Qualitative
Pulmonic valve morphology
Colour flow PR jet widtha
CW signal of PR jetb
Pulmonic vs. Aortic flow by PW
Semi-quantitative
VC width (mm)
Quantitative
EROA (mm2)
R Vol (mL)
RV size
| Pulmonic valve morphology |
| Mild |
| Normal |
| Moderate |
| Normal/ abnormal |
| Severe |
| Abnormal |
| Colour flow PR jet widtha |
| Mild |
| Small, usually <10 mm in length with a narrow origin |
| Moderate |
| Intermediate |
| Severe |
| Large, with a w ide origin; may be brief in duration |
| CW signal of PR jetb |
| Mild |
| Faint/slow deceleration |
| Moderate |
| Dense/variable |
| Severe |
| Dense/steep deceleration, early termination of diastolic flow |
| Pulmonic vs. Aortic flow by PW |
| Mild |
| Normal or slightly increased |
| Moderate |
| Intermediate |
| Severe |
| Greatly increased |
| VC width (mm) |
| Mild |
| Not defined |
| Moderate |
| Not defined |
| Severe |
| Not defined |
| EROA (mm2) |
| Mild |
| Not defined |
| Moderate |
| Not defined |
| Severe |
| Not defined |
| R Vol (mL) |
| Mild |
| Not defined |
| Moderate |
| Not defined |
| Severe |
| Not defined |
| RV size |
| Unless for other reasons, the RV size is usually normal in patients with mild PR. In acute severe PR, the RV size is often normal. Accepted cut-off values for non-significant RV enlargement (measurements obtained from the apical four-chamber view): Mid RV dimension ≤33 mm, RV end-diastolic area ≤28 cm2, RV end-systolic area ≤16 cm2, RV fractional area change .32%, maximal. |
PR = pulmonic regurgitation; CW = continuous wave; EROA = effective regurgitant orifice area; PW = pulse wave; RV = right ventricle; R Vol = regurgitant volume; VC = vena contracta.
aAt a Nyquist limit of 50–60 cm/s. - bSteep deceleration is not specific for severe PR.