Right Heart Enlargement

In this episode, Jailyn discusses right heart ultrasound, and speaks on RV systolic dysfunction and differentiating between acute and chronic RV enlargement. She reviews: RV systolic dysfunction markers using TAPSE (M-mode tricuspid annular excursion; abnormal less than 1.6 cm) and S’ (tissue Doppler velocity; abnormal is less than 10 cm/s) Estimating right-sided pressures by deriving right atrial pressure from IVC diameter and respiratory collapse and calculating pulmonary artery systolic pressure from right atrial pressure plus the tricuspid regurgitant gradient (Bernoulli equation). Differentiating acute vs chronic RV enlargement using RV free wall hypertrophy, McConnell’s sign, the 60/60 sign (PASP less than 60 mmHg and pulmonary acceleration time less than 60 ms), and early systolic notching **CORRECTION! When determining the 60/60 sign for acute RH strain, you still need to identify the pulmonary acceleration time, but you don't need to calculate the PASP, which is the tricuspid pressure gradient plus the CVP (the latter of which is estimated from the collapsibility and overall size of the IVC). You just need the tricuspid gradient alone for the second "60" you're looking for.*** 00:00 Course Intro and Goals 01:22 Right Heart Strain Overview 01:52 Basics RV Enlargement Views 03:56 Quick Course Plug 04:42 More Views and Wrap Basics 06:22 RV Systolic Dysfunction TAPSE 09:15 Tissue Doppler S Prime 10:58 Estimating PASP and RAP 13:19 IVC Measurement Without M Mode 17:27 TR Jet and Pressure Gradient 21:05 Acute vs Chronic RV Enlargement 23:58 60 60 Sign and Accel Time 28:30 Early Systolic Notching 29:26 Clinical Pearl Not Always PE 30:45 Summary and Next Steps 🌐 Connect with Us 🌐 If you want more education goodness, check out the links below! Check out our courses here: https://courses.coreultrasound.com Check out our question bank here: https://courses.coreultrasound.com/co... Check out our FREE content on our website: https://www.coreultrasound.com Check out our in-person course in San Diego, Ca on Nov 12-14 2026 here: https://www.soundandsurf.com/essentia... Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.