Pulmonary artery pressure

Question 1

PAP estimated from what measurements?

Answer 1

Tricuspid regurgitation jet velocity + estimated RA pressure 
TR_{max velocity} + RAP (from IVC)

Question 2

Three signs of pulmonary hypertension.

Answer 2

• elevated PA pressure (normal <20)
  – short time to peak velocity in PA velocity curve
  – paradoxical septal motion (short axis views)
  – high, end-diastolic pulmonic regurgitation velocity. 

Question 3

Flying W

Answer 3

M mode mid systolic notching of posterior pulmonary valve cusp
Equals pulmonary hypertension

Question 4

Pulmonary hypertension findings

Answer 4

• flying W
  – RV chamber enlargement with flattening of IVS
  – RV hypertrophy/systolic dysfunction.
  – 

Question 5

Pulmonary systolic pressure a.k.a.…

Answer 5

RV pressure.
PAP = 4(V_TRpeak)²

Question 6

When is RV pressure not the same as pulmonary systolic pressure?

Answer 6

When pulmonary stenosis is present, subtract RV-PA gradient 

Question 7

When is wall thickness measured?
And where?

Answer 7

At end diastole, PLAX
– at level of MV chordae
– septum
– posterior wall

Question 8

When is end diastole measured?

Answer 8

At the onset of the QRS

Question 9

When is end systole measured?

Answer 9

Just before aortic valve closure… A.k.a.…
Minimum chamber size

Question 10

What views are used to calculate 2D biplane EF?
Which wall is missed?

Answer 10

Apical 4C
Apical 2C
Inferior/lateral wall.


Question 11

Apical long axis, a.k.a.…

Answer 11

3C apical view