What is the proper format for an echocardiography report?

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Last updated: March 10, 2026 • View editorial policy

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Echocardiography Report Format

A standardized echocardiography report must include mandatory demographic/technical data, normalized quantitative measurements with reference values, structured findings organized by cardiac chamber, and a concise conclusion that directly answers the clinical question while highlighting abnormal findings first. 1

Essential Report Components

Mandatory Header Information

Every echocardiography report must document 1:

  • Patient demographics: Age, height, weight, and calculated body surface area (BSA)
  • Clinical data: Blood pressure, heart rate, heart rhythm at time of examination
  • Technical specifications: Ultrasound machine vendor and model (critical due to inter-vendor variability, especially for strain measurements)
  • Image quality grading: Optimal, fair, suboptimal, or poor (essential because poor quality makes advanced parameters like strain and 3D measurements potentially misleading)
  • Referral diagnosis: The clinical question being asked
  • Study date/time and report finalization date/time
  • Dialysis status if applicable (pre- or post-dialysis)

Quantitative Measurements Section

Organize measurements by anatomic structure in logical sequence 1, 2. For each cardiac chamber, report:

Left Ventricle 1

  • Linear dimensions: End-diastolic and end-systolic diameters (indexed to BSA)
  • Volumes and function:
    • 3D echocardiography-derived end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) when possible (more reproducible than 2D)
    • If 3D unavailable, use 2D biplane Simpson's method
  • LV mass (indexed to BSA)
  • Global longitudinal strain (GLS): Should be obtained whenever possible (normal range -18% to -22%, though vendor-dependent). GLS detects subclinical LV dysfunction before EF declines and provides incremental prognostic value 1
  • Diastolic parameters: E/A ratio, E/e' ratio, deceleration time, left atrial volume index

Right Ventricle 1

  • Linear dimensions: Basal and mid-cavity dimensions, RV outflow tract measurements (do NOT index to BSA—no validated cut-offs exist)
  • Systolic function: At least one of the following:
    • Fractional area change (FAC)
    • Tricuspid annular plane systolic excursion (TAPSE)
    • Tissue Doppler s' velocity at lateral tricuspid annulus
    • Myocardial performance index (MPI)
    • RV free wall longitudinal strain (normal >23%)

Valves 1

Integrate morphological findings (thickening, calcification, prolapse) with functional measurements (gradients, regurgitant volumes, effective regurgitant orifice area).

Reference Values

Always include normal reference ranges adjacent to measured values 1. This allows immediate differentiation of normal from pathological conditions and is mandatory for standardization.

Findings Organization

Group all parameters for each structure together 2. Use the standardized 17-segment model for describing regional wall motion abnormalities, ischemia, or scarring 2. This ensures consistency across institutions and time points.

Avoid reporting the same parameter using multiple techniques 1. For example, if your lab has expertise in 3D EF measurement, use that consistently rather than alternating with 2D methods, as this improves serial comparison reliability.

Conclusion Section

The conclusion must be concise but definitive 1:

  • Answer the clinical question explicitly
  • Highlight abnormal findings first
  • Address key elements: LV structure and function, left atrial dilation, aortic dilation, RV dysfunction, pulmonary hypertension
  • Compare to prior studies when available, but only use highly reproducible parameters (E/e' ratio, GLS, 3D-derived EF) for tracking changes over time. Parameters like 2D-derived EF and LV mass have lower reproducibility and require cautious interpretation 1
  • Lead to objective communication with the referring physician responsible for clinical management

Critical Reporting Principles

Standardization Benefits 3

Standardized reporting enables:

  • Quality assurance and consistency across echo labs
  • Meaningful serial comparisons
  • Big data analysis and machine learning applications
  • Clear communication between cardiologists and non-cardiologists

Common Pitfalls to Avoid

  1. Inconsistent measurement techniques: Switching between 2D and 3D methods or different Doppler approaches makes serial comparisons unreliable 1

  2. Ignoring vendor variability: GLS and tissue Doppler values vary significantly between ultrasound manufacturers—always document the machine type 1

  3. Failing to normalize measurements: Many parameters (LV dimensions, volumes, mass, LA volume) must be indexed to BSA for accurate interpretation 1

  4. Omitting image quality assessment: Poor image quality invalidates advanced measurements and must be documented 1

  5. Vague conclusions: Avoid non-specific terms; use standardized semi-quantitative descriptors (mild, moderate, severe) with defined cut-off values 1

Disease-Specific Tailoring 1

For valvular heart disease: Emphasize valve morphology integrated with hemodynamic measurements and the impact on cardiac chambers.

For cardiomyopathies: Include 2D wall thickness, cavity diameters, volumes, EF, GLS, and comprehensive diastolic parameters.

For systemic diseases with cardiac involvement: Comprehensive quantitative assessment including LV mass for hypertrophy detection, as subtle findings require thorough documentation.

Personnel Documentation 2

Include names and credentials of all personnel involved: technicians, trainees, nurses, physician assistants, and the interpreting physician. Document any trainee involvement with appropriate attestation.

References

3
Research

Guidelines for the Standardization of Adult Echocardiography Reporting: Recommendations From the American Society of Echocardiography.

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2025

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.