RVSP and PASP calculator: tricuspid regurgitation velocity

Review the tricuspid regurgitation velocity and right atrial pressure inputs used by the RVSP and PASP tool.

Created by Mohammed Kamareddine, MD · Sources & educational scope

Method

RVSP = 4(TR Vmax)² + RAP; PASP = RVSP − PS gradient

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

TR Vmax m/s

CW Doppler through the TR jet

Search RV inflow, apical four-chamber, and subcostal windows; use the highest well-aligned signal.
Trace the dense primary edge (‘chin’), not faint overgained noise, and reject truncated triangular envelopes when estimating pressure.
Average three representative beats; in atrial fibrillation average 5–10 beats and exclude post-pause or post-ectopic velocities.

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.

Peak pulmonic (RVOT) 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.

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 1 JASE p. 145 · Table 4 pp. 161–163 · RVSP pp. 164–166

Primary reference

Equation and pulmonic-gradient correction · Table 4 · JASE pp. 161–163; RVSP pp. 164–166
RVSP from peak TR velocity plus RAP and equality of PASP and RVSP only when RVOT or pulmonic obstruction is absent.
Acquisition, threshold, and limitations · Table 1 JASE p. 145 · RVSP / Table 5 pp. 164–166
Multiple-window acquisition, rhythm averaging, generally abnormal RVSP at least 35 mmHg, and TR-envelope and hemodynamic pitfalls.

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

All echo guides · Learning paths