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Resuscitation Point of Care Ultrasound / Education / Vascular Resistance / Pulmonary Artery Pressure

Pulmonary Artery Pressure

How-to

  • Get a visual assessment of the tricuspid valve.
  • Place color doppler over the tricuspid valve and look for a regurgitant jet.
  • If a regurgitant jet is found, place the CW doppler tracer over the jet.
  • Measure the max velocity of the regurgitant jet.
  • Measure or estimate RAP.

Interpretation

Simplified Bernoulli Equation ΔP = 4[TRmax]2

PASP = 4[TRmax]2+ RAP

Peak TR velocity value of ≤ 2.8 m/s is within normal limits

Normal value of PASP is up to 25 mmHg

Tips

If the patient is in atrial fibrillation, obtain mean TRmax.

Can not be used in patients with pulmonary valve stenosis.

Figures

Figure 1 - Tricuspid Valve Jet

Figure 2 - Tricuspid Valve Regurgitant Jet Waveform

Figure 3 - Tricuspid Valve Max Regurgitant Jet Velocity

Clip 1 - Tricuspid Valve Regurgitant Jet

References

Parasuraman, Sathish, et al. “Assessment of pulmonary artery pressure by echocardiography—a comprehensive review.” IJC Heart & Vasculature 12 (2016): 45-51.