Pulmonary Hypertension

PASP

Measure TR Vmax.
Bernoulli equation transforms this into pressure gradient (gradient = 4 x V2). Machine will calculate this. This is the difference between RVSP and RAP.

Gradient = RVSP – RAP

Therefore 
RSVP = gradient + RAP

Assuming no PS then 

PASP = RSVP


If PS then peak gradient across the valve will be the difference between RSVP and PASP so 

PASP = RSVP – PS gradient


Normal PASP 15-30mmHg

PADP

Measure PR Vmax to get pressure gradient between PA and RV

Gradient = PADP – RVDP

Therefore

PADP = gradient + RVDP

RVDP assumed to be the same as RAP so

PADP = gradient + RAP

Normal PADP 5-15mmHg

MPAP

MPAP = ((PASP – PADP) / 3) + PADP


Normal MPAP is 15mmHg
Pulmonary hypertension when MPAP >25 (this will usually mean a PASP of >40)

Full BSE guideline for pulmonary hypertension (2010):

You won’t need to know the full pulmonary hypertension guideline in the table but I add it for completeness. It just goes to show how 30mins (fairly standartd for a depatmental study) is not long enough for a full echo unless the scan is normal.

PH

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