To the Editor.—The echocardiographic discussion in the January issue of the Journal (127:48-55, 1974) by Nora et al of the Ullrich-Noonan syndrome deserves several comments.
First, the tracing shown is technically too indistinct to allow measurement of the right ventricular wall. Next, the interventricular septum, as labeled, may be partially artifact with only the lower half of the "septal" echo shown actually being septum, and, third, the left ventricular posterior wall echoes are indistinct and are probably mislabeled. If this labeling is correct, the septal and left ventricular posterior wall are identical in thickness. This is symmetrical concentric hypertrophy.
Too much gain or insufficient damping may have been used, or the polaroid technique caused over-exposure. If a low (2 to 3 megahertz) transducer was used in this study, a higher frequency transducer (5 MHz) would have allowed better resolution.
Assuming that the echocardiograms of the other seven patients allow