“What Symptoms & Echocardiogram Readings Determine Heart Failure?” Asks Jesse

I just received an interesting email from Jesse regarding mitral regurgitation, heart failure and echocardiograms.

Jesse writes to me, “Hi Adam – I recently learned that I suffer from severe mitral regurgitation. While I was diagnosed with a heart murmur many years ago, it appears the disease progressed quickly.  I haven’t had an echo for a few years and I’m now short of breath constantly. My cardiologist used the term ‘heart failure’ during my last appointment. I’m curious to know what echocardiogram readings determine that I am approaching heart failure? I’m looking at an echocardiogram print-out and do not understand any of the numbers in front of me. Or, is heart failure diagnosed just by my symptoms? Can you help me?”


Fatigued Heart In Failure


I wanted to provide Jesse an expert response, so I contacted Doctor Hiroo Takayama from NewYork-Presbyterian Hospital in New York. So you know, Dr. Takayama is an assistant professor of surgery and recent recipient of 2012 the Dwight C. McGoon Award for educating and mentoring cardiac surgery physicians in training. Heart failure is one of Dr. Takyama’s specialties.


Dr. Hiroo Takayama, MD - Heart Surgeon
Dr. Hiroo Takayama – Heart Surgeon


In his response to Jesse’s questions, Dr. Takayama noted:

Your valve disease can lead you to a diagnosis of ‘heart failure’. For instance, severe mitral regurgitation will cause congestion of the lungs and cause various symptoms such as short of breath and/or decreased tolerance of exercise. This usually correlates with findings on echocardiogram such as dilatation of the chamber size of the left ventricle and decreased function of the left ventricle. A clinician uses the term ‘heart failure’ once a patient develops these symptoms and/or echo findings — often both.

Dr. Takayama continued to address the echocardiogram readings for evaluating heart failure:

In reviewing the result of an echocardiogram for mitral regurgitation with suspected ‘heart failure’, several important points are: severity of mitral regurgitation, ejection fraction (or EF) of the left ventricle, and size of the left ventricle. In general, surgery is not indicated unless your mitral regurgitation is ‘severe’. The ejection will be decreased compared to a normal value if you have heart failure. The size of the left ventricle is represented by two numbers: left ventricular end-diastolic diameter (or LVEDD) and left ventricular end-systolic diameter (LVESD). Either or both will be increased in heart failure.

Here is a great educational video for patients from Dr. Takayama about valve disease, decreased heart function and cardiac surgery.



I realize your echocardiogram readings are technical and often confusing. However, I wanted to thank Jesse for raising these very important questions. I would also like to thank Dr. Hiroo Takayama for taking the time to share his clinical experience and research with our community. To learn more about Dr. Takayama, click here.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

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