Echocardiographic examination

EN / SK

TECHmED.sk

New examination
Left ventricle
LV diastolic function
Right ventricle
RV pressure
Kinetics and effusion
Atria and IVC
Aorta
AV
MV
TV
PV
Summary
Values
Views

Echocardiographic examination

TECHmED.sk

New
LV
LV diastole
RV
RV pressure
Kinetics
Atria
Aorta
AV
MV
TV
PV
Summary
Values
Views

Tricuspid valve

Tricuspid valve Va (Aliasing velocity) A4C (apical 4 chamber view) RV focused

Va

Aliasing velocity

Tricuspid valve VCW (Vena contracta width) A4C (apical 4 chamber view) RV focused

VCW

Vena contracta width

Tricuspid valve PISA (Proximal isovelocity surface area radius) A4C (apical 4 chamber view) RV focused

PISAr

Proximal isovelocity surface area radius

Vmax TR (Peak tricuspidal regurgitation velocity) Apical 4 chamber (A4C). Tricuspid valve CW doppler

Vmax TR

Peak tricuspidal regurgitation velocity

Tricuspid valve PISA and alising velocity Vmax TR (Peak tricuspidal regurgitation velocity) Tricuspid valve PISA and EROA (Effective regurgitant orifice area)

EROA

Effective regurgitant orifice area

VTI TR (Velocity time integral of tricuspidal regurgitant jet) Apical 4 chamber (A4C). Tricuspid valve CW doppler

VTI TR

Velocity time integral of tricuspidal regurgitant jet

Tricuspid valve PISA and alising velocity Vmax TR (Peak tricuspidal regurgitation velocity)
VTI TR (Velocity time integral of tricuspidal regurgitant jet) Tricuspid valve PISA and EROA (Effective regurgitant orifice area)

RegVolTR

Regurgitant volume of tricuspidal regurgitation

RegJet soft density (Regurgitant jet soft density) Apical 4 chamber (A4C). Tricuspid valve CW doppler

RegJetsoft density

Regurgitant jet soft density

RegJet hard density (Regurgitant jet hard density) Apical 4 chamber (A4C). Tricuspid valve CW doppler

RegJethard density

Regurgitant jet hard density

Dominant tricuspidal A wave (A wave > E wave) Apical 4 chamber (A4C) PW doppler of tricuspid valve inflow

A wavedominant

Dominant tricuspidal A wave (A wave > E wave)

RA major (Right atrium major axis dimension) A4C (apical 4 chamber view) RV focused

RA major

Right atrium major axis dimension

RVD1 basal (Right ventricular basal diameter at end-diastole) A4C (apical 4 chamber view) RV focused

RVD1basal

Right ventricular basal diameter at end-diastole

TV annulus (Tricuspid valve annulus diameter) A4C (apical 4 chamber view) RV focused

TVannulus

Tricuspid valve annulus diameter

RegJet area (Regurgitation jet area) A4C (apical 4 chamber view) RV focused

RegJetarea

Regurgitation jet area

RA area (Right atrial area) A4C (apical 4 chamber view) RV focused

RA area

Right atrial area

Ratio regurgitant jet area and right atrium - RA  area Right atrial area

RegJet/RA area

Ratio RegJetarea / RA area

HV reversal flow (Hepatic vein reversal flow) SC window (Hepatic vein) PW doppler of hepatic vein

HVreversal flow

Hepatic vein reversal flow

HV forward flow (Hepatic vein forward flow) SC window (Hepatic vein) PW doppler of hepatic vein

HVforward flow

Hepatic vein forward flow

RVOT diastal (Right ventricular outflow tract dimension at distal) RVOT VTI (Velocity time integral of right ventricular outflow tract)

SVPV

Stroke volume of pulmonary valve

VTI TV (Velocity time integral of tricuspid valve - inflow) RV modified apical 4 chamber (A4C) CW doppler of tricuspid valve inflow

VTI TrV

Velocity time integral of tricuspid valve (inflow)

Right ventricular outflow tract dimension at distal Velocity time integral of right ventricular outflow tract Velocity time integral of tricuspid valve (inflow)

TrVA

Tricuspid valve area (continuity equation)

meanPG TV (Mean pressure gradient tricuspidal valve) RV modified apical 4 chamber (A4C) CW doppler of tricuspid valve inflow

meanPG TrV

Mean pressure gradient tricuspidal valve

PHT TV (Pressure half time of tricuspidal valve) RV modified apical 4 chamber (A4C) CW doppler of tricuspid valve inflow

PHT TrV

Pressure half time of tricuspidal valve

IVC diameter (Inferior vena cava diameter) SC (subcostal view) long axis inferior vena cava IVC.

IVCdiameter

Inferior vena cava diameter

References:

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)

Recommendations on the use of echocardiography in adult hypertension: a report from the EACVI and the ASE (2015)

Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the EACVI and the ASE (2017)

ASE Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation (2017)

Guidelines for performing a comprehensive TTE examination in adults: Recommendations from the ASE (2018)

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: ASE, EACVI, ESC, CSE (2010)

Guidelines for the diagnosis and management of acute pulmonary embolism ESC, ERS (2019)

Echocardiography in aortic diseases: EAE recommendations for clinical practice (2010)

Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice (2009)

ESSENTIAL ECHOCARDIOGRAPHY A Companion to Braunwald’s Heart Disease

Coronary Artery Territories (Echocardiography Illustrated Book 4)

Regurgitation

Va
cm/s

Aliasing velocity

VCW
cm

Vena contracta width

PISAr
cm

Proximal isovelocity surface area radius

Vmax TR
m/s

Peak tricuspidal regurgitation velocity

EROA
cm2

Effective regurgitant orifice area
EROA = 2π x PISAr2 x Va / Vmax TR

VTI TR
cm

Velocity time integral of tricuspidal regurgitant jet

RegVolTR
ml

Regurgitant volume of tricuspidal regurgitation
RegVolTR = EROA x VTI TR

RegJetsoft density

Regurgitant jet soft density

RegJethard density

Regurgitant jet hard density

A wavedominant

Dominant tricuspidal A wave (A wave > E wave)

RA major
cm

Right atrium major axis dimension

RVD1basal
cm

Right ventricular basal diameter at end-diastole

TVannulus
cm

Tricuspid valve annulus diameter

RegJetarea
cm2

Regurgitation jet area

RA area
cm2

Right atrial area

RegJet/RA area
%

Ratio RegJetarea / RA area
RegJet/RA area = RegJetarea/RA area x 100

HVreversal flow

Hepatic vein reversal flow

HVforward flow

Hepatic vein forward flow

Stenosis

SVPV
ml

Stroke volume of pulmonary valve
SVPV = CSARVOT x VTIRVOT

VTI TrV
cm

Velocity time integral of tricuspid valve (inflow)

TrVA
cm2

Tricuspid valve area (continuity equation)
TrVA = SVPV / VTI TrV

meanPG TrV
mmHg

Mean pressure gradient tricuspidal valve

PHT TrV
ms

Pressure half time of tricuspidal valve

IVCdiameter
cm

Inferior vena cava diameter

Tricuspid valve Va (Aliasing velocity) A4C (apical 4 chamber view) RV focused

Va

Aliasing velocity

  • Manually set value on the echocardiography machine.
  • It´s used to calculate: EROA.
  • Nyquist limit: 50-70cm/s
    • Baseline is shifted in the direction of tricuspid regurgitation jet to 30-40cm/s.
    • Aliasing occurs: If the blood flow from the probe (blue) exceeds the Va speed (38.5cm/s).