How to read an echocardiogram
Feb 24, 2023
Source: Cainiu Health
Dr. Tian Hongbo
Introduction
Echocardiography primarily evaluates aspects such as cardiac chamber size, valve changes, ejection fraction, thickness of the ventricular wall and interventricular septum, and pulmonary artery pressure. Additionally, the purpose of echocardiography is to assess whether the heart's structure is normal and to detect the presence of heart failure. If any abnormalities are found in the above parameters, it is recommended to follow appropriate treatment under medical guidance.
Echocardiography primarily evaluates cardiac structure and function through parameters such as chamber size, valve changes, ejection fraction, thickness of the ventricular wall and interventricular septum, and pulmonary artery pressure. The specific analysis is as follows:
1. Cardiac Chamber Size
Echocardiography typically assesses whether there is myocardial hypertrophy or chamber enlargement by measuring the sizes of the four cardiac chambers: left ventricle, left atrium, right ventricle, and right atrium. Normal dimensions are approximately 20–25 mm for the right ventricle, 30 mm for the right atrium, and 40 mm for the left atrium. The normal left ventricular diameter should not exceed 55 mm in men and 50 mm in women. For example, a left ventricular end-diastolic wall thickness of 13 mm or greater on echocardiography indicates left ventricular hypertrophy.
2. Valve Changes
If an echocardiogram report indicates minor or mild regurgitation or valvular insufficiency, excessive concern is usually unnecessary. Valve calcification is commonly caused by aging, high blood pressure, elevated lipid levels, and other factors leading to degenerative changes in heart valves.
3. Ejection Fraction
Echocardiography also measures ejection fraction. Left ventricular ejection fraction (LVEF) refers to the percentage of blood pumped out of the left ventricle with each heartbeat. A normal LVEF is generally greater than 60%. An LVEF below 60% suggests reduced left ventricular systolic function and may indicate possible heart failure. In patients with hypertension, myocardial contractility often increases during the early stages of high blood pressure.
4. Ventricular Wall and Interventricular Septal Thickness
Under normal conditions, the posterior wall of the left ventricle and the interventricular septum are both less than 12 mm thick. Measurements exceeding this range indicate ventricular wall thickening or septal hypertrophy.
5. Pulmonary Artery Pressure
Normal pulmonary artery pressure ranges from 15 to 30 mmHg. Pressures above 30 mmHg indicate pulmonary hypertension: 30–50 mmHg is considered mild, 50–70 mmHg moderate, and greater than 70 mmHg severe.
In addition, the purpose of echocardiography is to evaluate whether cardiac structure is normal and to detect signs of heart failure. If any of the above parameters are abnormal, it is recommended to consult with a physician for appropriate management and treatment.
