- The tricuspid valve has thin mobile leaflets with normal diastolic excursion
- The right ventricle demonstrates normal systolic function
- Color Doppler of tricuspid valve inflow.
- Normal laminar flow across the tricuspid valve
- Mild tricuspid regurgitation (denoted by the narrow blue jet of regurgitation at the point of tricuspid valve coaptation)
The assessment of tricuspid regurgitation peak velocity from this view allows for estimation of right ventricular systolic pressures.
Estimating right ventricular pressure using Bernoulli Equation
- Estimated right ventricular systolic Pressure = 4v2 + right atrial pressure
- v= peak velocity of tricuspid regurgitation jet by spectral Doppler
The parasternal long axis view tilted posteriorly is an excellent view to profile the tricuspid valve and assess its morphology. This is one of the more optimal views to assess and quantify tricuspid regurgitation.
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- Transducer placed at the left sternal border
- 3rd or 4th intercostal space
- Notch pointed towards the patient's right shoulder
- Transducer angled inferiorly towards right hip
- Tricuspid valve abnormality (prolapse, regurgitation)
- Pulmonary hypertension (estimate right ventricular systolic pressure)
- Unroofed or partially unroofed coronary sinus (coronary sinus ASD)
- Right ventricular hypertrophy or dilation
- Right ventricular dysfunction