Pulmonary Artery Systolic pressure assessment

Echocardiography Textbook

 

 

For the assessment of pulmonary artery systolic pressure, the maximum rate of Tricuspid Regurgitation is determined and, using the Bernoulli's formula, the pressure gradient between the right ventricle and the right atrium calculated (Modern ultrasound machines automatically calculate the pressure gradient (PG) after tracing the spectrogram by the operator).
Tricuspid regurgitation is examined by spectral Dopple in the Apical Four - chamber position.

 

Bernoulli's formula:


V - maximum flow rate.

 

Tricuspid regurgitation is normal in 75-80% of the population. If the regulation signal is not optimal, echo contrast agents can be used.

If there is no pulmonary artery stenosis, it can be assumed that the systolic pressure in the pulmonary artery and the right ventricle is the same. Systolic pressure in the pulmonary artery is calculated using the following formula:

 

 

PPA - Pulmonary artery sistolic pressure. PRV - Sistolic pressure in the right ventricle. PGTV - Sistolic pressure gradient on the tricuspid valve (between RA and RV). PRA - Pressure in the right atrium.

 

Right atrial pressure (PRA) can be measured by examining the collapse of the Inferior Vena Cava during deep inspiration (in the norm, the diameter decreases by more than 50%):

 

IVC diameter
Reaction on deep inhale
PRA
<15
Collapse
0-5
15-25
>50%
5-10
15-25
<50%
10-15
>25
<50%
15-20
>25 + Hepatic Vein dilatation
No reaction
>20

 

 

assessment of Pulmonary Regurgitation

Subcostal View, the Long axis of Inferior Vena Cava. Simulation By Echocardiography Online Simulator MyEchocardiography.com

 

assessment of Pulmonary Regurgitation

Subcostal View, the Long axis of Inferior Vena Cava. Deep inhale. Simulation By Echocardiography Online Simulator MyEchocardiography.com

 

assessment of Pulmonary Regurgitation

RA pressure Calculation by examining the collapse of the Inferior Vena Cava during deep inspiration. Simulation By Echocardiography Online Simulator MyEchocardiography.com

 

assessment of Pulmonary Regurgitation

Apical 4 chamber View. Control Volume Position for Tricuspid flow PW doppler. Simulation By Echocardiography Online Simulator MyEchocardiography.com

 

assessment of Pulmonary Regurgitation

Tricuspid flow PW doppler. Calculation of Tricuspid regurgitation PG max and Pulmonary Artery Systolic Pressure. Simulation By Echocardiography Online Simulator MyEchocardiography.com

 

ASE Guideline for Pulmonary Artery Systolic pressure Assessment

 

How to Simulate Assessment of the Pulmonary Artery Sistolic Pressure? >>>