Who wants to read ASE’s 29 pages on RV assessment when you can have them in the form of flashcards? Useful pocket cards to go with Aidan’s RV assessment article.
Some useful thoughts to have in mind when looking at the RV are –
What are we looking at and measuring? How can I corroborate the findings to the clinical situation?
As the RV is a complex crescentic structure, correlating visual appearance with measurements allow us to make some conclusions about RV function. The RV is complicated – RV has MANY relationships (RV-LV ventricular interdependence, RV-PA coupling, RV inflow-LV outflow)
As well as that, because the RV has been less studied than the LV, the standard measures obtained form studies are subjected to heterogeneity. The RV is very relevant to the intensivists.
Important and useful measurements include: dimensions, TAPSE (Tricuspid Annular Plane Systolic Excursion), s’ (systolic velocity of tricuspid annulus), RVSP in the presence of TR, RV wall thickness
Useful things to look at include: shape of RV, relation to LV size, apex relation, motion of the lateral wall of RV
PARASTERNAL VIEWS:
PLAX RV flashcard
PSAX RV flashcard
APICAL VIEWS:
A4C RV flashcard
A4C RV flashcard I
A4C RV flashcard II
SUBCOSTAL VIEWS:
SC RV flashcard
Assessment using TDI and PW on the lateral TV annulus to ascertain RVs’
RV – Right ventricle
LV – Left ventricle
PA – Pulmonary artery
RVSP – Right ventricular systolic pressure
RVOT – Right ventricular outflow tract
CFD – Colour Flow Doppler
CW – Continuous Wave
PW – Pulsed Wave
TDI – Tissue Doppler Imaging
TR – Tricuspid regurgitation
SPAP – systolic pulmonary artery pressure
PADP – Pulmonary artery diastolic pressure
PVAT – Pulmonary valve acceleration time
PR – Pulmonary regurgitation
MPA- Main pulmonary artery
RIMP – Right ventricular myocardial performance index
IVR(C)T – Isovolumic relaxation (contraction) time
ET – Ejection time
Vs – Systolic velocity
Vd – Diastolic velocity
References:
Tags: Right ventricle systolic function
