Basic Course in Pediatric Heart Failure and Heart Transplantation

Course Content

Total learning: 67 lessons / 6 quizzes Time: 8 hours

Tricuspid flow velocity recordings, with the use of a similar criteria, characterize the right ventricular (RV) diastolic filling pattern.
Left and right diastolic filling patterns are not necessarily the same in a patient.
The main difference between mitral and tricuspid velocities is that in normal subjects tricuspid flow velocities have a respiratory variation and mitral flow velocities usually do not.
Hepatic vein velocities reflect changes in the pressure, volume, and compliance of the right atrium (RA).
In normal subjects, hepatic vein flow velocities consist of four components : systolic forward flow (S), diastolic forward flow (D), systolic flow reversal (SR), and diastolic flow reversal (DR).

Timing and respiratory changes in forward and reversal velocities of hepatic vein flow are important in the assessment of tricuspid regurgitation, constriction, tamponade, restriction and PH.
As RV filling pressure increases, hepatic systolic flow velocity decreases and diastolic flow velocity increases, analogous to the pulmonary vein pattern. With marked increase in RV filling pressure, a prominent flow reversal occurs during systole and diastole (or both)
Diastolic flow reversal in the hepatic vein is seen in patients with pulmonary hypertension or constrictive pericarditis . It is characteristically augmented with expiration in constriction and remains constant, without respiratory variation, in pulmonary hypertension