So the RV is a complex beast…
- A variety of ways to measure, but TAPSE still pretty good.
- TAPSE evolves using TDI into the RV S’. It can predict right ventricular dysfunction (ejection fraction < 45%) with a sensitivity of 90% and a specificity of 85%. Reference here.
- Get the end diastolic area in A4C and compare it to the LVEDA
- <0.6 ratio is OK, >1.0 is severely enlarged.
- Get a good idea of the RA pressure by actually measuring the nearby Hepatic Vein flow (subcostally). See here.
- Essentially most RV assessment is qualitative right now.
- But whatever you do, don’t forget to fully assess the left side of the heart to see if that’s the cause for the poor right side.
In summary, clinically fabulously important, and awaiting the gamut of measurements to define function that the LV has.
And anyone that knows me knows that I am going to add this to finish: