Severe pulmonary regurgitation
by Nanda Navin C

Comprehensive Textbook of Echocardiography

by Navin C Nanda
About Video

This video clip aortic short-axis view shows the pulmonary regurgitation (PR) jet is wide at its origin occupying approximately 75% of the width of the right ventricular (RV) outflow tract on the ventricular aspect of the pulmonary valve. This indicates severe PR. Also, the jet extends all the way to the tricuspid valve and into the right atrium (RA) in diastole (blue signals). Extension of the PR jet into the RA occurs when the diastolic pressure in the RV increases above the RA pressure as a result of severe PR and this leads to backflow into the RA in diastole through a partially closed tricuspid valve. This is also a reliable sign of severe PR. Any PR jet extending into the RV within 1 cm of the tricuspid valve is considered severe. This type of PR jet is easily missed and the severity of PR underestimated because of loss of turbulence and high velocity as a result of impingement of the PR jet against the RV wall. The flow signals thus change from high velocity mosaic colored signals to low velocity laminar signals, mostly blue. They are identified as representing PR because of their continuity with the turbulent jet and similar phasic motion in diastole. (LA: Left atrium).

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