From the Guidelines
A normal echocardiogram report shows no cardiac abnormalities, with the left ventricle having a normal size, thickness, and function with an ejection fraction of 55-70%, as recommended by recent guidelines 1. The report should include the following elements:
- Clinical history, indication for imaging, and type of device
- Type of echocardiography performed: transthoracic or transesophageal
- Overall adequacy of the study and specific comment on the adequacy of imaging to assess any prosthetic device or CIED
- Statement of the major findings with respect to abnormal structures or flows
- For prosthetic valves, report whether there is evidence for stenosis or regurgitation and whether the latter is transvalvular or perivalvular Some key findings in a normal echocardiogram report include:
- The right ventricle appears normal in size and function
- All four cardiac valves (mitral, aortic, tricuspid, and pulmonic) demonstrate normal structure and function without stenosis or regurgitation
- The left atrium and right atrium are normal in size
- There is no evidence of pericardial effusion, intracardiac masses, or thrombi
- The aortic root and ascending aorta are of normal caliber
- Doppler studies show normal blood flow patterns across all valves with no significant gradients
- The estimated pulmonary artery systolic pressure is normal (less than 25 mmHg)
- The interventricular and interatrial septa are intact without defects
- Wall motion is normal throughout all segments of the left ventricle without regional abnormalities These findings indicate normal cardiac structure and function, suggesting adequate cardiac output and normal hemodynamics, as supported by the European Association of Cardiovascular Imaging 2, 3.
From the Research
Normal Echocardiogram Report
A normal echocardiogram report typically includes the following parameters:
- Left ventricular linear dimensions and mass: within normal limits as defined by the British Society of Echocardiography 4
- Left ventricular volumes: within normal limits, with left ventricular ejection fraction (LVEF) being the most validated and commonly used measure of systolic function 5
- Left atrial size: within normal limits, with new terminology introduced by the British Society of Echocardiography for left atrial size 4
- Right heart parameters: within normal limits, with the British Society of Echocardiography advocating a new approach to the assessment of the right heart 4
- Aortic dimensions: within normal limits, with the British Society of Echocardiography introducing a new approach to the assessment of the aortic root 4
- Tissue Doppler imaging: within normal limits, with global longitudinal strain (GLS) being a sensitive and feasible method for assessing left ventricular systolic function 5
Key Parameters
The following parameters are crucial in assessing left ventricular systolic function:
- LVEF: the most validated and commonly used measure of systolic function 5
- GLS: a sensitive and feasible method for assessing left ventricular systolic function, which overcomes many of the limitations of LVEF 5
- Left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV): important parameters in assessing left ventricular size and function 6
Clinical Decision Making
Echocardiographic parameters, such as LVEF and GLS, play a crucial role in clinical decision making, including the assessment of heart failure patients 7 and the prediction of symptomatic heart failure in patients treated with anthracyclines 6. However, the reliability of these parameters can be influenced by variability in assessment and image quality 8.