Table 4. Echocardiography protocol for the diagnosis of pulmonary hypertension (if available).
| Parameters | Comments |
|---|---|
| Assess LV systolic & diastolic function | Rule out group 2 diseases |
| Assess MV & AV structure and function | Rule out rheumatic heart disease |
| Assess LA dimensions & area | Central or rightward position of the inter-atrial septum indicates a left atrial pressure higher than or equal to the right atrial pressure and makes the diagnosis of PAH less likely. |
| Assess RV & RA dimensions and function | ∘ RV free wall thickness ∘ RV dimensions ∘ RA volume index ∘ TAPSEo Tei index |
| Assess PV & TV structure and function | Rule out RHD |
| Exclude RVOT obstruction | PS [valvular /sub-valvular] |
| Measure TR | Best possible jet/Doppler alignment, use contrast if necessary |
| To assess for intra-cardiac shunts | Use contrast if needed |
| IVC collapsibility | For the estimation of RAP |
Notes.
- LV
- left ventricle
- MV
- mitral valve
- AV
- aortic valve
- LA
- left atrium
- RV
- right ventricle
- RA
- right atrium
- PV
- pulmonary valve
- TV
- tricuspid valve
- RVOT
- right ventricular outflow tract
- TR
- tricuspid regurgitation
- IVC
- inferior vana cava
- PAH
- pulmonary arterial hypertension
- TAPSE
- Tricuspid annular plain systolic excursion
- RHD
- rheumatic heart disease
- PS
- pulmonary stenosis
- RAP
- right atrial pressure