Graphic representation of transthoracic echocardiographic parameters in the assessment of right ventricular pressure overload. A′ = peak late diastolic (during atrial contraction) velocity of tricuspid annulus by tissue Doppler imaging; AcT = right ventricular outflow Doppler acceleration time; Ao = aorta; E′ = peak early diastolic velocity of tricuspid annulus by tissue Doppler imaging; IVC = inferior vena cava; LA = left atrium; LV = left ventricle; RA = right atrium; RiHTh = right heart thrombus (or thrombi); RV = right ventricle/ventricular; S′ = peak systolic velocity of tricuspid annulus by tissue Doppler imaging; TAPSE = tricuspid annular plane systolic excursion; TRPG = tricuspid valve peak systolic gradient. A. Enlarged right ventricle, parasternal long D(is view B. Dilated RV with basal RV/LV ratio > I .0, and McConnell sign (arrow), four chamber view C. Flattened intraventricle septum (arrows) parasternal short axis view D. Distended inferior vena cava with diminished inspiratory collapsibility, subcostal view E. 60/60 sign: coexistence of acceleration time of pulmonary ejection ms and midsystolic "notch" with mildy elevated (<60 mmHg) peak systolic gradient at the tricuspic valve F. Right heart mobile thrombus detected in right heart cavities (arrow) G. Decreased tricuspid annular plane systolic excursion (TAPSE) measured with M-Mode (<16 mm) H. Decreased peak systolic (S') velocity of tricuspid annulus (<9.5 cmls) #TTE #Echocardiogram #RVStrain #RVOverload #PulmonaryEmbolism #Transthoracic #Diagnosis #RightVentricular #Cardiology
