An echocardiogram, often called an “echo,” is a non-invasive procedure that uses ultrasound technology to create moving images of the heart. This test allows healthcare professionals to visualize the heart’s anatomy, including its four chambers and valves, and to assess its overall function. The primary goal of an echocardiogram is to evaluate how effectively the heart is pumping blood and to determine if its physical structures are within expected limits. The results are complex, containing numerous measurements, and this article will explain the common metrics found in a typical report that indicate normal heart health.
Core Metrics: Understanding Heart Pumping Power
The most frequently reported metric of the heart’s mechanical performance is the Ejection Fraction (EF), which is a percentage describing the amount of blood pumped out of the main chamber with each contraction. Specifically, the Left Ventricular Ejection Fraction (LVEF) measures the percentage of blood leaving the left ventricle, the heart’s strongest chamber responsible for pushing oxygenated blood to the body. A normal LVEF generally falls within the range of 50% to 70% in healthy adults, indicating that the heart is efficiently emptying more than half of its blood volume with every beat. An EF in this range suggests that the heart muscle is contracting forcefully and the global systolic function is well preserved. Results below this range are categorized as mildly, moderately, or severely reduced, suggesting a diminished ability to pump blood effectively.
Another measurement related to contractility is Fractional Shortening (FS), which quantifies the percentage change in the diameter of the left ventricle between its relaxed and contracted states. A normal FS ranges from 25% to 45% in adults, providing a simpler, one-dimensional indicator of how much the muscle fibers shorten during a beat. While EF is a volumetric measurement, FS provides supporting data on the efficiency of the muscle’s mechanical squeeze. Both metrics are central to assessing the heart’s role as a pump.
Structural Integrity: Chamber Size and Wall Thickness
A normal echocardiogram report confirms that the physical dimensions of the heart’s four chambers (the two atria and two ventricles) are not enlarged or “dilated.” The size of these chambers is often “indexed,” meaning the measurement is adjusted for the patient’s body size, such as height or surface area, to ensure accuracy. Normal results for the left ventricle mean its internal diameter is within a specified range at the end of its relaxation phase.
For the left atrium, the chamber that receives oxygenated blood from the lungs, the Left Atrial Volume Index (LAVI) is a standard measurement used to assess its size. A normal LAVI is typically less than 34 milliliters per square meter (\(\text{mL/m}^2\)) of body surface area. Any enlargement of this chamber can reflect chronic pressure issues, so a result within this range confirms that the atrium is not working against elevated pressures.
The thickness of the heart muscle walls, or myocardium, is also measured, particularly the interventricular septum and the left ventricular posterior wall. Normal wall thickness for healthy adults is between 0.6 and 1.0 centimeters (6 to 10 millimeters) when the heart is relaxed. Thicknesses significantly above this range suggest hypertrophy, where the muscle has thickened, often in response to chronically high blood pressure or other conditions that force the heart to work harder. A normal report confirms the absence of this abnormal thickening.
Valvular Function: Flow and Movement
The heart contains four valves—the mitral, aortic, tricuspid, and pulmonary—which must open and close to maintain one-way blood flow. Normal valvular function means the valve leaflets are thin, pliable, and mobile, moving completely out of the way when open (preventing stenosis) and meeting perfectly when closed (preventing regurgitation). Stenosis, or narrowing, is ruled out when the valve opens widely, and the velocity and pressure gradient across the valve are low.
Normal blood flow through the heart and major vessels is described as “laminar,” meaning it moves smoothly and in a single direction, which appears as a uniform color on the Color Doppler imaging portion of the test. When the flow is abnormal, it becomes turbulent, often appearing as a disorganized, multi-colored mosaic pattern. The mean pressure gradient across a normal valve, such as the aortic valve, is typically less than 5 millimeters of mercury (mmHg).
It is common, however, for an echocardiogram to report “trace” or “physiologic” regurgitation, especially in the tricuspid and pulmonary valves. This finding refers to a tiny backward leak that is present in many healthy people and does not place any strain on the heart. Such trivial leakage is considered a normal variant and is distinct from moderate or severe regurgitation, which would indicate a true valve problem.
Contextualizing the Results
The numerical values and qualitative descriptions in an echocardiogram report are not isolated data points but are interpreted together to form a comprehensive picture of heart health. A final report will often include a general statement summarizing the findings, such as “normal left ventricular systolic and diastolic function” or “no significant valvular disease.” A normal result means all the key measurements—like LVEF, chamber sizes, wall thickness, and valve function—fall within the established reference ranges.
The exact “normal” ranges can have minor variations based on the specific guidelines used by the interpreting facility, the equipment, and the patient’s individual characteristics, like age and body size. Some measurements are adjusted for a patient’s body surface area for greater accuracy. Self-interpretation of raw numbers is discouraged because the complete diagnosis relies on the expertise of a cardiologist who reviews the moving images alongside the numerical data and the patient’s overall medical history.
The determination of a normal result is a holistic assessment. The final interpretation from a medical professional is the most important part of the echocardiogram process. While the metrics provide objective data, the professional evaluation integrates this data to confirm that the heart is structurally sound and operating effectively.