is an echo the best right heart catheter? · 2016. 8. 18. · • alignment. atria j am soc...
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![Page 1: Is an echo the best right heart catheter? · 2016. 8. 18. · • Alignment. Atria J Am Soc Echocardiogr 2015;28:1-39 LA RA. MPA / PAs & IVC. Pulmonary Hypertension. Pulmonary Hypertension](https://reader033.vdocument.in/reader033/viewer/2022061005/60b34c941c4bee1ec7639d3d/html5/thumbnails/1.jpg)
Is an echo the best rightheart catheter?
PD Dr med. Bernhard Herzog
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No disclosures
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Can echo answer myquestion?
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Right Heart Disease
Tricuspid valve disease
Right Ventriular Infarction
Pulmonary Hypertension
Pulmonary valve disease
ARVC
Shunts
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Right Heart Disease
Size & Function- Right Ventricle- Left Ventricle
Size- Atria- MPA / PAs- Inferior Vena Cava
Morphology & Function- Tricuspid Valve- Pulmonary Valve- Mitral Valve- Aortic Valve
Pulmonary Pressure
Tricuspid valve disease
Right Ventriular Infarction
Pulmonary Hypertension
Pulmonary valve disease
ARVC / Sarcoidosis
Shunts
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Right Ventricular Size
RV linear dimensions
- inflow
RV linear dimensions
- outflow
RV end-diastolic area
RV 3D volume
J Am Soc Echocardiogr 2015;28:1-39
RV modified / focusedapical 4CH
J Am Soc Echocardiogr 2010;23:685-713
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Right Ventricular Size - Limitations- Image Quality-
?
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Right Ventricular Size - Limitations- Image Plane-
J Am Soc Echocardiogr 2015;28:1-39
?
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Right Ventricular Size - Limitations
• Image Quality
• Image Plane
• Trabeculations
X
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Right Ventricular Size - Limitations
• Image Quality
• Image Plane
• Trabeculations
• Normal Values
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Right Ventricular Function
FAC
3D function
RV longitudinal functionTAPSE
Color tissue Doppler
S wave
Pulsed tissue Doppler
S wave
Global longitudinal strain
J Am Soc Echocardiogr 2015;28:1-39
RIMP PW
RIMP TDI
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Right Ventricular Function- Limitations
• Image Quality
• Image Plane
• Trabeculations
• Normal Values
• Alignment
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Atria
J Am Soc Echocardiogr 2015;28:1-39
LA RA
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MPA / PAs & IVC
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Pulmonary Hypertension
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Pulmonary Hypertension
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Pulmonary Hypertension - Limitations
• Image Quality
• Image Plane
• Trabeculations
• Normal Values
• Alignment
• Severity of tricuspid regurgitation
• Right ventricular function
• Inspiration (higher with inspiration)
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• Echo is the first line modality
• Echo is not a right heart catheter
• RV assessment is challenging – NOT only for echo
• Get as many pieces of the puzzle as possible
• Take other imaging modalities if necessary
Take Home Message
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