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What Does My Echocardiogram Test Report Indicate?
Question: Dear Dr. Iliri,
I have just returned from my echo. It was completely normal, as you predicted, no changes since last echo with the doctor 5 months ago. However, the tech recorded my EF as 80 Teicholz but told me that cardio would record at 65. Dr said 60-65. Why would Teicholz be so high? Is all of this simply normal and I just need to forget about it?
I don't have echo report yet but will share when it is available. I am happy I went 3 1/2 months with no echo and all is still normal. I hope that soon I can forget that I was ever sick. In any case, EF certainly isn't low, I know that. And PAP is normal, and still just trivial to mild mitral regurgitation.
I am relieved but know I need to keep working on the anxiety.
Thank you so much for all your help.
XXXX
I have just returned from my echo. It was completely normal, as you predicted, no changes since last echo with the doctor 5 months ago. However, the tech recorded my EF as 80 Teicholz but told me that cardio would record at 65. Dr said 60-65. Why would Teicholz be so high? Is all of this simply normal and I just need to forget about it?
I don't have echo report yet but will share when it is available. I am happy I went 3 1/2 months with no echo and all is still normal. I hope that soon I can forget that I was ever sick. In any case, EF certainly isn't low, I know that. And PAP is normal, and still just trivial to mild mitral regurgitation.
I am relieved but know I need to keep working on the anxiety.
Thank you so much for all your help.
XXXX
Brief Answer:
Glad to hear good news from you!
Detailed Answer:
Hello XXXX,
I am glad to hear this good news from you.
In fact I was expecting the echo result to be normal as you have demonstrated amazing improvements from your cardiac ablation.
Your clinical status is normal, your follow up echos and lab tests repeatedly within normal ranges.
Regarding the Teicholz method of EF estimation (by using LV diameters instead of volumes) the results are OK.
Also, no clinically significant valvular dysfunctions are present.
So, relax and don't worry about your cardiac issues any more!
I would like to directly review your echo report when available.
Meanwhile, as I have advised you before, try to consider more intense physical and recreational activities, to change the way of thinking about health issues, and most importantly to follow a healthy daily life style.
I would be happy to support you, if you are having further uncertainties.
Best wishes,
Dr. Iliri
Glad to hear good news from you!
Detailed Answer:
Hello XXXX,
I am glad to hear this good news from you.
In fact I was expecting the echo result to be normal as you have demonstrated amazing improvements from your cardiac ablation.
Your clinical status is normal, your follow up echos and lab tests repeatedly within normal ranges.
Regarding the Teicholz method of EF estimation (by using LV diameters instead of volumes) the results are OK.
Also, no clinically significant valvular dysfunctions are present.
So, relax and don't worry about your cardiac issues any more!
I would like to directly review your echo report when available.
Meanwhile, as I have advised you before, try to consider more intense physical and recreational activities, to change the way of thinking about health issues, and most importantly to follow a healthy daily life style.
I would be happy to support you, if you are having further uncertainties.
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you so much, as always. I am still awaiting the official echo report which I will send to you as soon as I have it.
I am, of course, anxious a bit about the Teicholz computer reading of 80. The tech (who has been doing echoes for 28 years) explained immediately that she was quite sure the cardiologist would read the EF as 65. Why the disparity in the teicholz and the doctor's interepretation? Only I could worry that EF may be both too high and too low! Is it possible my EF is as high as 80? I know I must simply trust my doctor who says its a perfect 60-65.
My cardio also said, as you do, that fluid is no concern with normal heart function. I am trying so hard to forget it but it is so entrenched as a habit and a mindset. But echo said everything is fine so can I truly put fluid out of my head and just drink as much as I want? I tend to drink about 2.5 L a day, but worry about every ounce of that. And small weight fluctuations, as well, have nothing to do with my heart? I must must overcome this obsession.
Thank you for your suggestions of exercise. I cycle 10 miles daily, but will be adding yoga, boxing, and weights at the gym I just joined. Also will be attending Buddhist temple to intensively meditate. I will overcome this.
You are most helpful and kind. I hope you have a wonderful weekend.
Many thanks, as always,
XXXX
Thank you so much, as always. I am still awaiting the official echo report which I will send to you as soon as I have it.
I am, of course, anxious a bit about the Teicholz computer reading of 80. The tech (who has been doing echoes for 28 years) explained immediately that she was quite sure the cardiologist would read the EF as 65. Why the disparity in the teicholz and the doctor's interepretation? Only I could worry that EF may be both too high and too low! Is it possible my EF is as high as 80? I know I must simply trust my doctor who says its a perfect 60-65.
My cardio also said, as you do, that fluid is no concern with normal heart function. I am trying so hard to forget it but it is so entrenched as a habit and a mindset. But echo said everything is fine so can I truly put fluid out of my head and just drink as much as I want? I tend to drink about 2.5 L a day, but worry about every ounce of that. And small weight fluctuations, as well, have nothing to do with my heart? I must must overcome this obsession.
Thank you for your suggestions of exercise. I cycle 10 miles daily, but will be adding yoga, boxing, and weights at the gym I just joined. Also will be attending Buddhist temple to intensively meditate. I will overcome this.
You are most helpful and kind. I hope you have a wonderful weekend.
Many thanks, as always,
XXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear XXXX,
The most important part of your medical history is that you actually have a normal cardiac function.
Teicholz is a method for measuring fractional shortening and thus EF by utilizing systolic and diastolic LV diameters. It may yield an approximate value of LV EF by making assumptions about LV geometry, while other methods like volumetric are more precise in this regard.
So my opinion is that you should trust the conclusion of your cardiologist.
Regarding the fluids issues I would like to assure you once more that there is no reason to make limitations over fluid intake. So you can have as much water and other fluids as you need without being afraid of fluid overload and heart failure exacerbation.
I would strongly encourage you those above mentioned physical activities. My advice is that those would be better performed under the supervision of a certified physical trainer.
Wishing you a wonderful weekend!
Kind regards!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear XXXX,
The most important part of your medical history is that you actually have a normal cardiac function.
Teicholz is a method for measuring fractional shortening and thus EF by utilizing systolic and diastolic LV diameters. It may yield an approximate value of LV EF by making assumptions about LV geometry, while other methods like volumetric are more precise in this regard.
So my opinion is that you should trust the conclusion of your cardiologist.
Regarding the fluids issues I would like to assure you once more that there is no reason to make limitations over fluid intake. So you can have as much water and other fluids as you need without being afraid of fluid overload and heart failure exacerbation.
I would strongly encourage you those above mentioned physical activities. My advice is that those would be better performed under the supervision of a certified physical trainer.
Wishing you a wonderful weekend!
Kind regards!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you so much, again for all your help. I am still awaiting the final echo report from last week.
As usual, despite the normal echo, I have lingering questions and worries. While I know I have to trust my cardio, as you have said, I continue to wonder about the Teicholz EF of 81. Is it normal to see such a number but then have a final cardio reading of 60-65? I know on an older echo report it said Teicholz 61. Does this infer any changes which could be worrisome?
Also, is it worrisome to have blood pressure of 125/80? When I was going to the ER almost every week and on carvedilol of 6.25, BP never exceeded 110/65. Now carvedilol is lowered to 3.125 and I was very nervous as I hadnt seen dr in over 3 months. Was it likely just my nervousness causing slightly higher BP? I never had BP issues before cardiomyopathy. I am concerned I will not be able to completely discontinue carvedilol in the future.
A physician friend of mine (radiologist, not cardio) said to me last night that what I fear is impossible: water cannot kill me and with normal heart function I simply won't retain fluid and go into heart failure. It helped me to hear this. I need to believe that my fears are actually completely irrational. Once my fluid fears are eased, I believe I will be ok.
Thank you so much, for all your help. With your advice, I went from going to ER every week to now not going in over 3 months. Perhaps I will be cured of the OCD, after all. The cardiologist who scared me so much said I would either be dead or in need of a transplant right now. It has been exactly a year since I was diagnosed.
Thank you so much for everything.
Best to you,
XXXX
Thank you so much, again for all your help. I am still awaiting the final echo report from last week.
As usual, despite the normal echo, I have lingering questions and worries. While I know I have to trust my cardio, as you have said, I continue to wonder about the Teicholz EF of 81. Is it normal to see such a number but then have a final cardio reading of 60-65? I know on an older echo report it said Teicholz 61. Does this infer any changes which could be worrisome?
Also, is it worrisome to have blood pressure of 125/80? When I was going to the ER almost every week and on carvedilol of 6.25, BP never exceeded 110/65. Now carvedilol is lowered to 3.125 and I was very nervous as I hadnt seen dr in over 3 months. Was it likely just my nervousness causing slightly higher BP? I never had BP issues before cardiomyopathy. I am concerned I will not be able to completely discontinue carvedilol in the future.
A physician friend of mine (radiologist, not cardio) said to me last night that what I fear is impossible: water cannot kill me and with normal heart function I simply won't retain fluid and go into heart failure. It helped me to hear this. I need to believe that my fears are actually completely irrational. Once my fluid fears are eased, I believe I will be ok.
Thank you so much, for all your help. With your advice, I went from going to ER every week to now not going in over 3 months. Perhaps I will be cured of the OCD, after all. The cardiologist who scared me so much said I would either be dead or in need of a transplant right now. It has been exactly a year since I was diagnosed.
Thank you so much for everything.
Best to you,
XXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear XXXX,
As I explained above Teicholz is utilized by considering some left ventricle anatomical assumptions. So its derived EF value is just an approximation. We have to wait for the echo report to see how the final judgment about LVEF is considered.
When you have the report I could directly review it again.
Regarding your blood pressure values, I would assure you that everything seems to be ok. You don’t have to worry about it. Also about carvedilol use, as those are such small doses and in continuing down titration.
Your doctor friend is right. You are quite safe from experiencing a fluid retention symptomatology. Your cardiac function is normal and there is no reason for believing in a heart failure relapse.
I am quite sure that you are on the right way of succeeding over OCD and anxiety disorder.
Hope to have been helpful!
Kind regards!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear XXXX,
As I explained above Teicholz is utilized by considering some left ventricle anatomical assumptions. So its derived EF value is just an approximation. We have to wait for the echo report to see how the final judgment about LVEF is considered.
When you have the report I could directly review it again.
Regarding your blood pressure values, I would assure you that everything seems to be ok. You don’t have to worry about it. Also about carvedilol use, as those are such small doses and in continuing down titration.
Your doctor friend is right. You are quite safe from experiencing a fluid retention symptomatology. Your cardiac function is normal and there is no reason for believing in a heart failure relapse.
I am quite sure that you are on the right way of succeeding over OCD and anxiety disorder.
Hope to have been helpful!
Kind regards!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much, Dr iliri. I'm attaching the echo report along with the echo performed by this doctor in XXXXXXX Now in between these two echoes, I had two echoes by different doctors, one with EF 55-60 in July, and EF 65-70 in August.
Sorry- the quality of these images isnt great. They are physical printouts which have small, strange fonts. I notice differences in 2D/M mode: LA, AO, RV, LVDd, LVDs, in the LV diastolic function section as well. I noticed that deceleration time and tissue doppler seem out of normal range, but cardio didn't mention anything abnormal at all. I know I shouldn't examine so thoroughly, just listen to cardio but of course I'm hypervigilant about tiny signs that my heart may be having issues again.
Many many thanks again.
XXXX
Sorry- the quality of these images isnt great. They are physical printouts which have small, strange fonts. I notice differences in 2D/M mode: LA, AO, RV, LVDd, LVDs, in the LV diastolic function section as well. I noticed that deceleration time and tissue doppler seem out of normal range, but cardio didn't mention anything abnormal at all. I know I shouldn't examine so thoroughly, just listen to cardio but of course I'm hypervigilant about tiny signs that my heart may be having issues again.
Many many thanks again.
XXXX
Brief Answer:
You have just a perfect cardiac ultrasound.
Detailed Answer:
Dear XXXX,
I carefully review both of your cardiac ultrasounds and I am glad to confirm they look great, perfectly normal.
You don't have to worry about those value changes observed in several echo parameters like Ao, AM, LV diameters, tissue Doppler measurements, as first they are all normal, and what is more important seem to be caused by intraobserver measurement variability (a frequent finding inherent in cardiac ultrasound techiques).
So relax and don't worry my dear!
All the observer cardiac structures are perfectly normal, also LV function (including diastolic function) is perfect. You have experienced a fantastic recovery from your previous heart disorder.
Congratulation XXXX!
Kind regards,
Dr. Iliri
You have just a perfect cardiac ultrasound.
Detailed Answer:
Dear XXXX,
I carefully review both of your cardiac ultrasounds and I am glad to confirm they look great, perfectly normal.
You don't have to worry about those value changes observed in several echo parameters like Ao, AM, LV diameters, tissue Doppler measurements, as first they are all normal, and what is more important seem to be caused by intraobserver measurement variability (a frequent finding inherent in cardiac ultrasound techiques).
So relax and don't worry my dear!
All the observer cardiac structures are perfectly normal, also LV function (including diastolic function) is perfect. You have experienced a fantastic recovery from your previous heart disorder.
Congratulation XXXX!
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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