Echocardiographic findings in acute and chronic pressure and volume overload

RV: right ventricular; PA: pulmonary artery.
* RV size and systolic function may remain normal in the presence of mild-moderate acute increases in PA systolic pressure <55 mmHg, whereas the normal RV cannot usually overcome acute increases in PA systolic pressure >55 mmHg and thus fails. For chronic increases in PA pressure, the RV progressively adapts and remodels to tolerate higher pressures before failing.
¶ RV dysfunction may exhibit a pattern of apical sparring in acute pulmonary embolism, referred to as "McConnell's sign."
Δ RV dysfunction may exhibit a pattern of longitudinal sparing in precapillary pulmonary arterial hypertension, defined as normal tissue Doppler annular velocity (S') or tricuspid annular plane systolic excursion (TAPSE) in the presence of reduced fractional area change (FAC) or global RV ejection fraction.
◊ RA dilation, indicative of elevated RA pressure, is a poor prognostic sign for survival in pulmonary arterial hypertension.