Dr. Usman's Cardiology Notes

Echocardiographic Signs of Pulmonary Hypertension (PH) 1. Elevated Pulmonary Artery Systolic Pressure (PASP) Most important screening parameter. Estimated from TR Jet Velocity: PASP = 4(V_{TR})^2 + RAP TR velocity >2.8–3.4 m/s suggests PH Higher velocity → higher probability of PH --- 2. Right Ventricular (RV) Changes RV dilatation RV hypertrophy (RV free wall >5 mm) Reduced RV systolic function RV pressure overload pattern Severe PH: RV larger than LV Reduced TAPSE Reduced RV FAC --- 3. Interventricular Septal Flattening Due to RV pressure overload. D-shaped LV in PSAX Systolic flattening → pressure overload Diastolic flattening → volume overload --- 4. Right Atrial Enlargement Enlarged RA area Dilated IVC with reduced collapse Suggests elevated right-sided pressures. --- 5. Pulmonary Artery Abnormalities Dilated main pulmonary artery PA diameter >25 mm Early systolic notching on RVOT Doppler --- 6. Shortened Pulmonary Acceleration Time (PAT) RVOT PW Doppler: PAT <105 ms s...