Background
- Normal LV systolic function: Ejection fraction > 55%
- Report may be qualitative – mild/moderate/severe LV impairment
Valvular disease
- Mild or trace regurgitation requires no action
- Valve disease is usually a chronic process
- If valve anatomy is abnormal but functional lesion is mild, still consider referral
- Echos can underestimate valve severity – if significant symptoms or clear signs, refer
Diastolic dysfunction
- Questionable significance if patient is well
- No prognostic treatments
- Treatments based around treating symptoms using diuretics
Regional wall motion abnormalities
- Questionable significance
- May be due to previous cardiac event
- If patient is well, LV normal size and function then unlikely to be important
Pulmonary artery pressures
- Normal PAP < 30 mmHg
- Echos measure PASP (pulmonary artery systolic pressure) – the PAP can be calculated:
- mean PAP = 0.61 * PASP + 2
- PASP can only be measured if tricuspid regurgitation
- Raised PASP usually secondary to: lung disease, left sided heart disease, OSA
Pericardial effusions
- Up to 1cm likely to be physiological
- For larger effusions, no urgent action needed if
- no echo mention of haemodynamic compromise
- asymptomatic