Dr. Davis,
You might remember that I discussed my aortic valve stenosis finding on a Wednesday night meetup about a year ago. At that time, an EBCT scan indicated the possibility of aortic valve calcification and an echocardiogram was recommended. If I’m correctly interpreting the echocardiogram results of 07/12/19, my aortic valve area was 1.8cm.
I had a follow up echocardiogram performed on 9/14/20 from a different source and technician. Again, I’m not sure I’m interpreting it correctly, but It seems to indicate that my aortic valve area increased to 2.1cm. I’m not sure whether or not I should be excited by this new result due to my lack of expertise in this area.
My treatment included increasing my supplementation of 25-hydorxy vitamin D from 6000 IU/Day to 13000 IU/Day beginning in August, 2019 and continuing. On 1/13/20 my 25-hydroxy vitamin D blood level had risen to 85. Continuing with the same 13000 IU/Day on 8/28/20 it had risen to 92.
Below are the 2 echocardiogram results. Hopefully, they make sense. I had to copy and paste the information. I’d really appreciate your help in interpreting the results.
I have other interesting results related to my overall health.
Michael
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ECHOCARDIOGRAM REPORT
Date 07/12/2019
Name MICHAEL
Sex Male
Sonographer PORTER, RDCS ROMS RVT, ROBIN M
Referred By DR. GERBER, JEFFRY Birthdate 07/1961 Age57
Referral Reasons ABN STRESS, BRADY, CAO
Findings
ECG rhythm: Sinus rhythm. Study quality: This was a technically good study. 2D imaging, color flow and doppler were used.
Left Ventricle: LV size, wall thickness and systolic function are normal, with an EF of 60%. The diastolic filling pattern Is normal for the age of the patient
Left Atrium: The left atrial size is normal.
Right Ventricle: The right ventricle Is normal in size and function.
Right Atrium: The right atrial size is normal.
Aortic Valve: Trace amount of aortic regurgitation. Mild aortic stenosis with peak/mean pressure gradient of 29.11mmHg / 16.30mmHg, the aortic valve area by continuity equation is 1.8cm2. The dimensionless Index is 0.48.
Mitral Valve: The mitral valve is normal. There is trace mitral regurgitation.
Tricuspid Valve: The tricuspid valve appears structurally normal. Trace tricuspid regurgitation present. RVSP could not be measured due to inadequate TR.
Pulmonic Valve: Trace/mild (physiologic) pulmonic regurgitation.
Pericardium: There is no pericardia! effusion.
Aorta: The aortic root, ascending aorta and aortic arch are normal.
IVC/Hepatic Veins· The Inferior vena cava is normal. The hepatic veins are normal.
Summary
- LV size, wall thickness and systolic function are normal with an EF of 60%.
- Trace amount of aortic regurgitation.
- Mild aortic stenosis with peak/mean pressure gradient of 29.11 mmHg /16.30 mmHg, the aortic valve area by continuity equation is 1.8cm2.
- There is trace mitral regurgitation.
- Trace tricuspid regurgitation present.
2D Measurements Ejection Fraction Diastolic Function
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IVSd
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1.0cm
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EF(Teich)
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65 %
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MV EVel
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0. 72 mis
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LVIDd
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4.2cm
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%FS
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35%
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MV DecT
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295ms
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LVPWd
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1.1cm
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MVA Vel
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0.49mis
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LVIDs
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2.7cm
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MV E/A R atio
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1.46
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LA Diam
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3.4cm
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E’
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0.06mis
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A oDiam
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3.3cm
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E/E’
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12.02
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LVOTDiam
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2.1cm
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RVDd
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3.2cm
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IVC
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14.37 mm
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Doppler Valvular Evaluation
LVOT maxPG 6.73mmHg
LVOT meanPG 3.43mmHg
LVOT VTI 25.4cm
AVVmax 2.70 m/s
AVVmean 1.91 m/s
AV maxPG 29.11 mmHg
AV meanPG 16.30 mmHg
AV VTI 51.9 cm
AVA Vmax 1.7cm2
AVA (VTI) 1.8cm2
PVVmax 0.86 m/s
PV maxPG 2.92 mmHg
AVAI (Vmax) 0.00 cm squared /m squared
AVAI (VT) 0.00 cm squared /m squared
=================================================================================================
ECHOCARDIOGRAM REPORT
MICHAEL September 14, 2020
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MRN:
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3598
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DOB:
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1961-07
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Gender:
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M
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HR:
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189
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Height:
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67in
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BSA:
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1.87m2
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BMI:
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25.07
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Age 59, weight 160 lbs
Left Ventricle Normal
LVEDV(A4C) 94.1 ml (62-150)
LVEDV(A4C)/BSA 50.26 ml/m2 (34-74)
LVESV(A4C) 45.4 ml (21-61)
LVESV(A4C) BSA 24.25 ml/m2 (13-29)
LVEDV 91.8 ml
LVESV 21.6 ml
EF 76.0% (52 – 72)
IVSd 0.8cm (0.6 - 1)
LVIDd 4.5cm (4.2 - 5.8)
LVIDd/BSA 2.40 cm/m2 (2.1 – 3.1)
LVPWd 0.8cm (0.6 - 1)
LV FS(midwall) 45.0% (14 – 22)
IVSs 1.4cm (0.8 – 1)
LVIDs 2.5cm (2.5 – 4)
LVPWs 1.4cm (0.9 – 1.8)
IVRT 96.0 ms (60 – 88)
LVRWT 0.34
LV Length D 8.3cm
LV length S 6.1cm
Right Ventricle
RV 3.2cm
Left Atrium
LA(Mm) 3.0cm (3 – 4)
LA 2.8cm (3 – 4)
LA /BSA 1.50cm/m2 (1.5 – 2.3)
Mitral Valve
MV PkE Vel 0.8 mis (0.7 – 1.2)
MV PkA Vel 0.7 mis (0.4 – 0.7)
MV E/A Ratio 1.0 (0.78 – 1.78)
MV Decel Time 186.0ms (143 – 219)
Septal e’ 8.41 cm/s (7.6 – 16.8)
Septal Ele’ 9.1 (<8)
Tricuspid Valve
TR Pk Ve l 2.2 mis
TR Pk Grad 19.2 mmHg
RVSP 24.4 mmHg (18 – 25)
RAP 5.0 mmHg (<5)
Aorta
AoD 2.5cm
AoD(Mm) 2.5cm
Aortic Valve Normal
LVOTDiam 2.1cm (1.8-2.2)
LVOTPkVe l 1.13 mis
LVOTPkGrad 5.1 mmHg
LVOTVTI 25.8cm (18-22)
LVOTSV 70.2 ml
LVOTCO 16.7 Umin
AV Pk Vel 2.00 mis
AV Pk Grad 16.0 mmHg (<10)
AV Mean Grad 9.1 mmHg (<=40)
AV VTI 42.3cm (18-22)
AVA(VTI) 2.1cm2 (>1)
AVA / BSA 1.12cm2/m2 (>0.6)
Pulmonary Valve
PV PkVel 0.8 mis
PV PkGrad 2.4 mmHg
Left ventricle cavity is normal in size. Normal global wall motion.
Doppler evidence of grade I (impaired) diastolic dysfunction.
Calculated EF 76%.
Trileaflet aortic valve with trace regurgitation. Moderate aortic valve leaflet calcification.
Trace aortic valve stenosis.
Structurally normal mitral valve with trace regurgitation. Structurally normal tricuspid valve with trace regurgitation.