Reporting Guide

An echocardiography report should answer the clinical question, describe the major abnormalities, acknowledge important limitations, and communicate findings that may change management.

Report Structure¶

Include:

1. Study type and indication
2. Image quality and technical limitations
3. Rhythm and relevant hemodynamic conditions
4. Structured findings
5. Comparison with prior imaging
6. Concise final impression
7. Documentation of critical-result communication

Image Quality¶

State what could not be assessed rather than simply writing “technically difficult.”

The study is technically difficult because of limited acoustic windows. LV endocardial definition is inadequate for reliable regional wall-motion assessment.

Do not describe a structure as normal if it was not adequately visualized.

Structured Findings¶

Left Ventricle¶

Report:

• Size and wall thickness
• Global systolic function
• LVEF and method
• Regional wall motion
• Diastolic function when assessed
• Thrombus or dynamic obstruction when relevant

The LV is normal in size with normal systolic function. The calculated biplane LVEF is 62%.

Avoid false precision and make clear when LVEF is visually estimated.

Right Heart¶

Report:

• RV size and systolic function
• RA size
• Estimated right atrial pressure
• Estimated RVSP or PASP
• Pressure- or volume-overload findings

The RV is moderately dilated with mildly reduced systolic function.

Do not call RV function normal based on a single parameter.

Valves¶

Describe:

Posterior mitral leaflet prolapse results in severe anteriorly directed mitral regurgitation with severe left atrial dilation.

Use an integrated assessment when severity parameters disagree.

Prosthetic Valves¶

Include:

• Position, type, and size when known
• Leaflet or occluder motion
• Peak velocity and mean gradient
• Regurgitation
• Comparison with baseline measurements

Do not diagnose obstruction from an elevated gradient alone. Consider flow, heart rate, valve size, Doppler alignment, and prior studies.

Pericardium and Aorta¶

Specify effusion size, distribution, and whether echocardiographic tamponade physiology is present.

A moderate circumferential pericardial effusion is present without echocardiographic evidence of tamponade physiology.

Identify the exact aortic segment and measurement.

The proximal ascending aorta is dilated, measuring 4.4 cm.

Diagnostic Uncertainty¶

Describe the observation, limitation, and appropriate next step.

The LV apex is inadequately visualized. Apical thrombus cannot be excluded. Repeat imaging with an ultrasound-enhancing agent is recommended.

A mobile mitral-valve echodensity is concerning for vegetation in the appropriate clinical setting. Clinical correlation and TEE should be considered.

Avoid prematurely labeling an uncertain echodensity as thrombus, vegetation, or tumor.

Comparison¶

Name the prior study date and describe meaningful interval changes.

Compared with the study dated March 4, 2026, LVEF has decreased from 55–60% to 35–40%.

Do not write “no change” unless a prior study was reviewed. Small differences may reflect technique or loading conditions rather than true progression.

Final Impression¶

Prioritize:

1. Major acute or new finding
2. Ventricular function
3. Significant valve disease
4. RV and pulmonary pressure findings
5. Pericardial or aortic disease
6. Meaningful interval change
7. Important limitation or next test

Example¶

1. Moderately reduced LV systolic function; LVEF 35–40%.
2. Inferior and inferolateral wall-motion abnormalities.
3. Moderate ischemic mitral regurgitation.
4. Mildly dilated RV with preserved systolic function.
5. LVEF has decreased compared with the prior study dated ___.

Do not repeat every normal finding in the impression.

Preferred Language¶

Critical Findings¶

Communicate urgent findings directly and document:

• Finding communicated
• Recipient
• Date and time
• Method of communication

Critical findings were communicated directly to Dr. ___ by telephone at ___ on ___.

Final Checklist¶

Before signing:

• Answer the indication.
• Confirm measurements and units.
• Ensure the findings and impression agree.
• State meaningful limitations.
• Compare with prior imaging.
• Remove unsupported diagnoses.
• Prioritize actionable findings.
• Document critical communication.

Key Points¶

• Answer the clinical question.
• Report anatomy, mechanism, severity, and consequences.
• State what cannot be determined and why.
• Keep the impression short and prioritized.
• Communicate critical findings directly.

References¶

1. Standardization of Adult Echocardiography Reporting — ASE, 2025
2. Comprehensive Transthoracic Echocardiographic Examination — ASE, 2019
3. Standardized Report for Adult TTE — ASE