Left ventricle:

• normal sized chamber with normal left ventricular wall thickness

• no thrombus

• borderline systolic function LVEF: ~50-55%

Right ventricle:

• mildly dilated, basal diameter: ~4.1cm with borderline systolic function

• TAPSE: 1.6 cm

• tissue Doppler imaging systolic velocity (TDI S'): 10 cm/s

Interventricular septum: intact

Atria:

• left atrium: dilated, area: 41 cm², LAVI: 84 mL/m² with smoke appearance within the chamber (spontaneous echo contrast)

• right atrium: dilated, area: 27 cm²

Aortic valve:

• normal tricuspid

• no aortic regurgitation

Mitral valve:

• thickened and calcified mitral valve leaflet tips with diastolic doming of the anterior mitral valve leaflet giving a "hockey stick" appearance and restricted motion of the posterior mitral valve leaflet. No mitral regurgitation

• mitral valve area by PHT: 0.30 cm², transmitral mean pressure gradient: 17 mmHg

Tricuspid valve:

• severe eccentric tricuspid regurgitation

Additional findings:

• severely elevated pulmonary pressures (estimated sPAP ~80 mmHg)

• dilated IVC with <50% inspirational collapse, dilated hepatic veins

The heart is enlarged CTR 15:26. Enlarged left atrium is seen splaying the carina.

Filling of the pulmonary bay is noted. No hilar or mediastinal adenopathy is seen.
Lungs show normal aeration. Costophrenic and cardiophrenic angles are clear. Bony cage appears intact.

Post mitral valve replacement

• mechanical prosthetic mitral valve is normally functioning. No mitral regurgitation. No paravalvular prosthetic leaks noted

• mitral valve area by PHT: 3.28 cm², transmitral mean pressure gradient: 4 mmHg, mitral valve PHT: 67 ms

• no pulmonary arterial hypertension estimated sPAP ~32 mmHg)