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Echocardiographic Evaluation of the Right Heart

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Abstract

There is one consensus Guideline for the Echocardiographic Assessment of the Right heart in adults in 2010, with a recent update ASE/EACVI in 2015.The RV is particularly prone to inaccurate measurements due to its triangular/crescentic shape, and requires modification of some views, including the RV focused four chamber apical view. Complete assessment requires a combination of qualitative and quantitative measurements of the RH chamber size, two RV regional and one global systolic function measurements, and estimation of systolic pulmonary artery pressure. Additional measurements are optional and disease or situation specific.

RH measurements are not corrected for body surface area, age or ethnicity, although there are increasing data aiming to provide these stratifications.

Most causes of RV dysfunction are secondary to either pressure overload, volume overload, or acute myocardial contractility dysfunction. A minority of cases are congenital or secondary intrinsic wall dysfunction. Conditions associated with pressure overload pattern include acute and chronic PE, Pulmonary Arterial Hypertension, Left Heart Disease and Lung disease. Conditions associated with volume overload include Tricuspid Regurgitation, Left Heart Disease, Intrinsic myocardial disorders.

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Abbreviations

2DE:

Two dimensional echo

3DE:

Three dimensional echo

4C:

Four chamber

AMI:

Acute myocardial infarction

BSA:

Body surface area

CHFpEF:

CHF with preserved EF

CHFrEF:

CHF with reduced EF

CTED:

Chronic thromboembolic disease

CTEPH:

Chronic thromboembolic PH

DTI:

Doppler tissue imagine

EF:

Ejection fraction

ET:

Excursion time

FAC:

Fractional area change

HF:

Heart failure

IVC:

Inferior vena cava

LHD:

Left heart disease

LV:

Left ventricle

MPAP:

Mean pulmonary artery pressure

PADP:

Pulmonary artery diastolic pressure

PE:

Pulmonary embolus

PH:

Pulmonary hypertension

PLAX:

Parasternal long axis

POCUS:

Point of care ultrasound

PSAX:

Parasternal short axis

PW:

Power wave

RA:

Right atrium

RH:

Right heart

RV:

Right ventricle

RVOT:

Right ventricular outflow tract

RVSP:

Right ventricular systolic pressure

SPAP:

Systolic pulmonary artery pressure

STE:

Speckle tracking echocardiography

TA:

Tricuspid annulus

TCO:

Tricuspid closure-opening time

TR:

Tricuspid regurgitation

TV:

Tricuspid valve

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Author information

Authors and Affiliations

  1. Azrieli Heart Center Division of Cardiology, Department of Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada

    L. Rudski MD, FRCPC, FACC, FASE & J. Deschamps MD, FRCPC

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  1. L. Rudski MD, FRCPC, FACC, FASE
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Editors and Affiliations

  1. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Anita Sadeghpour

  2. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Azin Alizadehasl

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Rudski, L., Deschamps, J. (2018). Echocardiographic Evaluation of the Right Heart. In: Sadeghpour, A., Alizadehasl, A. (eds) Case-Based Textbook of Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-67691-3_14

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  • DOI: https://doi.org/10.1007/978-3-319-67691-3_14

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