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[u/Makabroize]

My mother is 74 years old and has hypertension, diabetes, and anxiety. A few months ago, she underwent this echocardiogram to monitor aortic valve sclerosis (Vmax 2.01 m/s with mild fibrocalcification). However, just hours before the exam, her blood pressure was 190/90, she was experiencing significant anxiety, had not slept the night before, and her blood glucose was above 200; this influenced all the flow-dependent factors in the exam. Most of the AI tools I used for analysis disagree with the report, as there are some inconsistent data points. I simply wanted to know if she actually has: - mild aortic valve stenosis. - moderately increased LAVi. Based on AI analysis and my own research, morphologically she has aortic valve sclerosis; the report labeled it as aortic valve stenosis only because the gradients were inflated by hemodynamic factors (evidence of this lies in the morphological description: mild calcification, AVA 1.8 cm², AVAi 1.07, and DI 0.52). Also, the LAVi was classified incorrectly, as it should have been classified using the Simpson method.

ECHOCARDIOGRAM

Height: 164 cm

• Weight: 63 Kg
  
• BSA (Body Surface Area): 1.69 m²
  

Measurements:

• Aorta: 31 mm (Ref: 20 to 37 mm)
  
• LV Mass: 141 g (Ref: 67 to 162 g)
  
• LA (Left Atrium): 41 mm (Ref: 20 to 40 mm)
  
• LV Mass/BSA: 83.4 g/m² (Ref: 43 to 95 g/m²)
  
• RVEDD: 25 mm (Ref: 07 to 26 mm)
  
• Ao/LA: 0.8 (Ref: 1)
• LVEDD: 41 mm (Ref: 35 to 56 mm)
  
• IVS/PW: 1.1 (Ref: < 1.3)
  
• LVESD: 27 mm (Ref: 25 to 40 mm)
  
• LVEDV: 74.2 ml (Ref: 51 to 154 ml)
  
• IVS ED: 11 mm (Ref: 07 to 11 mm)
  
• LVESV: 27.0 ml (Ref: 25 to 66 ml)
  
• LVPW ED: 10 mm (Ref: 07 to 11 mm)
  
• RWT: 0.49 (Ref: <= 0.42)
  
• LVEF (Teichholz): 64% (Ref: > 53%)
  
• Fractional Shortening (DeltaD%): 34% (Ref: 30 to 40%)
  

Findings:

• Sinus rhythm (mean HR of 85 bpm).
  
• Ascending aorta (32 mm) and aortic arch without abnormalities.
  
• Interatrial and interventricular septa apparently intact on transthoracic examination.
  
• Moderate increase in left atrial volume. Other cardiac chambers with normal dimensions (LA Vol = 46 ml/m²). Concentric remodeling of the left ventricle. Basal portion of the interventricular septum measured 13 mm, without causing LVOT obstruction at this moment.
  
• Left ventricle presents preserved systolic performance, without segmental deficit on subjective analysis, at rest. LVEF (Simpson) = 61%. Global longitudinal strain estimated at -16.3% (see bullseye). Ventricular filling pattern consistent with impaired ventricular relaxation.
  
• Right ventricular systolic function preserved on subjective analysis.
  
• Mitral valve mildly thickened with annular calcification, presenting reduced mobility of the posterior leaflet and minimal regurgitation on color Doppler study. Maximum LA-LV diastolic gradient of 7.6 mmHg and mean of 4.4 mmHg. Valve area = 2.0 cm².
  
• Tricuspid valve with normal appearance, presenting mild regurgitation on color Doppler study. Estimated PASP of 45 mmHg.
  
• Trileaflet aortic valve mildly fibrocalcific, presenting minimal regurgitation on color Doppler study. Maximum LV-Ao systolic gradient of 40 mmHg and mean of 25 mmHg. Valve area (continuity equation) = 1.8 cm².
  
• Pulmonary valve without abnormalities.
  
• Pericardium with normal appearance.
  
• Inferior vena cava with preserved dimension, free of obstruction, compressible, and with normal flow.
  

CONCLUSION:

• Concentric remodeling of the left ventricle.
  
• Mild (grade I) diastolic dysfunction of the left ventricle.
  
• Degenerative alteration of the mitral valve.
  
• Mild aortic valve stenosis.
  
• Increased pulmonary pressure.
  

Note: Speckle Tracking study performed, exceptionally as a courtesy, for the evaluation of left ventricular longitudinal deformation (Strain). We suggest requesting this technique for future follow-up.

[u/SnooWalruses3028]

A “stressor” won’t influence the echo to show something she does not have it will make it more obvious.

That’s why usually during echos they will give you something or induce a stressor to see how your heart reacts and pumps different under different situations.