ASE American Society of

Echocardiography
Heart & Circulation Ultrasound Specialists

Findings Indicative of
hemodynamlcally significant trlcuspld stenosls
Specific Findings
Mean pressure gradient �5 mm Hg
Inflow time velocity integral >60cm
T"!z � 190 ms
Valve area by continuity equation*
s 1 cm2
Supportive Findings

Enlarged right atrium � moderate

Dilated inferior vena cava

*Stroke volume derived from left or right ventricular

outflow. In the presence of more than mlld trlcuapid
regurgitation, the derived valve area will be underntlmat9d.
Nevertheless a value :s 1 cm2 Implies a significant
hemodynamlc burden Imposed by the combined lesion.
Stenotic tricuspid valve The peak velocity, diastolic
obtained in a modified time-velocity integral, mean
apical 4-chamber view gradient, and pressure half-
during diastole. time by continuous wave
Doppler.

ulmonic Grading of Pulmonary Stenosis

Mild Moderate Severe

Peak Velocity <3 3-4 >4

(mis)

Peak gradient < 36 36 to 64 >64

(mm Hg)

Doming of the pulmonary Aliasing of velocities at Continuous wave Doppler

leaflets in systole noted the level of the pulmonary across the pulmonary valve
in valvular stenosis. valve in pulmonary showing increased velocities.
stenosis.

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