Puting It All Together For The Pulmonary Artery Systolic Pressure (PASP) So if a patient has an IVC that measures 1.9 cm and it collapses more than 50%, they would have an estimated mean RAP of 3 mmHg. IVC Collapsibility Index For Mean Right Atrial Pressure Normal Diameter In short, in order to estimate the RAP, you need to measure the diameter of the IVC and then look to see if the IVC collapses more than 50% of its diameter, or less than 50% of its diameter.īelow is a chart explaining what the estimated right atrial pressure is based on your findings. (This is true because there is no valve between the right atrium and the IVC).įor a complete guide on how to accurately estimate RAP and to learn more about the Inverior Vena Cava and how it’s used in echo, be sure to read my post, IVC Assessment With Echo: What Does IVC Collapse Even Mean? So if we can estimate what the pressure is in that section of the IVC, then we can assume that the pressure in the right atrium is the same or similar. We know that the inferior vena cava is attached to the right atrium. The next thing we need to do to obtain the PASP is figure out what the right atrial pressure is (RAP), and add it to the RVSP. You remember that the formula for pressure gradients is 4 x V 2. With your continuous wave Doppler, you measure a peak velocity of the tricuspid regurgitant jet of 3.7 m/s. We would start by multiplying that by itself (V 2 ).Īnd since we’re looking for a pressure gradient as the answer, we assign it mmHg. Say that the peak TR velocity was 2.5 m/s. Pressure Gradient Formula: 4 x V 2 Example #1: Now to find out the pressure gradient, all you need to do is plug it into the formula 4V 2. This will give you the peak velocity of the TR jet. To measure the RVSP in echo, all you need to do is line up your cursor parallel with the tricuspid regurgitant jet and turn on continuous wave Doppler. Right Ventricular Systolic Pressure (RVSP) in echo is obtained by simply measuring the pressure gradient of the tricuspid regurgitant jet. The way we do this is by using echo to measure the right ventricular systolic pressure, or RVSP. Right Ventricular Systolic Pressure (RVSP) And Echo Measuring peak TR velocity for RVSP on echo. But not everyone with tricuspid regurgitation (TR) has pulmonary hypertension.īut the good news is, we can use the existing tricuspid regurgitation to help us determine the patient’s pulmonary artery pressure, (PAP) which is what we’re trying to ultimately get to in order to determine whether or not they have pulmonary hypertension. Tricuspid Regurgitation and Pulmonary Hypertensionįunctional tricuspid regurgitation is a common side effect of pulmonary hypertension. But how do we measure pulmonary artery systolic pressure (PASP) with echocardiography?Īnd it all starts with tricuspid regurgitation. This is the measurement that we’re most interested in. Ultimately, we want to know what the Pulmonary Artery Systolic Pressure is (PASP). As a matter of fact, PHTN is something you should always interrogate in these cases. Like I mentioned earlier, echo plays a critical role in not only helping diagnose pulmonary hypertension, but also in helping learn what might be causing the increased pulmonary pressures.įor example, a patient who has significant mitral stenosis can also present with pulmonary hypertension. Let’s dive right in! How To Assess For Pulmonary Hypertension With Echocardiography So how do you assess for pulmonary hypertension using echocardiography? I’ll show you how. This measurement alone can tell us a lot. In this post, we are going to focus on screening for pulmonary hypertension with echo by measuring the pulmonary artery systolic pressure.
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