Thread by @PulmCrit

Doppler evaluation of the RVOT
- @khaycock2 at #HRreloaded

how to get the views
(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

Pw gate right before the pulmonic valve
PVAT is acceleration time - this reduces with pulmonary HTN.
- @khaycock2 at #HRreloaded

pulmonary HTN
- acceleration and deceleration shortens
- very severe: mid-systolic notch due to reflected pressure (earlier notch = worse)
- @khaycock2 at #HRreloaded

mean PA pressure can be estimated from acceleration time (although this isn't typically the way that PA pressure is measured)
- @khaycock2 at #HRreloaded

- post-capillary pulmonary HTN doesn't seem to cause the notching.
- notch suggests pre-capillary pulmonary HTN
- @khaycock2 at #HRreloaded

- PE may cause early systolic notch
- very short acceleration & decelleration curves b/c RV is poorly able to tolerate acute increase in pressure
- @khaycock2 at #HRreloaded

continuous wave doppler (CW) used to determine peak velocities, to find pressure gradients.
- peak velocity correlates with mean PA pressures
- end-diastolic velocity correlates with diastolic PA pressures
- @khaycock2 at #HRreloaded