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Patient Details Personal ID Code Date DOB Sex Male Female Patient ID Referred By Heart Rhythm Height (CM) Weight (KG) BSA Chart Indication CHAMBERS LV Wall Thickness, Size and Systolic Function LV diastolic diameter (normal 4.2-5.9, mild 6.0-6.3, Moderate 6.4-6.8, Severe > 6.9) 0cm LV diastolic diameter/BSA (normal 2.2-3.1, mild 3.2-3.4, Moderate 3.5-3.6, Severe > 3.7) 0cm/m2 LV diastolic volume (normal 67-155, mild 156-178, Moderate 179-201, Severe > 202) 0ml LV diastolic volume/BSA (normal 35-75, mild 76-86, Moderate 87-96, Severe > 97) 0ml/m2 Endocardial fractional shortening (normal 25-43, mild 20-24, Moderate 15-19, Severe < 14 ) 0% Midwall fractional shortening (normal 14-22, mild 12-13, Moderate 10-11, Severe < 9 ) 0% LV systolic volume (normal 22-58, mild 59-70, Moderate 71-82, Severe > 83) 0ml LV systolic volume/BSA (normal 12-30, mild 31-36, Moderate 37-42, Severe > 43) 0ml/m2 LV internal systolic diameter (mm) IVSd/PWd thickness (normal 0.6-1.2, mild 1.3-1.5, Moderate 1.6-1.9, Severe > 2.0) 0cm MM: LV mass (normal 88-224, mild 225-258, Moderate 259-292, Severe > 293) 0g 2D: LV mass (normal 96-200, mild 201-227, Moderate 228-254, Severe > 255) 0g MM: LV mass/BSA (normal 49-115, mild 116-131, Moderate 132-148, Severe > 149) 0g/m2 2D: LV mass/BSA (normal 50-102, mild 103-116, Moderate 117-130, Severe > 131) 0g/m2 2D: Ejection fraction (normal > 55, mild 45-54, Moderate 36-44, Severe < 35 ) 0% Cardial Output (l/m) (normal > 4-8, low output < 4, high output > 8) 0l/m Cardiac Index (L/m/m2) (Normal = 2.5-4, low output < 2.5, high output > 4) 0L/m/m2 GLS (%) (abnormal < 16, borderline 16-20, normal > 20) 0% RV Wall Thickness, Size and Systolic Function (in D) A4C Basal RV Diameter (RVD1) Normal (Less than 4.2cm) Abnormal (Greater than 4.2cm) Enter ValueEnter Value Mid RV Diameter (RVD2) Normal (Less than 3.5cm) Abnormal (Greater than 3.5cm) RV Longitudinal (RVOT3) Normal (Less than 8.6cm) Abnormal (Greater than 8.6cm) RV Wall Thickness Normal (Less than 5mm) Abnormal (Greater than 5mm) (RV Free wall thickness is best done in Subcoastal followed by PSAX, normal=1-5mm) PSAX RVOT at AV Level (RVOT1) Normal (Less than 3.3cm) Abnormal (Greater than 3.3cm) RVOT at PV annulus (RVOT2) Diameter (RVD1) Normal (Less than 2.7cm) Abnormal (Greater than 2.7cm) Main PA (PA1) Normal (Less than 2.2cm) Abnormal RV AREA RV Diastolic Area Normal (Less than 25cm2) Abnormal (Greater than 25cm2) RV EDA indexed (cm2/m2) Male values Female values RV Systolic Area Normal (Less than 14cm2) Abnormal (Greater than 14cm2) RV ESA indexed (cm2/m2) Male values Female values RV Function Fractional Area Change Normal (Greater than or equal to 35%) Abnormal (Less than 35%) TAPSE Normal (Greater than or equal to 17mm) Abnormal (Less than 17mm) PW TDI S'(cm/s) Normal (More than 9.5 cm/s) Abnormal (Less than 9.5 cm/s) Actual valueActual value RV Free Wall Strain Normal (29+/-4.5) Abnormal (Less than 14.5) Actual valueActual value Diastology MV inflow dynamics. Consider rLVEF or LVH with rLVEF. E/A If E/A is less than or equal to 0.8 +E less than or equal to 50cm/s = Normal Lap - Grade I If E/A less than or equal to 0.8 +E greater than 50cm/s If E/A = 0.9 - 1.9 Criteria Present If 3 criteria are present If 2 criteria are present If 3 criteria are present (i) E/e' > 14 (ii) TR vel > 2.8m/s (iii) LAVi > 34 ml/m2 > 2 of 3 are positive = Increased LAP - Grade II > 2 of 3 are negative = Normal LAP - Grade I If 2 criteria are present If 2 are positive = increased LAP - Grade II If 1 is positive & 1 is negative = Indeterminate If 2 are negative = Normal LAP - Grade I Criteria Present If 3 criteria are present If 2 criteria are present If 3 criteria are present (i) E/e' > 14 (ii) TR vel > 2.8m/s (iii) LAVi > 34 ml/m2 > 2 of 3 are positive = Increased LAP - Grade II > 2 of 3 are negative = Normal LAP - Grade I If 2 criteria are present If 2 are positive = increased LAP - Grade II If 1 is positive & 1 is negative = Indeterminate If 2 are negative = Normal LAP - Grade I If E/A > 2 = Increased LAP - Grade III Measured E/A Comments E velocity (cm/s) If E vel < 50 = Normal LAP - Grade I If E vel > 50 + E/A < 0.8 Criteria Present If 3 criteria are present If 2 criteria are present If 3 criteria are present (i) E/e' > 14 (ii) TR vel > 2.8m/s (iii) LAVi > 34 ml/m2 > 2 of 3 are positive = Increased LAP - Grade II > 2 of 3 are negative = Normal LAP - Grade I - If 2 criteria are present If 2 are positive = Increased LAP - Grade II If 1 is positive & 1 is negative - Indeterminate If 2 are negative - Normal LAP - Grade I Measured E velocity Comments e' Septal (cm/s) N = Greater than or equal to 8 I-III = Less than 8 Measured Value e' lateral (cm/s) N = Greater than or equal to 10 I-III = Less than 10 Measured Value E/e'-) Grade I: impaired relaxation = Less than or equal to 8 Grade II: Pseudonormal = Between 9 - 12 Grade III: Restrictive = Greater or equal to 13 If > 14 = indicates diastolic dysfunction in a patient with normal EF Measured Value Ar-A (ms) I = Less than 0 I-III = Greater than or equal to 30 Measured Value Deceleration time. DT (ms) I = Greater than 200 II = Between 160 - 200 III = Less than 160 Measured Value A velocity PVein S PVein D LAP Calculator: MR Vmax (m/s) SBP (mmHg) PCWP Information. e', the early diastolic velocity of mitral annulus as obtained by tissue Doppler imaging (TDI) of the septal and lateral sides of the mitral annulus behaves as a pre-load-independent index of LV relaxation. Mitral inflow E velocity as obtained by pulsed-wave (PW) Doppler when corrected for the influence of relaxation by using E/e' ratio correlates well to the mean pulmonary capillary wedge pressure (PCWP) as obtained by simultaneous catheter measurements. It is preferable to use the average e' velocity obtained from the septal and lateral sides of the mitral annulus for the prediction of LV filling pressures. Because septal e' is usually lower than lateral e' velocity, the E/e’ ratio using septal signals is usually higher than the ratio derived by lateral e', and different cutoff values should be applied on the basis of LV EF, as well as e' location. E/e' ratio < 8 is usually associated with normal LV filling pressures (PCWP < 15 mmHg), while a ratio > 15 is associated with increased filling pressures (PCWP > 15mmHg). Between 8 and 15, there is a gray zone with overlapping of values for filling pressures. Other Information. (1)Normal diastolic function: Septal e' >/=8 Lateral e'>/=10 Indexed LAV <34ml/m2 (2)Normal distolic function,Athlete's heart & pericardial constriction can give: Septal e' >/=8 Lateral e' >/=10 But LAVi >/=34ml/m2 (3)The four criteria used to diagnose Diastolic dysfunction in patient with normal EF are: (a) Av E/e' >14. (b) Septal e' <7cm/s or Lateral e' <10cm/s (c)TR vel >2.8m/s (d)LAVI >34 ml/m2. If < 50% positive (1+) = Normal. If 50% positive (2+) = Indeterminate If >50 % positive (3+) Diastology Dysfunction (4)Normal PCWP:4-12 If >15=Increased LAP/Left heart Disease which is the commonest cause if PHTN.If RVSP is elevated, check PCWP. If PCWP is elevated the raised RVSP is likely from left heart disease. A straightforward PHTN usually gives Grade I Diastolic Dysfunction but in left heart diseases(LHF,Mitral Stenosis) the PHTN caused by left heart diseases (LHF,Mitral Stenosis ) will produce Grade II-III Diastolic Dysfunction. LA/RA Walls And Sizes Left Atrium: (end of T wave/frame before MV opens) Area (normal < 20, mild 21-30, Moderate 31-40, Severe > 41 ) 0cm2 Volume (normal 18-58, mild 59-68, Moderate 69-78, Severe > 79) 0ml If LAVi is greater than 34, it indicates Diastolic dysfunction Volume/BSA Table Normal = 16 - 28 ml/ml2 Mild = 29 - 33 ml/ml2 Moderate = 34 - 39 ml/ml2 Severe = greater than 40 ml/ml2 Volume/BSA (normal 16-28, mild 29-33, Moderate 34-39, Severe > 40) 0ml/m2 Diameter (normal 3.0-4.0, mild 4.1-4.6, Moderate 4.7-5.2, Severe > 5.3) 0cm Diameter/BSA (normal 1.5-2.3, mild 2.4-2.6, Moderate 2.7-2.9, Severe > 3.0) 0cm/m2 Right Atrium RA Area RA Volume (RAV) RADi (cm2/m2) Female 0cm2/m2 Male 0cm2/m2 RAVI (ml/m2) Female (21 +/- 6) 0ml/m2 Male (25 +/- 7) 0ml/m2 Abnormal if RAVi is greater than 33 for males and if greater than 27 for females. Valves Aortic Valve Aortic Stenosis Aortic Stenosis No Stenosis Present Peak Velocity (mild < 3.0, Moderate 3.0-4.0, Severe > 4.0) 0m/s Mean Gradient (Mild < 25, Moderate 25-40, Severe > 40) 0mmHg AV PG (mmHg) Valve Area (Mild > 1.5, Moderate 1.0-1.5, Severe > < 1.0) 0cm2 Valve Area/BSA (Mild > 0.85, Moderate 0.60-0.85, Severe < 0.60 ) 0cm2/m2 Velocity Ratio (Mild > 0.5, Moderate 0.25-0.5, Severe > < 0.25) 0 Dimensional Index/DSI (Mild > 0.50, Moderate 0.50-0.25, Severe < 0.25) 0 LVOT Vmax Aortic Regurgitation (quantitative) No Regurgitation Present Regurgitant Volume (Mild < 30, Moderate 31-59, Severe > 60) 0ml Jet Width/LVOT Diameter (Mild < 20, Moderate 20-40, Severe > 40) 0% Regurgitant Fraction (Mild < 30, Moderate 31-49, Severe > 50) 0% Regurgitant Orifice Area (Mild < 0.20, Moderate 0.20-0.39, Severe > 0.40) 0cm2 End Diastolic Velocity (upper DAo) Severe (Greater than 20 cm/s) Aortic Regurgitation (qualitative) Not Regurgitation Present Pressure Half Time (Mild ) 500, Moderate 200-500, Severe < 200 ) 0ms Vena Contracta Width (Mild < 0.3, Moderate 0.3-0.6, Severe > > 0.6) 0cm CW intensity of AR Incomplete or faint Dense Dense (Severe) Desc Ao Flow Reversal Incomplete or faint Intermediate Pan diastolic Abd Ao Flow Reversal - Mild - Moderate Pan - diastolic LVOT-jet width (%) Less than 25% Between 25% & 65% Greater than 65% LVOT VTI (end of T) (cm) AV VTI (end of T) (cm) LVOT diameter DPI Mitral Valve Mitral Stenosis No Stenosis Present Mean Pressure Drop (Mild < 5, Moderate 5-10, Severe > 10) 0mmHg Valve Area (Mild 1.6-2.0, Moderate 1.0-1.5, Severe < 1.0) 0cm2 Pressure Half Time (Mild 71-139, Moderate 140-219, Severe > 219) 0ms Mitral Regurgitation (quantitative) No Regurgitation Present Jet Area/LA (Mild < 20, Moderate 20-40, Severe > 40) 0% Regurgitant Volume (Mild < 30, Moderate 31-59, Severe > 60) 0mL Regurgitant Fraction (Mild < 30, Moderate 31-49, Severe > 50) 0% Regurgitant Orifice Area (Mild < 0.20, Moderate 0.20-0.39, Severe > 0.40) 0cm2 PISA Radius at Nyquist 40cm/s (Mild < 0.4, Moderate 0.4-1.0, Severe > 1.0) 0cm Vena Contracta (Mild < 0.3, Moderate 0.3-0.6, Severe > 0.7) 0cm MV inflow VTI/LVOT VTI (Mild < 1, Severe > 1.4) 0 LAP Calculator: MR Vmax (m/s) SBP (mmHg) Mitral Regurgitation (qualitative) No Regurgitation Present PW transmitral inflow A wave dominant - age dependent Variable E wave dominant (greater than 1.5m/s) PW-pulminary vein Systolic Dominance Systolic Blunting Systolic Reversal CW-MR signal Incomplete or faint Variable Dense - severe Jet area ratio (%) Small jet Variable Large jet Vena Contracta width (cm) Less than 0.30 0.30 - 0.69 Greater than 0.7 Pulmonary Stenosis No Stenosis Present Peak Velocity (Mild < 3, Moderate 3-4, Severe > 4) 0m/s Peak Gradient (Mild < 36, Moderate 36-64, Severe > 64) 0mmHg Pressure half time (ms) Not Severe (equal to or greater than 100ms) Severe Actual ValueActual Value Regurgutant Fraction (%) Not Servere (less than or equal to 40%) Severe Actual ValueActual Value QP:Qs PA acceleration slope Pulmonary artery acceleration time (sec) 0sec Pulmonary Regurgitation (qualitative) No Regurgitation Present Jet width % of RVOT width Greater than 65% Less than 65% Actual ValueActual Value Pressure half-time Less than 100ms Greater than 100ms Actual ValueActual Value Dopper timing of PR Pre-systolic Other Actual ValueActual Value Dopper PR index (Duration on PR relative to whole of diastole) Less than 0.77 Greater than 0.77 Actual ValueActual Value Jet width (mm) Intensity Flow reversal pulmonary artery branch Tricuspid Valves Tricuspid Stenosis No Stenosis Present Mean pressure gradient (mmHg) Greater than 5 mmHg Less than 5 mmHg Actual ValueActual Value Inflow velocity-time integral (cm) Greater than 60cm Less than 60cm Actual ValueActual Value TR PG (mmHg) Pressure half time (ms) Greater than 190ms Less than 190ms Actual ValueActual Value Valve area by continuity equation (cm2) Less than 1 cm2 Greater than 1 cm2 A ValueA Value RA Pressure (mmHg) Between 0 - 5 mmHg Between 5 - 10 mmHg Between 10 - 20 mmHg Actual RAPActual RAP IVC Diameter (cm) Less than 2.1 cm Greater than 2.1 cm Measured IVC DiameterMeasured IVC Diameter Collapsibility (%) Greater than 50% Less than 50% Measured CollapsibilityMeasured Collapsibility Hepatic vein flow RVSP (mmHg) (RVSP = 4 v2max + RAP) 0mmHg Tricuspid Regurgitation (Qualitative) No Regurgitation Present TR Vmax (m/s) - if greater than 2.8m/s possibly diastolic dysfunction CW Jet Density/Contour Mild (Soft/Parabolic) Moderate (Dense/Variable) Severe (Dense/Early Peak) Hepatic Vein Flow Mild (Systolic Dominance) Moderate (Systolic Blunting) Severe (Systolic Reversal) PISA radius at Nyquist 28cm/s (Mild < 0.5, Moderate 0.5-0.9, Severe > 0.9) 0cm Save Results
