☐ Absent ☐ Present – ___________ - PDA: ☐ Absent ☐
Present

- Thrombus / Mass / Vegetation: ☐ Not Seen ☐ Present – Site: __________

- LVH / DCM / HCM / RCM: ___________________________

VII. FINAL IMPRESSION




















Dr. Shantanu Mall Visen


MD – Internal Medicine (ICU & Critical Care)
Reg. No. UPMC 71766

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