202407132038
Status:
Tags: Echocardiography
RVOT doppler
Description of flow profile
Abnormalities of RVOT flow patterns have long been recognized in patients with PH, initially recognized as mid-systolic partial closure of the pulmonary valve on M mode (the “flying W”) and then as mid-systolic notching in pulsed Doppler envelope
not all patients with elevated PA pressure have notching of the systolic Doppler envelope, whereas notching can be seen with modest PA pressure elevation in proximal banding or embolism, thereby implicating an upstream factor in the PA rather than simply the presence of elevated pulmonary pressure; instead, mid-systolic notching occurs due to PA reflected waves
Normal pulmonary vasculature with high compliance produces a reflected wave that propagates slowly, reaching the RVOT after the completion of the systolic phase
Parabolic → triangular → notching → spiked
no notch → notch → mid-systolic deceleration w/ an inflection point & no post-notching acceleration
