Pulmonary Valve
Pulmonary stenosis
Use PRVO (similar to PSAX view) and PSAX aortic level.
CW
Vmax (peak gradient) and trace VTI (mean gradient).
Can use PW to determine exactly where velocity greatest.
Some texts say >40 gradient is severe for PS. You will need to go with the BSE figures for the exam even though saying <40 is mild seems odd when on most studies you get a figure of around 5! I'd be worried if I had a gradient of 30.
Pulmonary regurgitation
Colour
Jet width
CW
Note density and contour. Deceleration of jet slow if mild and gets faster the more severe.
Peak velocity can be used to calculate PA diastolic pressure.
PW
Measure RVOTVTI and LVOTVTI and work out the ratio.
Regurgitant volume and fraction
As for MR above
Remember SV = VTI x CSA
Measure diameter TV annulus in A4C and RVOT at level of PV annulus in PSAX
RV = SVRVOT - SVTV
RF = (RV / SVTV) x 100