The Sonographer Attachment Programme At USA Report : Mayo Clinic: Sonographer Experience =Pulmonary Hypertension=

Pulmonary Hypertension : Initial Standard TTE Examination

>> Parasternal RV Outflow View

- 2D assessment with or without color Doppler of pulmonary valve

- CW Doppler for peak and end diastolic PR velocity

- PW Doppler of RVOT TVI

>> Apical Four Chamber View

- Focus on RV

- Bring the RV toward the center of the screen – minimize foreshortening

- Do not use a para apical view

- 2D assessment of RV size and systolic function

- RV end diastolic basal and mid ventricular dimensions and RV length

- Area and length measurements of RA

- M-Mode through lateral tricuspid annulus (TAPSE)

- Lateral tricuspid annulus TDI S’

- RV Strain

>> Subcostal View

- Inferior vena cava through one respiratory cycle and then sniff

- PW Doppler of hepatic vein flow or SVC flow

>> Arch View

- SVC flow

O2 saturation at rest

Pulmonary Hypertension : Follow Up

>> Parasternal Long Axis View

- 2D with and without Color Doppler of AV & MV

- LV dimensions and EF

- LVOT diameter

>> Parasternal RV Inflow View

- 2D with and without Color Doppler of TV

- Peak TR velocity

>> Parasternal RV Outflow View

- 2D assessment with and without Color Doppler of pulmonary valve

- CW Doppler for peak and end diastolic PR velocity

- PW Doppler of RVOT TVI

>> Parasternal Short Axis View (Basal Level)

- 2D with and without Color Doppler of pulmonary valve

- CW Doppler for peak and end diastolic PR velocity

- 2D assessment with and without color Doppler of TV

- CW Doppler for peak TR velocity

- PW Doppler of RVOT TVI

>> Parasternal Short Axis View (Papillary Muscle & Apical Levels)

- 2D visual assessment of biventricular size and systolic function

>> Apical 4 Ch View

- Focus on RV

- RV size, systolic fx (2D)

- RV end diastolic base and mid dimensions and RV length

- RA volume index

- Color Doppler of TV

- Lateral tricuspid annulus TDI

- TAPSE

- RV Strain

>> Apical 4 Ch View

- Focus on LV

- 2D assessment of LV size and systolic function

- Mitral inflow velocity at leaflet tips

- Tissue Doppler of medial and lateral mitral annulus velocity

- LV outflow tract velocity and TVI

>> Subcostal View

- Inferior Vena Cava through one respiratory cycle and then sniff

- PW Doppler of hepatic vein flow

>> SVC Flow

>> RIMP Measurement

>> Pulse oximetry and record of oxygen use