The left atrium is normal in dimension. The left ventricle is severely enlarged, with severely reduced systolic function. The right atrium and ventricle are normal in dimension, with normal systolic function.

The anterior and posterior mitral valve leaflets are appropriately thin with adequate apposition, intact chordae, and there is no significant prolapse. There is no significant mitral regurgitation identified. The tricuspid valve leaflets are appropriately thin with adequate apposition, intact chordae, no significant tricuspid regurgitation, and no evidence of pulmonary hypertension. The left ventricular outflow tract demonstrated severely turbulent flow with an overriding aorta and coaptation gap of the aortic valve leaflets. The left ventricular outflow tract velocity is marginally increased. There is a ventricular septal defect with high velocity left-to-right systolic flow documented. The right ventricular outflow tract assessment revealed laminar flow, with appropriate main pulmonary artery diameter and right pulmonary artery distensibility. The right ventricular outflow tract velocity is normal. There is mild pulmonic and severe aortic valve insufficiency identified. There is no visible pericardial, pleural, or free peritoneal fluid documented.

No evidence of hepatic venous congestion is noted. The cardiac chambers, pericardial and visible extra-cardiac regions were free of masses, spontaneous echo contrast, and thrombi.

• Overriding aorta with a resulting ventricular septal defect (VSD)
• Suspected (no ECG attached) high left-to-right systolic flow across the VSD, with severe aortic regurgitation as a result in the coaptation gap between aortic valve leaflets
• Severely enlarged left ventricle with reduced systolic function