Yes, it is possible for a **2D echocardiogram** to appear **normal** even if a person has **heart failure with preserved ejection fraction (HFpEF)**. HFpEF is a complex condition where the heart's **ejection fraction remains normal**, but there are **functional abnormalities**, such as **diastolic dysfunction**, **increased filling pressures**, or **vascular stiffness**, which may not be fully captured by a standard **2D echo**.
A **2D echo primarily assesses cardiac structure and systolic function**, but HFpEF is often characterized by **subtle diastolic dysfunction**, which may require **advanced echocardiographic techniques** like:
- **Tissue Doppler Imaging (TDI)** to assess myocardial relaxation.
- **Speckle-tracking echocardiography** for strain analysis.
- **Left atrial volume index and E/e' ratio** to estimate filling pressures.
In some cases, **clinical symptoms**, **biomarkers (like NT-proBNP)**, and **stress echocardiography** may be needed to confirm HFpEF, especially if the **2D echo appears normal**
Answered2025-05-26 07:01:54
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