(1) parasternal short axis or a modified parasternal long axis view that looks at the RVOT
(2) can get good doppler angles from subcostal windows
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIuK6kWsAIV6kG.png)
PVAT is acceleration time - this reduces with pulmonary HTN.
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIucMwXYAEwWdz.png)
![](https://pbs.twimg.com/media/EeIukyFXYAALLhY.png)
- acceleration and deceleration shortens
- very severe: mid-systolic notch due to reflected pressure (earlier notch = worse)
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIu5TvXoAAbUpf.png)
![](https://pbs.twimg.com/media/EeIvSiUXoAYw9TP.png)
![](https://pbs.twimg.com/media/EeIvZCYXkA8MXJr.png)
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIv0FmXoAIZ31k.png)
- notch suggests pre-capillary pulmonary HTN
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIv8T_XYAI9f9Z.png)
![](https://pbs.twimg.com/media/EeIwWBIXsAEqdy_.png)
- very short acceleration & decelleration curves b/c RV is poorly able to tolerate acute increase in pressure
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIweokXYAAGV5h.png)
- peak velocity correlates with mean PA pressures
- end-diastolic velocity correlates with diastolic PA pressures
- @khaycock2 at #HRreloaded
![](https://pbs.twimg.com/media/EeIxIHDXoAE39r5.png)