Heart & Cardiology/echo results


QUESTION: I had echo and was told right ventricle was mildly enlarged at 2.5 cm and mild pulmonary hypertension with RSVP of 37mmHg. I went for second opinion and on this echo I was told all was normal. Right ventricle was 3.3 cm but RSVP  was not done. I was told I was fine. How can these measurements be so differt in one month and why does one cardiologist say 2.5 cm is enlarged and one say 3.3 cm is normal? Should I be having further tests? I do have mitral regurgitation.

ANSWER: Hi, http://blog.myheart.net,

You would be amazed at the variation in the reports of some of these studies, a lot is dependent on the way the study was done and who was reading it at the time. It unfortunately difficult for me to comment on these without access to the studies.

As for the right ventricle size, a lot of the comments generated on the reports are from standardized reference ranges. 25 is considered normal and 33 would be considered as mildly abnormal. It once again depends where exactly in the right ventricle this was measured. It may have been a little different in the 2 studies. If you are specifically wanting the measurements addressed i would just call the office, state your concern and ask them to address the discrepancy.

If your cardiologist told you it was normal, they are really saying that there is no significant abnormality and nothing that specifically needs addressing. With mild pulmonary HTN, and no clear underlying cause, the treatment is similarly ensuring your cardiovascular health as normal, i.e. treating blood pressure, lifestyle and such.

Hope that was helpful,

---------- FOLLOW-UP ----------

QUESTION: Thanks for your response. I was told that my mitral regurgitation is what could be causing the increase in pressure. Is that correct? I do have appointment next week to get more answers. Thanks.

ANSWER: Hi, http://blog.myheart.net/2014/06/01/leaky-heart-valve-when-the-mitral-valve-fails. http://blog.myheart.net/2013/05/12/mitral-valve-prolapse-part-4-introduction-to-.

I'm not sure how severe your mitral regurgitation is. If it is indeed severe in nature, then its possible that its contributing to elevated pulmonary pressures. Current guidelines state that in the case of severe mitral regurgitation and PA pressures (RVSP) >40mmHg then surgical correction should be considered at that time. If your mitral regurgitation is mild/moderate then the mitral regurgitation is not to blame for the increased pressures. I attached some articles I've written on the subject above. Importantly you need to clarify what the grade of your mitral regurgitation is (mild/moderate/severe).

I hope that was helpful,  

---------- FOLLOW-UP ----------

QUESTION: Thanks again for your information.  My mitral regurgitation is mild to moderate.  On my first echo I was told RVSP was 37mmHg.  I had a second echo one month later and that doctor just told me that my Tricuspid regurgitation jet was not peaked enough to calculate the pressure.  She assures me that I do not have pulmonary hypertension and that the first echo with another doctor was just a estimate or eyeballed guess.  She told me my mitral regurgitation was benign and she feels I will never need surgery unless it gets worse.  I just can't seem to forget those words pulmonary hypertension that the first doctor told me.  Do you feel I need further tests?  I really have very little symptoms.  Chest pain occasionally but do have GERD.  No shortness of breath with exercise.  Never smoked, not overweight, blood pressure normal.


The mild to moderate regurgitation is certainly not of concern here. the fact your doctor told you that you don't need to worry about pulmonary hypertension is very reassuring and i wouldn't worry if i were you. Have check ups as usual. And if you were to ever develop symptoms of shortness of breath on exertion then it may be reasonable to repeat the echo at that time.

Hope that was helpful,  

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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