Doppler echocardiographic assessment of tricuspid regurgitation and the estimation of the gradient between right ventricle and right atrium

In the presence of TR, continuous wave Doppler interrogation can be performed across the tricuspid valve by aligning the Doppler ultrasound beam across the right heart (panel A). The Doppler shift caused by the TR will be displayed as shown in panel B. In this example, the velocity of the TR jet is 1.9 m/s, yielding a pressure gradient between the RV and RA of 15 mmHg ( = 4 x V² by the Bernoulli equation). If the RA pressure is known or can be estimated, the sum of the RA pressure and the RV to RA pressure gradient is equal to the RV systolic pressure (which is equal to the pulmonary artery systolic pressure in the absence of pulmonic stenosis).