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Heart Disease (Expert Forum)
echo
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echo
by dhflp, Apr 26, 2007 12:00AM
Hi,I'm a 53 year old male with BSA of 2.08 and the following echo results: "There was a minimal pericardial effusion,without hemodynamic compromise." 1. What's the acceptable amount of fluid around the heart in cc and is the above finding within this acceptable amount of fluid around the heart and therefore a normal finding? "Aorta: AoD(root) 39 mm Normal 20-37 mm.The aortic root was normal in size." 2. How can aortic root size of 39 mm be normal when it is over 37 mm? What are aortic root (sinus of Valsalva size)upper normal ranges for me? There are a few echo parameters witten on report for which there are no normal ranges. 3. What are acceptabble ranges for me for the following: LV mass, Peak AV gradient,AV obstruct index(Vmax),AV area index(Vmax),mitral valve peak gradient?Thank you
Doctor's Answer
by Forum-M.D.-MJM, Apr 26, 2007 12:00AM
Hello,
1. What's the acceptable amount of fluid around the heart in cc and is the above finding within this acceptable amount of fluid around the heart and therefore a normal finding?
I can only take their word that it was minimal. There should be about 30-50 cc of pericardial fluid. There is no way to non invasively quantitative a pericardial fluid volume.
I would caution you not to get to overwhelmed by the figures they report in an echo. I don't know the normal ranges for some of these values and some even vary by lab.
2. How can aortic root size of 39 mm be normal when it is over 37 mm? What are aortic root (sinus of Valsalva size)upper normal ranges for me? There are a few echo parameters witten on report for which there are no normal ranges.
It is difficult to assess individual normals based on height/body, but there are tables to calculate this. Your aortic root looks like it measure a little bit enlarged, but the clinical significance of this depends more on progression rather than one static measurement. If you are worried about it, you can always ask your doctor if they will repeat an echo in 6 months to evaluate for progression. Your sinus of valsalva should be about the same size 3.7.
3. What are acceptabble ranges for me for the following: LV mass, Peak AV gradient,AV obstruct index(Vmax),AV area index(Vmax),mitral valve peak gradient?
I don't have a list of these values for our lab. The values in general are a continuum and interpreted in the context of the question involved. I would suggest talking to your doctor to further clarify any abnormal values.
I hope this helps. Thanks for posting.
1. What's the acceptable amount of fluid around the heart in cc and is the above finding within this acceptable amount of fluid around the heart and therefore a normal finding?
I can only take their word that it was minimal. There should be about 30-50 cc of pericardial fluid. There is no way to non invasively quantitative a pericardial fluid volume.
I would caution you not to get to overwhelmed by the figures they report in an echo. I don't know the normal ranges for some of these values and some even vary by lab.
2. How can aortic root size of 39 mm be normal when it is over 37 mm? What are aortic root (sinus of Valsalva size)upper normal ranges for me? There are a few echo parameters witten on report for which there are no normal ranges.
It is difficult to assess individual normals based on height/body, but there are tables to calculate this. Your aortic root looks like it measure a little bit enlarged, but the clinical significance of this depends more on progression rather than one static measurement. If you are worried about it, you can always ask your doctor if they will repeat an echo in 6 months to evaluate for progression. Your sinus of valsalva should be about the same size 3.7.
3. What are acceptabble ranges for me for the following: LV mass, Peak AV gradient,AV obstruct index(Vmax),AV area index(Vmax),mitral valve peak gradient?
I don't have a list of these values for our lab. The values in general are a continuum and interpreted in the context of the question involved. I would suggest talking to your doctor to further clarify any abnormal values.
I hope this helps. Thanks for posting.
2.Essentially, the bigger you are, the bigger your aortic root can be. 3.7 is the average normal that was found over thousands of cases, but there are just physically bigger people like Shaq who will obviously have larger parts (hence larger values) than yourself who will also have larger parts than some little lady who is 5 foot tall and 100 pounds.
3. In our lab we do LV mass indexed against BSA, but un-indexed I think it is supposed to be under 220, but I really can't remember. Peak AV gradient normal range would roughly be 4 to 25 mmHg, AV obstruct we don't use ( I don't think it is applicable in your case anyways) AV area index we don't use ( not really useful in a daily clinical practice unless your trying to decide the severity of AS), and the peak mean MV gradient normal limit is anything less than 4 mmHg.
If you are feeling fine, then go out and enjoy life. Don't let these numbers stop you.
Good night and good luck.
I just had an echo and bubble test on Tuesday. The nurse called and said I have LV severe hypokinesis basal anterior/basal posterior segments. Valves and EF are normal. They want a nuclear stress test next. I am afraid of all this. My echo 7 months ago showed. LVDD grade 1. How can it go from bad to worse in 7 months? Could you email me with your thoughts so I don't disrupt the board? ***@****