Echocardiogram Results Explained: What Cardiologists Measure and What Each Number Means

An echocardiogram (often called an "echo") is an ultrasound of your heart. It's a safe, painless test that uses sound waves to create moving images of your heart chambers, valves, walls and blood vessels. When you receive your echocardiogram results, you'll see a variety of measurements and terms that may look intimidating. This guide breaks down the most common numbers cardiologists report, what they mean and when to follow up with a healthcare professional.

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1. Ejection Fraction (EF)

What it is:
Ejection fraction measures how much blood the left ventricle pumps out with each heartbeat as a percentage of the total amount of blood it holds.

• Normal range: 55–70%
• Borderline/"mildly reduced": 45–54%
• Reduced: <45%

Why it matters:
A lower EF can signal heart failure, cardiomyopathy or damage from a prior heart attack. An EF above 70% may reflect hyperdynamic function, sometimes seen in anemia or high blood pressure.

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2. Chamber Sizes and Volumes

Left Ventricle (LV)

• End‐Diastolic Diameter (LVEDD): size of the LV at rest
  • Normal: 3.8–5.7 cm in men, 3.5–5.2 cm in women
• End‐Systolic Diameter (LVESD): size of the LV at contraction
  • Normal: <4.0 cm

Left Atrium (LA)

• LA Volume Index: volume of the left atrium adjusted for body surface area
  • Normal: ≤34 mL/m²
  • Enlarged: >34 mL/m²

Right Ventricle (RV)

• RV Basal Diameter: width of the RV at its base
  • Normal: ≤4.2 cm
• RV Function (TAPSE): tricuspid annular plane systolic excursion
  • Normal: ≥17 mm

Why it matters:
Enlargement can indicate high blood pressure, valve disease or chronic lung problems. Reduced RV function may suggest pulmonary hypertension or right-sided heart failure.

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3. Wall Thickness and Motion

Interventricular Septum & LV Posterior Wall

• Normal Thickness: 0.6–1.1 cm
• Hypertrophy: >1.1 cm

Regional Wall Motion

• Described as:
  • Normal
  • Hypokinesis (reduced movement)
  • Akinesis (no movement)
  • Dyskinesis (abnormal outward bulge)

Why it matters:
Thickened walls (hypertrophy) often reflect high blood pressure or valve stenosis. Abnormal wall motion can signal prior heart attack or ongoing ischemia (reduced blood flow).

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4. Valve Function

Echocardiograms evaluate each valve for structure, opening and closing, and blood flow patterns.

Key Measurements

• Peak Velocity (m/s): speed of blood through a valve
• Mean/Max Gradient (mm Hg): pressure difference across a valve
• Regurgitation Severity: graded as trace, mild, moderate or severe

Normal Findings

• Aortic Valve peak velocity: 1.0–1.7 m/s
• Mitral inflow E/A ratio: 1.0–1.5 in younger adults

Abnormal Findings

• Aortic stenosis: peak velocity >2.6 m/s, mean gradient >20 mm Hg
• Mitral regurgitation: moderate or severe regurgitant fraction >30%

Why it matters:
Valvular stenosis (narrowing) or regurgitation (leakage) can strain your heart, lead to symptoms like shortness of breath or chest pain, and may require medical or surgical treatment.

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5. Diastolic Function

Diastolic function describes how well the heart relaxes and fills with blood.

Common Parameters

• E/A Ratio: early (E) to late (A) ventricular filling velocities
  • Normal in adults: 1.0–2.0
• E/e′ Ratio: estimate of left atrial pressure
  • Normal: <8
  • Elevated: >14

Why it matters:
Abnormal diastolic function can cause symptoms of heart failure even if the EF is preserved. It's common in high blood pressure, diabetes and aging.

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6. Pulmonary Artery Pressure

Estimated by measuring the velocity of tricuspid regurgitation flow:

• Normal Pulmonary Artery Systolic Pressure (PASP): ≤35 mm Hg
• Mild Pulmonary Hypertension: 36–45 mm Hg
• Moderate–Severe: >45 mm Hg

Why it matters:
Elevated pressures can indicate pulmonary hypertension, chronic lung disease or left‐sided heart problems.

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7. Pericardial Effusion

Echocardiograms can detect fluid around the heart:

• Small Effusion: <10 mm
• Moderate: 10–20 mm
• Large: >20 mm

Why it matters:
Small effusions may simply be monitored. Moderate to large effusions can impair heart function (tamponade) and require urgent treatment.

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Putting It All Together

When you review your echocardiogram results, focus on:

1. Overall Heart Function
   • Ejection fraction, chamber sizes, wall motion
2. Valve Health
   • Gradients, regurgitation severity
3. Pressure Estimates
   • Diastolic function, pulmonary pressures
4. Structural Findings
   • Hypertrophy, effusion, congenital abnormalities

Even a single abnormal value doesn't always indicate a serious problem. Cardiologists interpret results in the context of your age, symptoms and medical history.

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Next Steps and When to Seek Help

• Discuss any abnormal findings with your cardiologist.
• If you experience chest pain, fainting, severe shortness of breath or swelling in your legs, seek medical attention right away.
• If you're experiencing symptoms like chest pain, shortness of breath or unusual fatigue and want to better understand what might be causing them, you can use Ubie's free AI Symptom Checker to get personalized insights before your doctor's appointment.

Always speak to a doctor about anything that could be life threatening or serious. Your healthcare provider can explain your results in detail and recommend treatment or monitoring tailored to you.

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Bottom Line: An echocardiogram provides a wealth of information about your heart's structure and function. Understanding each measurement helps you have informed conversations with your cardiologist and take charge of your heart health.