Heart & Cardiology/Echo question


I had a echo yesterday & my doctor told me it looked great. I brought a copy home and have a few questions. All chambers were normal size and function. No RMWA?  Doppler TR  Trivial is circled. PR Trivial and Mild is circled. PV flow =NL LAP?  PASP 40-45mmHG  RAP 15-20mmHG

This echo is harder for me to read & understand. It looks very different from the one I had before.
I looked up PSAP and see this is a high value & am concerned. My doctor didn't mention it to me. My stress tests was normal. I had very high anxiety during this test. Can you tell me what all this means & if I need to call my doctor and ask more questions.



You basically have a normal echocardiogram. No RMWA is good, it means no regional wall motion abnormality. NL LAP means normal left atrial pressure. PASP is pulmonary artery systolic pressure, 40-45 is higher than normal. However its important to note this may not be accurate and the picture quality my be limited and the results automated.

If i were you i would drop a note to your cardiologist saying "I noticed the elevated estimated PA pressure on my echocardiogram, I'm not sure whether this was due to the quality of the TR jet or is indeed accurate, and if so do i have pulmonary hypertension." He/she can then go and review the study to see if theres any abnormality.

There is certainly no major abnormality, and i wouldn't worry too much. Keep up the good work exercising and paying attention to cardiovascular risk factors and exercising.

Hope that was helpful,

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

QUESTION: I was also told that I have a valve that is prominent. It is suppose to go away at birth. Also I see IVC looks like 2.5
could this help with the higher reading? Thanks!   I've been worried all weekend....


The valve you are referring to is a prominent eustachian valve, and i wouldn't worry about that at all, its likely of no consequence whatsoever to you. The IVC reading is a little high, but in the setting of no other disease its likely normal and once again unless told to, don't worry.

Hope that was helpful!

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

QUESTION: Well, I talked to the cardio dr. this afternoon and he says that the IVC is enlarged, but it's possible the measurment is not correct. This IVC measurement is calculated with the RAP and PASP and it would make these numbers higher.  I had a recent calcium score test that was graded as 0 :)) But it reaveled a few simple cysts in my liver. He wants me to follow up witha CT on my liver...

I think I want him to redo that part of the echo and see if the numbers are still elevated, I bet it's a mistake. I had a echo last year and it says IVC: right atrial pressure is 5-10 mmHg  Then if they are go in to a cath lab to see what the pressure is. I can't have this hanging over me. DO you have any opinions or ideas?

Hi, http://blog.myheart.net/2013/08/12/echocardiography-part-1-what-is-an-echocardio

I really think you should ask to briefly speak to the cardiologist regarding your concerns. He may be able to alleviate your concerns in just a few seconds.

Im not clear on why you had the test, the findings can be interpreted differently in the setting of symptoms, or no symptoms. The PA pressure is calculated by using the derived velocity of the tricuspid regurgitation and this is then added to the right atrial pressure, derived from the IVC to obtain an estimate. Importantly this is an estimate. There can be errors in the measurement of the tricuspid jet and also the IVC and therefore multiple sources of error in arriving at a final value. The person reading the echo officially usually reviews these components, but often there can be oversights.

Ask the simple question from your cardiologist, Do I have pulmonary hypertension (looks relatively mild even if you did). To answer that your echo will be reviewed and the components assessed for quality. Finally however, even if you did have mild pulmonary hypertension, you wouldn't be doing much more than lifestyle changes and continuation of watching your cardiac risk factors. I doubt you have anything serious at all going on, otherwise, they would have likely told you already. I'm not able to comment in detail as I haven't seen or taken a history from you, and I'm not sure why you have had 2 echocardiograms in 2 years.

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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