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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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Presentation Transcript
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

slide15

Acceleration Time

Acceleration time

slide17

Pulmonic Valve - PWD

MPAP = 80 – 0.5 x Acceleration Time

Normal MPAP = 9 to 18 mmHg

slide19

Pulmonic - CWD

PR – Peak Velocity

pulmonary artery end diastolic pressure
Pulmonary Artery End-Diastolic Pressure

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

slide21

PR-EDV

PR- EDV