Pulmonary Insufficiency

Quantification Pulmonary valve insufficiency1

	Slight	Moderate	Severe
RV dimension	normal	normal / dilated	dilated
Density contour + CW signal	light + blunt	holds + variable	holds + steep
Systolic flow in pulmonary artery	decreased slightly	decreased slightly	decreased
Color Doppler signal	narrow jet located under pulmonary valve level	wide jet reaching far into RV	wide retrograde jet outbound portion of pulmonary branches

 

Color doppler

With color Doppler, the degree of expansion of the jet flow back into the right ventricle can be used to quantify the degree of pulmonary insufficiency enigzinds it is most commonly used .

Continuous wave

Also by continuous wave signal with an impression can be gekeregen on the severity of the pulmonary valve insufficiency.

A Minimum insufficiency as seen in normal individuals: holodiastolic signal dip by atrial contraction. B Light insufficiency: holodiastolic backflow small reversal following atrial contraction only during inspiration. C Moderate insufficiency: return of the return current to zero before the end of diastole to late diastolic antegrade flow in the pulmonary artery due to the atrial contraction both in inspiration and in expiration. D Severe insufficiency: short sharp backflow indicating rapid equilibration of pulmonary and RV diastolic and end-diastolic pressure with mid forward flow in the pulmonary artery.2

Example

Moderate pulmonary insufficiency

References

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1. 1 pmid=20375260
2. 2 Mulder B.J.M., Pieper P.G., Spitaels S.E.C. Aangeboren hartafwijkingen bij volwassenen. Bohn Stafleu van Loghum Houten/Diegem 1999

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