Pulmonic regurgitation
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Pulmonic Regurgitation. Pulmonic Regurgitation. Incidental benign finding Pathologic PR – usually due to untreated or residual congenital PR. Acquired PR – rare. Usually due to endocarditis, carcinoid syndrome or myxomatous valve disease. Congenital Disease. Thickened deformed leaflets.

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Pulmonic regurgitation1
Pulmonic Regurgitation

  • Incidental benign finding

  • Pathologic PR – usually due to untreated or residual congenital PR.

  • Acquired PR – rare. Usually due to endocarditis, carcinoid syndrome or myxomatous valve disease.


Congenital disease
Congenital Disease

  • Thickened deformed leaflets


Endocarditis
Endocarditis

  • Valvular vegetation is present.


Carcinoid
Carcinoid

  • Shortening and thickening of the valve.


Myxomatous disease
Myxomatous Disease

  • Rare.

  • Thickened, redundant valve.

  • Sagging of the leaflet in diastole.


Physiologic pr
Physiologic PR

Physiologic PR

  • Normal Pulmonic valve

  • Normal Pulmonary artery

  • Normal Chamber dimension


Physiologic pr1
Physiologic PR

  • Normal Pulmonary pressure

  • PR Jet length < 1 cm

  • PR Jet duration – not holodiastolic


Borderline pr
Borderline PR

  • PR jet length 1 to 2 cm

  • PR duration - holodiastolic


Significant pr
Significant PR

  • PR Jet length > 2 cm

  • PR duration – holodiastolic


Pulmonic pressure
Pulmonic Pressure

  • SPAP

  • MPAP

  • PAEDP


Systolic pulmonary artery pressure
Systolic Pulmonary Artery Pressure

  • Equals to RVSP in the absence of RVOT obstruction

  • SPAP = 4 (TR peak velocity)2 + RAP

  • RAP estimated from IVC



Mean pulmonary artery pressure
Mean Pulmonary Artery Pressure

MPAP mmHg = 80 – 0.5 x acceleration time (RVOT)

MPAP mmHg = 4(PR peak velocity)²


Pulmonic regurgitation

Acceleration Time

Acceleration time



Pulmonic regurgitation

Pulmonic Valve - PWD

MPAP = 80 – 0.5 x Acceleration Time

Normal MPAP = 9 to 18 mmHg



Pulmonic regurgitation

Pulmonic - CWD

PR – Peak Velocity


Pulmonary artery end diastolic pressure
Pulmonary Artery End-Diastolic Pressure

PAEDP = 4 x (PR end-diastolic velocity)2 + RAP


Pulmonic regurgitation

PR-EDV

PR- EDV