Measurement of Pulmonary Diastolic Pressure

Color Doppler, parasternal short axis view of the base of the heart, with leftward tilt of transducer to image pulmonary valve and right ventricular outflow tract (RVOT).

Mild, central pulmonary valve regurgitation is evidenced (red / yellow jet directed towards anterior wall of RVOT). Subsequently, Continuous wave Doppler scan line is placed parallel and central to regurgitant jet to record diastolic velocities (see below).

Peak end-diastolic regurgitant velocity (+) is measured after the indentation (arrows) caused by right atrial contraction. Using the simplified Bernouilli equation, the ultrasound machine displays the corresponding pressure gradient occurring in end-diastole between the pulmonary artery and the right ventricle (RV).

The diastolic (=end-diastolic) pulmonary artery pressure is calculated by adding the estimated (observing the degree of inferior vena cava inspiratory collapse , 2D subcostal imaging) right atrial pressure (= to RV end-diastolic pressure) to the pul,onary artery – RV pressure gradient.

Pulmonary artery diastolic pressure = (pulmonary artery – RV pressure gradient) + right atrial pressure


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