Understanding Your Test Results

Medical Disclaimer: This content is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Your echocardiogram results should always be interpreted by your cardiologist or healthcare provider in the context of your individual clinical picture.
You are not alone if you have opened your MyChart portal, read an echocardiogram report, and felt overwhelmed. You are not alone if words like “diastolic dysfunction” or “mild regurgitation” made your heart race (ironically). This is normal. The language was not written for you — but the information is yours, and you deserve to understand it.
A note on “normal” findings: Many echo reports will describe findings that are technically present but clinically insignificant. A trace of valve regurgitation, a mildly thickened septum, a small pericardial effusion — these are extraordinarily common and usually do not require any treatment or follow-up. The word “abnormal” in a report does not always mean “dangerous.” Context is everything, and that context comes from your clinician.
Category EF Range What It Means
Hyperdynamic > 70% Usually due to adrenaline, dehydration, or a small cavity — not a sign of a “super heart”
Normal ≥ 50% The heart is squeezing normally
Reduced (per ESC 2026) 40–49% Previously called “mildly reduced” (HFmrEF). The ESC 2026 guidelines reclassified LVEF <50% as HFrEF, eliminating the HFmrEF category. These patients are now treated with the same guideline-directed therapies as LVEF ≤40%.
Moderately Reduced 30–39% Significant — heart failure medications typically indicated
Severely Reduced < 30% The heart is significantly weakened; may need advanced therapies or devices
Grade What It Means
Normal The heart relaxes and fills normally. No concern.
Grade I Impaired relaxation. Very common with age, hypertension, and diabetes. Often asymptomatic and does not require specific treatment beyond managing underlying conditions.
Grade II Elevated filling pressures (pseudonormal pattern). The heart appears to fill normally, but pressures inside are higher than they should be. This may cause symptoms like shortness of breath with exertion.
Grade III Restrictive filling. Significantly elevated pressures. This is the most severe grade and is associated with heart failure symptoms and poor outcomes if untreated.
Grade I diastolic dysfunction is extremely common and is found on a large proportion of echocardiograms in adults over 50. By itself, it is usually not a cause for alarm. It becomes more significant when combined with symptoms (shortness of breath, exercise intolerance, fluid retention) or when it progresses to a higher grade.
This is one of the most common findings on an echocardiogram — and one of the most commonly misunderstood. Many patients see this and worry they have hypertrophic cardiomyopathy (HCM). In the vast majority of cases, mild thickening of the upper part of the septum (the wall between the left and right ventricles) is a normal age-related change. It becomes more common as we get older and is typically benign. The key word is “mild.” Mild basal septal hypertrophy generally does not obstruct blood flow and does not require treatment.
Important: Pulmonary pressures estimated by echo are approximations. They can be overestimated or underestimated depending on image quality and the degree of tricuspid regurgitation. If your echo suggests elevated pulmonary pressures, your cardiologist may recommend a right heart catheterization for definitive measurement.

Your echocardiogram report was written by a specialist for specialists. It was never designed to be read by patients — but it is your data, and you deserve to understand it.

Many of the findings that appear alarming in medical language are, in context, common and benign. A trace of regurgitation. Mild diastolic dysfunction. A small pericardial effusion. These are the background noise of a heart doing its job over decades.

The findings that do matter — a reduced EF, a severely stenotic valve, significant regional wall motion abnormalities, elevated pulmonary pressures — are the ones your cardiologist will focus on and discuss with you.

Understand your report. Ask your questions. And know that having data about your heart is a powerful thing — as long as you have the tools to make sense of it.

Coming Next in This Series:

Part 2: Understanding Your Stress Test Results (Treadmill, Nuclear, and Stress Echocardiogram)

Part 3: Understanding Your EKG Report (And why “cannot rule out anterior infarct” probably does not mean what you think)

Part 4: Understanding Your Lipid Panel (Why non-HDL cholesterol matters more than ratios)

Part 5: Understanding Your CT Reports (Finding the language that suggests coronary disease)

CardioAdvocate helps people understand what matters — and how to speak up about it.

This content is for educational purposes only. It does not replace the advice of your physician. Always discuss your individual echocardiogram results with your cardiologist or healthcare provider.