II. Technique

  1. Best views to estimate right ventricular function
    1. Apical four chamber view
    2. Parasternal short axis

III. Imaging: Right ventricular dysfunction signs suggestive of increased right heart pressures

  1. Right ventricular dilation (RV diameter compared with LV) on apical four chamber view
    1. Right ventricle is normally 2/3 the size of the left ventricle
    2. Abnormal if RV is the same size or larger than the left ventricle
  2. Right ventricular wall contractility decreased
  3. D-Shaped left ventricle (PSAX View)
  4. McConnell's Sign
    1. Right ventricular tip contracts
    2. Right ventricular free wall does not contract
  5. Flattening or paradoxical movement of the septum in PSAX View
  6. Inferior Vena Cava dilation

IV. Differential diagnosis: Echocardiogram with right heart dysfunction

  1. Chronic Pulmonary Hypertension
    1. Right ventricle wall thickness >0.5 cm
  2. Cardiac Tamponade
  3. Right-sided Myocardial Infarction

V. References

  1. Swaminathan, Valois and Lanctot in Herbert (2019) EM:Rap 19(6): 6-8
  2. Orman, Dawson and Mallin in Majoewsky (2013) EM:Rap 13(1): 4-6

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