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PulsePoint Echo — Premium Adult Echocardiography Workstation ESC 2021–2025 ACC / AHA 2020–2024 ASE / EACVI

Department of Cardiology & Non-Invasive Cardiac Imaging Lab Created by Dr. Ata Ur Rahman

Patient Bio Data, Hospital Registration & Clinical Information

Complete PulsePoint patient demographics, vitals, presenting symptoms, cardiovascular comorbidities, ECG/labs & offline patient registry.

1. Patient Demographics & PulsePoint Registration

58 yr Male
/
Calculated BSA 1.97 m² Mosteller Formula
BMI & Nutritional Class 26.1 kg/m² Overweight
Mean Arterial Pressure 92 mmHg Pulse Pressure: 48 mmHg

2. Presenting Symptoms, NYHA Class & Risk Factors

Asymptomatic

3. ECG, Relevant Labs, Equipment & Current Therapy

Labs Optional

4. Clinical Summary, Prior Imaging & Offline Patient Vault

0 Saved
No saved offline patient studies in this browser yet. Click Save Current Patient anytime to store full bio + echo measurements locally.

2D / M-Mode / 3D Chamber Quantification, Strain & Wall Motion

Complete LV linear & volumetric indexing, FS%/Teichholz/EPSS/MAPSE, Tei MPI, Devereux geometry plot, 17-segment bullseye, atria & RV function.

ASE / EACVI 2015 ESC HF 2021/2023 AHA / ACC 2022

Left Ventricle: M-Mode, Biplane Simpson, 3D & Strain

Normal LVEF
mm
Normal: 6–10 mm (M)
mm
Normal: 42–58.4 mm (M)
mm
Normal: 25–39.8 mm (M)
mm
Normal: 6–10 mm (M)
mm
Normal: <7 mm (>7 reduced EF)
mm
Normal: ≥11–13 mm (<8 severe)
mL
EDVi: 34–74 mL/m² (M)
mL
ESVi: 11–31 mL/m² (M)
%
Blank = Biplane Simpson auto
%
Normal: ≤ -18% (|GLS| ≥18%)
ms
MCO minus ET (TDI/PW)
ms
Tei Index = (IVCT+IVRT)/ET
Biplane / Primary EF 60.7% Preserved EF (≥50%)
FS% / Teichholz EF 35.4% Teich: 64.5% | EPSS 4 mm
LV Mass / LVMI 80.5 g/m² 159 g | Normal LVMI
RWT / Tei Index 0.40 MPI: 0.36 (Normal <0.39)
LVEDVi / LVESVi 57 / 22 LVESDi: 15.7 mm/m²
Chamber Quantification & Heart Failure Phenotype
Normal LV size, normal geometry, and preserved global systolic function.

LV Remodeling & Hypertrophy Plot (ASE / ESC)

Normal Geometry

17-Segment AHA / ASE Polar Wall Motion Map

WMSI: 1.00
1 Normal 2 Hypo 3 Akinetic 4 Dyskinetic 5 Aneurysm

Tap/click any segment to cycle score (1→5).

Left Atrium, Right Ventricle, Right Atrium & IVC / RAP Assessment

Normal Atria & Right Heart
mL
LAVI Normal: 16–34 mL/m²
mm
Normal: ≤40 mm (M)
mm
Normal: 25–41 mm
mm
Normal: 19–35 mm
mm
Normal: 59–83 mm
mm
Normal: ≥ 17 mm
cm/s
Normal: ≥ 9.5 cm/s
%
Normal: ≥ 35%
%
Normal: ≤ -20% (|FWS| ≥20%)
cm²
Normal: ≤ 18 cm²
mL
RAVI: ≤39 (M) / ≤33 (F) mL/m²
mm
Normal: ≤ 21 mm
eRAP: 3 / 8 / 15 mmHg
Biplane LAVI 26.4 mL/m² | Normal (≤34)
Indexed RAVI 22.3 mL/m² | Normal RA
Est. RAP 3 mmHg Range 0–5 mmHg
RV Function Preserved TAPSE 22 | S′ 13.5 | FWS -24%

Diastolic Function, HFpEF Scoring & Full Pulmonary Hemodynamics

2016 ASE/EACVI vs. 2025 ASE Diastolic Update, ESC HFA-PEFF Score, sPAP / mPAP / PADP, Abbas PVR (Wood Units), ePLAR & 2022 ESC/ERS PH Probability.

ASE / EACVI 2016 ASE 2025 Update ESC / ERS PH 2022

Mitral Inflow, Tissue Doppler, Valsalva & LA Strain

Normal Diastolic Fn
cm/s
≤50 cm/s favors normal LAP
cm/s
Sinus atrial contraction
ms
<160 ms restrictive
ms
≤70 ms elevated LAP (ASE 25)
cm/s
2016: <7 | 2025: ≤6 cm/s
cm/s
2016: <10 | 2025: ≤7 cm/s
%
Abnormal LARS: ≤ 18%
ratio
Elevated LAP: <1.0 (≤0.67)
Δ
≥0.5 drop = Elevated LAP
ms
>30 ms = Elevated LVEDP
Mitral E / A Ratio 1.20 DT 195 ms | IVRT 85 ms
Avg e′ / Avg E/e′ 7.4 Avg e′: 10.5 cm/s
ESC HFA-PEFF Echo 0 / 4 pts Func + Morph domains
ASE / EACVI 2016 Standard
Normal Diastolic Function
0/4 screening criteria positive.
ASE 2025 Update
Normal Diastolic Function
Preserved e′ relaxation & normal LAP.

Pulmonary Pressures (sPAP, mPAP, PADP), PVR & ESC/ERS PH

Low PH Probability
m/s
>2.8 Int | >3.4 High PH Prob
m/s
Aduen mPAP = 4v² + RAP (>2.2 PH)
m/s
PADP = 4v² + RAP
ms
<105 ms PH sign (Mahan mPAP)
Est. sPAP / RVSP 25 mmHg 4×(2.35)² + 3 RAP
mPAP & PADP 17 / 8 Chemla 17 | Aduen 12 | Mahan 21
Abbas PVR (Non-Inv.) 1.54 WU Normal <2.0 Wood Units
TAPSE/sPAP & ePLAR 0.88 ePLAR: 0.32 (>0.30 Pre-Cap)
Low Echocardiographic Probability of PH
Peak TRV ≤2.8 m/s without multi-category PH signs.

Native & Prosthetic Valvular Heart Disease Studio

Continuity AVA, Angle-Corrected PISA, Rheumatic MS Wilkins Score, 5-Grade TR, and Full Mechanical/Bioprosthetic Valve Obstruction & PPM Analyzer.

ESC / EACTS VHD 2025 ACC / AHA VHD 2020 ASE Prosthetic Valves

Continuity Equation & AS Hemodynamics

No AS / Normal
mm
Inner-to-inner mid-systole
cm
SVi ≤35 mL/m² = Low Flow
m/s
Severe: ≥ 4.0 m/s
mmHg
Severe: ≥ 40 mmHg
cm
Multi-window CW (Apical/RUSB)
AU
>2000 (M) / >1200 (F) Severe
Continuity AVA 2.54 cm² AVAi: 1.29 cm²/m²
Dimensionless Index 0.73 ≤ 0.25 Severe AS
Stroke Vol. Index 38.6 mL/m² | Normal Flow

ESC 2025 & ACC/AHA 2020 Stage & Intervention Guide

Normal Valve
Aortic Stenosis Decision Support
Normal forward aortic velocity and valve area.
MetricMildModerateSevereVery Severe
Vmax (m/s)2.6–2.93.0–3.9≥ 4.0≥ 5.0
Mean PG< 2020–39≥ 40≥ 60
AVA (cm²)> 1.51.0–1.5≤ 1.0< 0.75
AVAi / DI>0.85 / >0.50.6–0.85≤0.6 / ≤0.25--

Aortic Regurgitation Integrative Quantification

None / Trace
mm
<3 Mild | 3–6 Mod | >6 Sev
%
<25% | 25–64% | ≥65% Sev
ms
>500 | 200–500 | <200 ms Sev
mm²
<10 | 10–29 | ≥30 mm² Sev
mL
<30 | 30–59 | ≥60 mL Sev
ESC 2025 vs. ACC/AHA 2020 Surgical Trigger Check
Live LV remodeling parameters synced from Module 1.

Asymptomatic Severe AR Surgical Thresholds

CriterionESC / EACTS 2025ACC / AHA 2020Patient Live
LVEF≤50% (I B) | ≤55% (IIb C)≤55% (Class 1)60.7%
LVESD>50 mm (Class I B)>50 mm (Class 2a)31 mm
LVESDi>25 (I B) | >22 mm/m² (IIb)>25 mm/m² (2a)15.7 mm/m²
LVESVi>45 mL/m² low risk (IIb C)Serial rise (2b)22.3 mL/m²

Mitral Regurgitation & Angle-Corrected PISA

None / Trace
mm
≥7 mm (≥8 biplane) Severe
mm
cm/s
deg
180° flat leaflet (α/180 corr.)
cm/s
cm
PISA Flow Rate 0 mL/s 2πr²·Va·(α/180)
PISA EROA 0 mm² Severe: ≥40 mm²
RegVol / RegFrac 0 mL RF: 0% (≥50% Sev)

ESC 2025 & ACC/AHA 2020 Mitral Decision Guide

Live MR Guideline Verdict
No significant MR currently entered.

Rheumatic / Calcific Mitral Stenosis & PMBC Evaluation

Normal MV Opening
cm²
Severe MS: ≤1.5 cm² (Very ≤1.0)
ms
MVA = 220 / PHT (≥150 ms ≤1.5)
mmHg
Record HR alongside gradient!
Pre-PMBC TOE mandatory!

Wilkins Rheumatic Morphology Score (1–4 pts each; ≤8 Ideal for PulsePoint Cath Lab PMBC)

pts
pts
pts
pts
Effective MVA 3.38 cm² PHT-derived (220/PHT)
Wilkins Echo Score 4 / 16 ≤8 Favorable for PMBC

PulsePoint Cath Lab PMBC Suitability Verdict

Mitral Stenosis & Percutaneous Commissurotomy Check
Normal mitral valve opening area.

Tricuspid (5-Grade TR + TS) & Pulmonic Valve

Trace / Mild TR
mm
Sev 7–13 | Mass 14–20 | Torr ≥21
mm²
Sev 40–59 | Mass 60–79 | Torr ≥80
mm
≥40 mm or >21 mm/m²
mmHg
Severe TS: ≥5 mmHg, PHT ≥190 ms
mmHg
<36 Mild | 36–64 Mod | >64 Sev
Tricuspid Annular Sizing & Concomitant Repair Check
TV Annulus normal.

ESC / EACVI 5-Tier TR Grading Reference

MetricMildModSevereMassiveTorrential
VC (mm)<33–6.97–1314–20≥21
EROA (mm²)<2020–3940–5960–79≥80
3D VCA----75–9495–114≥115

Prosthetic Valve Function, Obstruction & PPM Analyzer

No Prosthetic Valve
ASE & ESC 2025 Prosthetic Criteria
m/s
Ao ≥3–4 | Mitral ≥1.9–2.5 m/s
mmHg
Ao ≥20–35 | Mitral >5–10 mmHg
cm
Uses LVOT SV from AS tab
ms
Obstruction vs PPM: >100 ms / AT:ET >0.37
ms
Normal <130 ms | >200 ms Stenosis!
EOA / Indexed EOAi 0.81 cm²/m² EOA: 1.59 cm² (BMI-adjusted PPM)
DVI / VTI Ratio 0.46 AT/ET: 0.25 (>0.37 = Stenosis)

Prosthetic Valve Differential: Normal vs. PPM vs. Thrombosis/Pannus

Prosthetic Valve Clinical Interpretation
Select Aortic or Mitral Prosthesis on the left to evaluate obstruction, paravalvular leak, and BMI-adjusted Patient-Prosthesis Mismatch (PPM).

Thoracic Aorta, Tamponade, Constrictive Pericarditis & Shunts

ESC 2024 & ACC 2022 aortopathy thresholds, Mayo Clinic Constrictive Pericarditis criteria, cardiac tamponade Doppler, and ACHD Qp:Qs / VSD / Bubble study.

ESC Aorta 2024 Mayo Constriction ESC ACHD

Thoracic Aorta & Coarctation Evaluation

Normal Aorta
mm
mm
mm
mm
mm
m/s
>2.5 m/s + diastolic run-off = CoA!
Max Aortic Diam.33.0 mmASI: 16.8 mm/m²
Svensson Area / Ht4.88 cm²/m≥10 cm²/m Surgical (2a)
Aortopathy Surgical & Surveillance Thresholds
Normal root and tubular ascending dimensions.

Live Thoracic Aorta Anatomical Schematic

SVG Map

Pericardial Effusion, Tamponade & Constrictive Pericarditis

Normal Pericardium
mm
<10 Small | 10–20 Mod | >20 Large
cm/s
cm/s
>25% drop = Tamponade / Constriction

Mayo Clinic Constrictive Pericarditis Echo Criteria (TB / Post-Surgical Pericarditis)

Pericardial StatusNormalMV Var: 10.0% (≤25%)
Constriction CheckUnlikelyMayo Criteria Check

ACHD Shunts (Qp:Qs, ASD/PFO Bubble, VSD), CO & dP/dt

CI: 2.8 L/min/m²
mm
cm
Also drives Abbas PVR
m/s
0 = None (≥4 m/s Restrictive VSD)
m/s
ms
Systemic CO / CI5.5 L/minCI: 2.79 L/min/m²
Shunt Qp : Qs1.01 : 1Normal (<1.5)
4v² / LV dP/dt36 mmHgdP/dt: 1333 mmHg/s

Special Clinical Syndromes: HCM, Cardio-Oncology, Endocarditis & Stress

2023 ESC / 2024 AHA HCM & SAM obstruction, 2022 ESC Cardio-Oncology CTRCD tracker, 2023 ESC Endocarditis criteria, Intracardiac Thrombus/Masses & Stress Echo.

AHA/ACC HCM 2024 ESC Cardio-Onco 2022 ESC Endocarditis 2023

Hypertrophic Cardiomyopathy (HCM) & Dynamic LVOT Obstruction

No HCM Criteria
mm
≥15 mm (≥13 familial) | ≥30 SCD risk
mmHg
Dagger-shaped late-peaking CW
mmHg
≥30 Obstructive | ≥50 SRT threshold
HCM & Dynamic Obstruction Interpretation
Normal wall thickness and normal resting/provoked LVOT outflow gradients.

Cardio-Oncology CTRCD Tracker (ESC 2022)

No CTRCD
%
Compares vs live LVEF
%
>15% relative drop = Subclinical CTRCD!
Enter pre-therapy baseline LVEF and/or GLS above during anthracycline / HER2 surveillance to auto-calculate relative GLS drop % and CTRCD severity.

Infective Endocarditis, Masses/Thrombus & Stress Echo

Negative / Clear
TOE mandatory if clinical suspicion remains!
ESC 2023 Endocarditis & Cardioembolic Guidance
No vegetations, abscesses, or intracardiac thrombi recorded. Remember: TTE sensitivity is ~60–70% for native and ~50% for prosthetic endocarditis — perform TOE when clinical suspicion is intermediate/high!

Searchable ESC, ACC, AHA & ASE Master Reference Atlas

Instant bedside reference for PulsePoint cardiology fellows & consultants: chamber cutoffs, valve staging, prosthetics, constriction, views & formulas.

Comprehensive Guideline Reference Table

Showing All
Domain Parameter / Syndrome Normal Range Mild / Borderline Moderate Severe / Intervention Cutoff Guideline

Official PulsePoint Echo Report

Hospital-ready structured clinical report formatted for A4 printing, PDF archiving, WhatsApp/EHR plain-text copy, or JSON study storage.

PULSEPOINT ECHO

DEPARTMENT OF CARDIOLOGY • TRANSTHORACIC ECHOCARDIOGRAPHY REPORT

Quantitative Standards: ESC / EACVI • ACC / AHA / ASE

1. Final Echocardiographic Impressions & Guideline Recommendations

    2. Left Ventricle, M-Mode / Biplane Quantitative Indices & Regional Wall Motion

    3. Left Atrium, Diastolic Function & Filling Pressure Analysis

    4. Right Heart, IVC & Pulmonary Hemodynamics (sPAP, mPAP, PVR)

    5. Native & Prosthetic Valvular Apparatus

    6. Thoracic Aorta, Pericardium, Shunts & Special Syndromes

    7. Additional Clinical Notes & Plan

    Performing Doctor / PulsePoint Fellow
    Department of Cardiology, PulsePoint Echo
    Dr. Ata Ur Rahman
    Consultant Cardiologist • PulsePoint Echo

    Verification ID: PPE-DRAFT Adult Echocardiography Clinical Workstation • Created by Dr. Ata Ur Rahman (PulsePoint Echo, PulsePoint Echo)

    PulsePoint Department Local Registry, Fellow Sign-Off & PulsePoint Research Hub

    Local-first workflow: Fellow → Consultant sign-off queue, STAT critical triage, longitudinal serial Δ comparison, FCPS/SPSS de-identified research CSV export; optional Supabase sync.

    Department Studies 0 Local + Edge REST Ready
    Pending Fellow Sign-Off 0 Awaiting Consultant Review
    STAT Critical Echo Alerts 0 EF<30% / Tamponade / Severe VHD
    Cohort Mean LVEF --% 0 Consultant Verified

    1. Department Queue & Serial Echo Δ Comparison

    Queue empty. Click Submit Fellow Draft or Consultant Sign & Lock above to push the active patient into the PulsePoint Department Queue!
    Longitudinal Serial Echo Comparison (Δ Tracker)
    Click Δ Compare next to any prior study in the queue above to compute exact longitudinal changes in LVEF, GLS, LAVI, sPAP & AVA against today’s echo and auto-insert into the report!

    2. PulsePoint Research Registry (SPSS/Excel) & Supabase Cloud

    Local / Offline-First
    📊 One-Click De-Identified FCPS / PHJ Research Dataset (.csv)

    Automatically strips patient names, phone numbers & CNICs for hospital IRB privacy while exporting all quantitative echo parameters (`LVEF, GLS, LVMI, RWT, WMSI, LAVI, E/e', sPAP, PVR, AVA, SVi, Wilkins, Aorta`) straight to **SPSS / Excel / R**.

    Firebase sync is paused

    Firebase data transfer is disabled in this static deployment. Study records will not be sent to Firebase.

    ☁ Optional Alternative Cloud DB (Supabase PostgreSQL)

    This static deployment stores records in this browser's offline vault. Optional Supabase sync is separate; use only a properly secured project for patient data.