Question about echo report

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Rich - 28 Sep 2004 23:57 GMT

My son is 3 years old.. we'll be seeing his cardiologist in November. The
cardiologist spoke to me on the phone and was really happy about the
results, it's an improvement over the last exam.. but I have a few questions
until we see him in November:

1. Bicuspid aortic valve with minimal aortic stenosis [I know what this
means].

2. Aortic root dimensions indicate significant enlargement with a Z-value of
4.86 [I do not know what this means].

3. Aortic annulus also dilated [I do not know what this means].

4. Small VSD with high-velocity left-to-right shunting suggests normal right
ventricular pressures [I know what this means, this is an improvement from
our last echo].

5. There is good ventricular function without ventricular hypertrophy [I
think I know what this means].

Thanks.

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Terrence Chun, MD - 30 Sep 2004 07:27 GMT

> My son is 3 years old.. we'll be seeing his cardiologist in November.
> The cardiologist spoke to me on the phone and was really happy about
[quoted text clipped - 6 lines]
> 2. Aortic root dimensions indicate significant enlargement with a
> Z-value of 4.86 [I do not know what this means].

A "Z-value" means a standard-deviation from the mean, which attempts to quantify how
far from the normal range the value is. A Z-value greater than +2.0 means that it is
statistically out of the normal range (95th percentile).

The aortic root is the portion of the aorta just past the aortic valve. With stenotic valves
we will commonly see "post-stenotic dilatation", which is an enlargement of the
segment of blood vessel just past a narrowed valve.

> 3. Aortic annulus also dilated [I do not know what this means].

The aortic annulus is the "ring" of the aortic valve. Apparently it is larger than expected.

> 4. Small VSD with high-velocity left-to-right shunting suggests normal
> right ventricular pressures [I know what this means, this is an
> improvement from our last echo].

This is good. Hopefully, the VSD is closing and causing the high left-to-right gradient.
Left-sided obstructions (such as aortic stenosis) are notorious for making the shunt
from small VSD's much more significant and can "force our hand" in terms of deciding
to intervene.

> 5. There is good ventricular function without ventricular hypertrophy
> [I think I know what this means].

Left-sided obstructions (such as aortic stenosis or coarctation of the aorta) can result in
increase of the thickness of the left ventricle (hypertrophy), so your cardiologist is
following this. They are also measuring the function of the left (main pumping) ventricle.

Hope this helps.

- TC, md
Pediatric cardiology, pacing and electrophysiology

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