Echocardiography Normal Values: Complete Reference

Reference section 01

Atria

Left and right atrial measurements, volumes, and pressure-related reference values.

Reference measurements and assessment criteria for left and right atrial size, volume, and right atrial pressure.

Parameter	Female	Male
LA AP (cm)Left atrium anterior-posterior dimension	2,7 - 3,8	3,0 - 4,0
LA AP (cm/m²)Left atrium anterior-posterior dimension	1,5 - 2,3	1,5 - 2,3

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Parameter	Male
Parameter	Normal	Mildly	Moderately	Severely
LA volume (ml/m²)Left atrial volume (Biplane)	16 - 34	35 - 41	42 - 48	>48

Parameter	Female
Parameter	Normal	Mildly	Moderately	Severely
LA volume (ml/m²)Left atrial volume (Biplane)	16 - 34	35 - 41	42 - 48	>48

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Variable	Abnormal
RA major (mm)Right atrium major axis dimension	>53
RA minor (mm)Right atrium minor axis dimension	>44
RA area (cm²)Right atrial area	>18

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Parameter	Male	Female
RA major (cm/m²)Right atrium major axis dimension	2,4 ±0,3	2,5 ±0,3
RA minor (cm/m²)Right atrium minor axis dimension	1,9 ±0,3	1,9 ±0,3
RA volume (ml/m²)Right atrial area	25 ±7	21 ±6

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

IVC finding	Normal 3 mmHg (0 - 5 mmHg)	Intermediate 8 mmHg (5 - 10 mmHg)	Intermediate 8 mmHg (5 - 10 mmHg)	High 15 mmHg (10 - 20 mmHg)
IVC_diameterInferior vena cava diameter	<2,1cm	<2,1cm	>2,1cm	>2,1cm
IVC_collapsInferior vena cava collapsibility	>50%	<50%	>50%	<50%

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Reference section 02

Left Ventricle

Left ventricular dimensions, geometry, systolic function, and related reference values.

Left ventricle (Size)

	Male
	Normal	Mildly	Moderately	Severely
LVIDd (cm) Left ventricular internal dimension at end-diastole	4,2 - 5,8	5,9 - 6,3	6,4 - 6,8	>6,8
LVIDd (cm/m2) Left ventricular internal dimension at end-diastole	2,2 - 3,0	3,1 - 3,3	3,4 - 3,6	>3,6
LVIDs (cm) Left ventricular internal dimension at end-systole	2,5 - 4,0	4,1 - 4,3	4,4 - 4,5	>4,5
LVIDs (cm/m2) Left ventricular internal dimension at end-systole	1,3 - 2,1	2,2 - 2,3	2,4 - 2,5	>2,5
IVSd (cm) Interventricular septum thickness at end-diastole	0,6 - 1,0	1,1 - 1,3	1,4 - 1,6	>1,6
PWd (cm) Left ventricular posterior wall thickness at end-diastole	0,6 - 1,0	1,1 - 1,3	1,4 - 1,6	>1,6
RWT Relative wall thickness	0,24 - 0,42	0,43 - 0,46	0,47 - 0,51	>0,52

	Female
	Normal	Mildly	Moderately	Severely
LVIDd (cm) Left ventricular internal dimension at end-diastole	3,8 - 5,2	5,3 - 5,6	5,7 - 6,1	>6,1
LVIDd (cm/m2) Left ventricular internal dimension at end-diastole	2,3 - 3,1	3,2 - 3,4	3,5 - 3,7	>3,7
LVIDs (cm) Left ventricular internal dimension at end-systole	2,2 - 3,5	3,6 - 3,8	3,9 - 4,1	>4,1
LVIDs (cm/m2) Left ventricular internal dimension at end-systole	1,3 - 2,1	2,2 - 2,3	2,4 - 2,6	>2,6
IVSd (cm) Interventricular septum thickness at end-diastole	0,6 - 0,9	1,0 - 1,2	1,3 - 1,5	>1,5
PWd (cm) Left ventricular posterior wall thickness at end-diastole	0,6 - 0,9	1,0 - 1,2	1,3 - 1,5	>1,5
RWT Relative wall thickness	0,22 - 0,42	0,43 - 0,47	0,48 - 0,52	>0,53

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Left ventricle (Mass)

	Male
	Normal	Mildly	Moderately	Severely
LV mass (g) Left ventricular mass	88 - 224	225 - 258	259 - 292	>292
LV mass (g/m2) Left ventricular mass	49 - 115	116 - 131	132 - 148	>148

	Female
	Normal	Mildly	Moderately	Severely
LV mass (g) Left ventricular mass	67 - 162	163 - 186	187 - 210	>210
LV mass (g/m2) Left ventricular mass	43 - 95	96 - 108	109 - 121	>121

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Left ventricle (Volume)

	Male
	Normal	Mildly	Moderately	Severely
LVEDV (ml) Left ventricular end-diastole volume (Biplane)	62 - 150	151 - 174	175 - 200	>200
LVEDV (ml/m2) Left ventricular end-diastole volume (Biplane)	34 - 74	75 - 89	90 - 100	>100
LVESV (ml) Left ventricular end-systole volume (Biplane)	21 - 61	62 - 73	74 - 85	>85
LVESV (ml/m2) Left ventricular end-systole volume (Biplane)	11 - 31	32 - 38	39 - 45	>45

	Female
	Normal	Mildly	Moderately	Severely
LVEDV (ml) Left ventricular end-diastole volume (Biplane)	46 - 106	107 - 120	121 - 130	>130
LVEDV (ml/m2) Left ventricular end-diastole volume (Biplane)	29 - 61	62 - 70	71 - 80	>80
LVESV (ml) Left ventricular end-systole volume (Biplane)	14 - 42	43 - 55	56 - 67	>67
LVESV (ml/m2) Left ventricular end-systole volume (Biplane)	8 - 24	25 - 32	33 - 40	>40

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Left ventricle (Ejection fraction)

	Male
	Normal	Mildly	Moderately	Severely
LV EF (%) Left ventricular ejection fraction (Biplane)	52 - 72	41 - 51	30 - 40	<30

	Female
	Normal	Mildly	Moderately	Severely
LV EF (%) Left ventricular ejection fraction (Biplane)	54 - 74	41 - 53	30 - 40	<30

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

HUDSON, Sarah; PETTIT, Stephen. What is ‘normal’ left ventricular ejection fraction?. Heart, 2020.

Left ventricle (Geometry)

	LV mass(g/m²) Left ventricular mass		RWT Relative wall thickness
Normal left ventricle	<115 (Male)	<95 (Female)	<0,42
Concentric hypertrophy	>115 (Male)	>95 (Female)	>0,42
Eccentric hypertrophy	>115 (Male)	>95 (Female)	<0,42
Concentric remodeling	<115 (Male)	<95 (Female)	>0,42

Description of LV geometry, using at the minimum the four categories of normal geometry, concentric remodelling, and concentric and eccentric hypertrophy, should be a standard component of the echocardiography report.
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

	LVEDV(ml/m²) Left ventricular end-diastole volume (Biplane)	LV mass(g/m²) Left ventricular mass		RWT Relative wall thickness
Normal left ventricle	<75	<115 (Male)	<95 (Female)	0,32-0,42
Physiological hypertrophy	>75	>115 (Male)	>95 (Female)	0,32-0,42
Concentric remodeling	<75	<115 (Male)	<95 (Female)	>0,42
Eccentric remodelling	>75	<115 (Male)	<95 (Female)	<0,32
Concentric hypertrophy	<75	>115 (Male)	>95 (Female)	>0,42
Mixed hypertrophy	>75	>115 (Male)	>95 (Female)	>0,42
Dilated hypertrophy	>75	>115 (Male)	>95 (Female)	0,32-0,42
Eccentric hypertrophy	>75	>115 (Male)	>95 (Female)	<0,32

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

- The red horizontal line separates LV hypertrophy from normal LV mass.
- The black vertical line separates dilated from nondilated ventricles.
- The two oblique blue lines delimit the upper (0.42) and lower (0.32) limit of normal RWT.
- This leads to eight categories of ventricles.
- The green ellipse indicates the area of normal ventricles including physiological LV enlargement.

Parameter	Reference diameter (mm)	Indexed diameter (mm/m²)
AoAAortic annulus diameter	20–31	13 ± 1
AoSVAortic sinuses of valsalva diameter	29–45	19 ± 1
AoSTJAortic sinotubular junction diameter	22–36	15 ± 1
AoPxAProximal ascending aorta diameter	22–36	15 ± 2
AoArchAortic arch diameter	22–36	—
AoDescDescending aorta diameter	20–30	—

Parameter

Reference diameter (mm)

Indexed diameter (mm/m²)

AoAAortic annulus diameter

20–31

13 ± 1

AoSVAortic sinuses of valsalva diameter

29–45

19 ± 1

AoSTJAortic sinotubular junction diameter

22–36

15 ± 1

AoPxAProximal ascending aorta diameter

22–36

15 ± 2

AoArchAortic arch diameter

22–36

—

AoDescDescending aorta diameter

20–30

—

RVD1_basal Right ventricular basal diameter at end-diastole	25 - 41mm
RVD2_mid Right ventricular mid diameter at end-diastole	19 - 35mm
RVD3_long Right ventricular longitudinal diameter at end-diastole	59 - 83mm
RVOT_prox(PLAX) Right ventricular outflow tract at proximal (PLAX)	20 - 30mm
RVOT_prox(PSAX) Right ventricular outflow tract at proximal (PSAX)	21 - 35mm
RVOT_distal(PSAX) Right ventricular outflow tract at distal (PSAX)	17 - 27mm
PA_diameter Main pulmonary artery diameter	15 - 25mm
RVWT Right ventricular wall thickness	1 - 5mm

	Male	Female
RV EDA (cm²) Right ventricular end-diastolic area	10 - 24	8 - 20
RV EDA (cm²/m²) Right ventricular end-diastolic area	5 - 12,6	4,5 - 11,5
RV ESA (cm²) Right ventricular end-systolic area	3 - 15	3 - 11
RV ESA (cm²/m²) Right ventricular end-systolic area	2 - 7,4	1,6 - 6,4
RV EDV (ml/m²) Right ventricular end-diastolic volume	35 - 87	32 - 74
RV ESV (ml/m²) Right ventricular end-systolic volume	10 - 44	8 - 36

Variable	Abnormal
TAPSE Tricuspid annular plane systolic excursion	<17mm
S’ Wave_pulsedTDI Peak systolic velocity tricuspid annulus (Pulsed TDI)	<9,5cm/s
S’ Wave_colorTDI Peak systolic velocity tricuspid annulus (Color TDI)	<6cm/s
FAC Fractional Area Change	<35%
RV EF Right ventricular ejection fraction	<45%
RIMP_TDI Right Ventricular Index of Myocardial Performance (TDI)	>0,54
RIMP_PWd Right Ventricular Index of Myocardial Performance (PWd)	>0,43
IVA_RV Myocardial acceleration during isovolumic contraction	<1,1m/s²
PVR Pulmonary vascular ressistance	>3WU
RV dP/dt Rate of rise of right ventricle pressure	<400mmHg/s
E/A_TrV Tricuspid valve E / A wave ratio	<0,8 >2
DT TrV Tricuspid valve deceleration time	<119ms >242ms
e’ wave_TrV eak velocity in early diastole of tricuspid annulus (TDI)	<7,8cm/s
e’/a’_TrV Tricuspid valve e� / a� ratio (TDI)	<0,52
E/e’_TrV Tricuspid valve E / e� ratio	>6
PAAT Pulmonary artery acceleration time	<100ms

Variable	Abnormal
RVSP_(SPAP) Right ventricular systolic pressure	>35mmHg
mPAP Mean pulmonar arterial pressure	>25mmHg
PADP Pulmonary artery diastolic pressure	>15mmHg

Variable	Abnormal
RVOT_prox(PLAX) Right ventricular outflow tract at proximal (PLAX)	>30mm
Basal RV/LV Basal right/left ventricle ratio	>1
D septum D shaped septum	Yes
IVC_diameter Inferior vena cava diameter	>2,1cm
IVC_collaps Inferior vena cava collapsibility	<50%
60/60 sign 60/60 Echo sign	Yes
McConnel’s sign Mid wall hypokinesia and apical hyperkinesia	Yes
Trombus RV Right heart mobile trombus	Yes
TAPSE Tricuspid annular plane systolic excursion	<16mm
S’ wave_pulsedTDI Peak systolic velocity tricuspid annulus (Pulsed TDI)	<9,5cm/s

Echocardiography Values

Atria

Left Ventricle

Right Ventricle

Aorta

Aorta (Size)

Inferior Vena Cava

Inferior vena cava measurement

Pericardial Effusion

Echocardiographic Reference

Regional Wall Motion

Regional Wall Motion Views

Coronary Artery Territories

Classification	Measurement	Volume / Finding
Small	<1mm	300ml
Moderate	10 - 20mm	500 - 700ml
Large	>20mm	>700ml
Very large	>30mm	Compression