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

Screen Shot 2014-12-26 at 9.39.50 pm

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:

—Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography

 

 

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