Document Z1ka16bYrGr36bOB5j37qvnp

CHC 000064 w1 CASCADE HEART CLINIC, PLLC 13033 Bel-Red Road Suite 230 Bellevue, WA 98005 tel (425) 454.1560 fax (425) 457,7107 www.cascadebeait.com Name ofPatient Medical Record No.: Date ofStudy: ECHOCARDIOGRAM Deane Smith 6759/4202 09/15/08 Indkatioas: An 80-year-old has echocardiogram for evaluation ofmitral regurgitation and exertional dyspnea. M-Mode, 2D and Doppler: M-Mode, 2D and Doppler assessment was performed. M-Mode: Left ventricular end-diastolic and end-systolic dimensions are within normal limits, end diastole 46 mm, end systole 37 mm. Right ventricular size is mildly dilated at 28-29 mm. Left ventricular wall thickn^s measures 11 mnratlhe upper limitsofnormal: ...................... The 2D imaging reveals normal left ventricular size with atrial fibrillation, irregular arrhythmia, and suboptimal acoustic windows. It appears LV ejection fraction is visually estimated at approximately 40% with apical and septal hypokinesia. Mitral valve demonstrates mild mitral annular calcification and appears to Open and dose normally without stenosis. Left atrial size is mildly to moderately dilated. Aortic valve demonstrates mild sclerocalcifk thickening but opens and closes without stenosis. Aortic root is mildly dilated at 40 mm. Right ventricular size is mildly dilated with preserved right ventricular systolic function. Right atrial size is moderately dilated. Tricuspid and pulmonic valves open and close normally without stenosis. No pericardial effusion, intracavitary masses, or thrombi are detected. Doppler reveals mild to moderate mitral regurgitation. Moderate to severe tricuspid regurgitation is present with tricuspid regurgitation velocity at 32 m/sec and dilated inferior vena cava which translates to a peak pulmonary aitoy pressure approximately 45-55 mmHg. Right pacing wires are noted in the right cardiac chambers. Patent foramen ovale is detected by color flow Doppler. Conclusions: 1. Normal left ventricularsize with LV ejection fraction visually estimated at 40%. 2. Anteroapical and septal apical hypokinesis. 3. Mild to moderate mitral regurgitation. 4. Moderate to severe tricuspid regurgitation with pulmonary hypertension. 5. Patent foramen ovale. 6. Atrial fibrillation arrhythmia with left bundle-branch block EKG. cc: Barry Marmorstem, M.D. PRK/acl/dsq/rbl CHC 000064 D-1078