VALENZUELA MEDICAL CENTER FM-IM-016

Rev 0 – 06/23/16
Padrigal St., Karuhatan, Valenzuela City
Tel. No. 294-6711 to 16, Telefax 291-4259

Name: Date: Weight:

kg.
Address: Age: Height:
cm.
Ref MD: Sex: BSA:
m2
Study No: Patient’s ID : SBP:
mm
Dvd No: Sonographer: Heart Rate: per min DBP:
mmHg
Chief complaint/ Diagnosis:

Conclusion:
     
            Normal left ventricular geometry adequate contractility and preserved overall systolic and diastolic
function with ejection fraction of ___ % by Simpson’s
Structurally normal right and left atrial dimensions
Normal right ventricular dimensions with normal contractility and systolic function
Structurally normal aortic, mitral, tricuspid and pulmonic valve leaflets.
Normal main pulmonary artery and aortic root dimensions
Normal pulmonary pressure

ROSEMARIE M. RAMIREZ-RAGASA, MD, FPCP,FPCC,FPSE

                                                                                                              Cardiologist