I am confused – did both of my echoes measure the same thing?

I have had mitral valve regurgitation for as long as I can remember. On a recent echo my cardiologist told me my right ventricle was mildly enlarged at 2.5 cm and my RVSP was 37 mmHg. I was very scared so I got a second opinion. One month later I saw a different cardiologist and had another echo. She said everything was normal except for mild to moderate mitral valve regurgitation and trace tricuspid regurgitation. My right ventricle on this echo was 3.3 cm and was normal. I am confused – did both echoes measure the same thing? How is 2.5 cm enlarged for one doctor and 3.3 cm normal for another? This new cardiologist said my echo was normal and not to worry. I can’t stop worrying until I understand why the numbers are so different. The second echo did not measure my RSVP. Any advice would be great. Thanks.

Submitted by Kimberly from United States on 11/07/2014

It is understandable that this type of discrepancy in the echo reports could cause concern or mistrust. There are many different ways to measure the right ventricle size, but by most criteria, the numbers you provided for each report are in the normal range in which case the first report could simply have a “typo” error. The degree of mitral regurgitation can also be somewhat difficult to accurately assess and there can be some variability among labs & even in the same lab. The only way to sort out the questions that you have would be to provide the images from the first exam to the second cardiologist & this would allow direct comparison. If you have no symptoms, the diagnosis of mild to moderate MR may warrant a follow up exam in 1 year to ensure stability at which point all of this could be brought up with your new cardiologist or sooner if you are very anxious about the discrepancy & think you may have symptoms.