Canonical: https://echosuite.app/guides/pa-pressure/

# Pulmonary artery pressure calculator

Explore the pulmonary artery pressure methods available in EchoSuite and check each method’s Doppler measurements and qualifications.

Created by [Mohammed Kamareddine, MD](https://echosuite.app/about/) · [Sources & educational scope](https://echosuite.app/about/)

[Open interactive calculator →](https://echosuite.app/calculators/#pa-pressure)

## Method

PAEDP = 4(PR EDV)² + RAP; mPAP = 4(PR early peak)² + RAP

Use the measurement units shown below. Some fields apply only to a selected method or condition; follow the interactive tool’s method choices. The interactive tool keeps missing measurements incomplete and provides its method-specific results and reference context.

## Measurements and acquisition

### Pressure method

Contemporaneous cuff or invasive value

- PA end-diastolic · PR endpoint
- Mean PA · early PR peak
- Mean PA · PASP and PAEDP
- Mean PA · mean TR gradient
- Use a pressure obtained in the same hemodynamic state as the echo.
- Confirm the value is entered in mmHg.
- Do not mix values acquired under different loading conditions.

### PR end-diastolic velocity  m/s

CW Doppler through the PR jet

- From PSAX at the aortic-valve level, angle superiorly to show the RVOT and pulmonary valve, then align CW Doppler with the PR jet.
- Use the early-diastolic peak velocity for mean PA pressure and the velocity immediately before the QRS for PA end-diastolic pressure.
- Use a dense complete envelope; average representative beats and use 5–10 beats when the rhythm is irregular.

### PR early-diastolic peak velocity  m/s

CW Doppler through the PR jet

- From PSAX at the aortic-valve level, angle superiorly to show the RVOT and pulmonary valve, then align CW Doppler with the PR jet.
- Use the early-diastolic peak velocity for mean PA pressure and the velocity immediately before the QRS for PA end-diastolic pressure.
- Use a dense complete envelope; average representative beats and use 5–10 beats when the rhythm is irregular.

### Mean RV–RA gradient  mmHg

Complete traced CW envelope

- Align through the valve or shunt and record a complete envelope.
- Trace the modal velocity envelope using the machine tool.
- Use the machine-calculated mean gradient in mmHg.

### Estimated RAP  mmHg

Subcostal long axis · M-mode or 2D

- From subcostal IVC long axis, measure end-expiratory diameter 0.5–3.0 cm proximal to the right-atrial ostium.
- Keep the calipers perpendicular to the IVC and observe variation with both a sniff and quiet respiration.
- Record whether inspiratory collapse is at least 50%; do not use collapse alone during positive-pressure ventilation.

### PA systolic pressure  mmHg

Contemporaneous cuff or invasive value

- Use a pressure obtained in the same hemodynamic state as the echo.
- Confirm the value is entered in mmHg.
- Do not mix values acquired under different loading conditions.

### PA end-diastolic pressure  mmHg

Contemporaneous cuff or invasive value

- Use a pressure obtained in the same hemodynamic state as the echo.
- Confirm the value is entered in mmHg.
- Do not mix values acquired under different loading conditions.

## Sources and method context

American Society of Echocardiography · 2025 · Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension · Table 4 JASE pp. 161–163 · PAEDP pp. 165–166 · mPAP p. 166

[Primary reference](https://www.asecho.org/wp-content/uploads/2026/08/ASE-Right-Heart-Guidelines-May-2025.pdf)

- PAEDP · PAEDP section · JASE pp. 165–166

End-diastolic PR velocity equation, acquisition from the PA-focused PSAX view, and the abnormal 2.2-m/s PR-velocity threshold.

- Mean PA pressure · mPAP section · JASE p. 166

PASP/PAEDP, early PR, and mean TR-gradient approaches; echo mPAP limitations and invasive confirmation requirements.

- [Mean TR-gradient method · Aduen 2009](https://pubmed.ncbi.nlm.nih.gov/19505794/) · JASE 22:814–819 · doi:10.1016/j.echo.2009.04.007

Mean RV–RA systolic gradient plus RAP, compared with catheter-derived mean PA pressure. Trace the systolic TR envelope; peak-gradient arithmetic is a different method.

Catalogue review status: Exact guideline locator mapped · clinical sign-off pending

These pages describe the educational tool. Interpret measurements with the complete clinical context and the method’s acquisition limitations.

## Keep exploring

- [RV outflow acquisition guide](https://echosuite.app/guides/views/rv-outflow/) · [Open in Probe Lab](https://echosuite.app/#rvOutflow)
- [Parasternal short axis, aortic valve level acquisition guide](https://echosuite.app/guides/views/psax-aortic-valve/) · [Open in Probe Lab](https://echosuite.app/#psaxAV)
- [Right atrial pressure assessment: IVC and hepatic vein flow](https://echosuite.app/guides/rap/)
- [Right atrial size calculator and measurement guide](https://echosuite.app/guides/ra-size/)
- [Right ventricular size calculator and measurement guide](https://echosuite.app/guides/rv-size-calc/)
- [Right ventricular function calculator: TAPSE, FAC and coupling](https://echosuite.app/guides/rv-function-calc/)

[All echo guides](https://echosuite.app/guides/) · [Learning paths](https://echosuite.app/learn/)