<p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</strong></p><figure class="table"><table><tbody><tr><td><strong>HEIGHT(cm) =</strong></td><td><strong>WEIGHT(Kg) =</strong></td><td><strong>BSA =</strong></td></tr></tbody></table></figure><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; M - MODE</strong></p><figure class="table"><table><tbody><tr><td>Aortic room [mm]=</td><td>IVSTd [mm]=</td><td>LVEDV [ml]=</td></tr><tr><td>Asc Aorta [mm]=</td><td>LVEDD [mm]=</td><td>LVESV [ml]=</td></tr><tr><td>AVD [mm]=</td><td>LVPWTd [mm]=</td><td>LV SV [ml]=</td></tr><tr><td>LA [mm]=</td><td>IVSTs [mm]=</td><td>LVEF [%]=</td></tr><tr><td>RVOTd [mm]=</td><td>LVESD [mm]=</td><td>LVSF [%]=</td></tr><tr><td>RVOTs [mm]=</td><td>LVPWTs [mm]=</td><td>LV mass [g]=</td></tr><tr><td>RV basal [mm]=</td><td>RWT=</td><td>LV Mass Index=</td></tr></tbody></table></figure><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 2-D</strong></p><figure class="table"><table><tbody><tr><td>AORTIC ROOT:</td></tr><tr><td>LV:</td></tr><tr><td>OTHER CHAMBERS:</td></tr><tr><td>VALVES:</td></tr><tr><td>PERICARDIUM:</td></tr></tbody></table></figure><p>&nbsp;</p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; DOPPLER</strong></p><figure class="table"><table><tbody><tr><td colspan="4">AV:</td></tr><tr><td>Peak Vel [m/s] = &nbsp;</td><td>Mean Pressure Gradient [mmHg] =&nbsp;</td><td>VTI =&nbsp;</td><td>LVET [ms] =</td></tr><tr><td>AV regurgitation =</td><td>&nbsp;</td><td>&nbsp;</td><td>&nbsp;</td></tr><tr><td colspan="4">MV:</td></tr><tr><td>E wave Vel [cm/s] =</td><td>A wave Vel [cm/s] =&nbsp;</td><td>E/A =&nbsp;</td><td>E wave DT [m/s] =</td></tr><tr><td>e"Vel [cm/s] = &nbsp;</td><td>a"Vel [cm/s] =&nbsp;</td><td>E/e" =</td><td>MV regurgitation =</td></tr><tr><td colspan="4">TV</td></tr><tr><td>TV regurgitation =&nbsp;</td><td>TR peak Vel [m/s] =</td><td colspan="2">&nbsp;</td></tr><tr><td colspan="4">PV</td></tr><tr><td>Acceleration Time [m/s] =&nbsp;</td><td>PV regurgitaion =&nbsp;</td><td>Peak Vel [m/s] =</td><td>PA systolic pressure [mmHg] =&nbsp;</td></tr><tr><td>MPAP [mmHg] =</td><td>Pulmonary HTN =</td><td>&nbsp;</td><td>&nbsp;</td></tr></tbody></table></figure><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;COMMENTS</strong></p><figure class="table"><table><tbody><tr><td><p>&nbsp;</p><p>&nbsp;</p><p>&nbsp;</p></td></tr></tbody></table></figure><p>_________________________________________________________________________________________________________________________</p><p>ECHOCARDIOGRAPHY PERFORMED BY: <strong>Dr. Bashir G Ahmad MBBS, FWACP (Int. Med - Cardiol.)</strong></p><p><i><strong>DATE:___________________________________ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;SIGNATURE:</strong></i><strong>_______________________________________</strong></p>