Case 10 — M-Mode Echocardiography

M-mode echocardiogram of the left ventricle showing markedly enlarged end-diastolic diameter of 7 cm (normal 4.7 cm) and moderately enlarged end-systolic diameter of 5 cm (normal 3.2 cm). Shortening fraction is 29%, within normal range (25-40%).
M-mode of the left ventricle (overview).
M-mode echocardiogram with end-diastolic measurement markers showing LV EDD of 7 cm.
M-mode with diastolic measurements.
M-mode echocardiogram with end-systolic measurement markers showing LV ESD of 5 cm.
M-mode with systolic measurements.

The left ventricular end-diastolic diameter (EDD) is markedly enlarged at 7 cm (normal = 4.7 cm). The end-systolic diameter (ESD) is moderately enlarged at 5 cm (normal = 3.2 cm). The shortening fraction is 29%, within normal range (25–40%). However, myocardial contractility is at least moderately decreased, as evidenced by the moderate increase in end-systolic diameter (the shortening fraction is within normal range only because the end-diastolic diameter is larger than normal). The interventricular septum (IVS) motion is increased (hyperdynamic) while left ventricular free wall (LVFW) motion is reduced. Wall thicknesses are normal (~1 cm), indicating eccentric (volume overload) hypertrophy is present.

The E-point to septal separation (EPSS) was 16 mm, at least moderately increased from the normal of less than 6 mm. The left atrial diameter on a short-axis basilar view was 48 mm compared to an aortic diameter of 20 mm, for a ratio of 2.4 (normal <1.5).

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