Canonical: https://echosuite.app/guides/rvsp/

# 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](https://echosuite.app/about/) · [Sources & educational scope](https://echosuite.app/about/)

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

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

- 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

- [RV inflow acquisition guide](https://echosuite.app/guides/views/rv-inflow/) · [Open in Probe Lab](https://echosuite.app/#rvInflow)
- [Apical four chamber acquisition guide](https://echosuite.app/guides/views/apical-four-chamber/) · [Open in Probe Lab](https://echosuite.app/#a4c)
- [Subcostal four chamber acquisition guide](https://echosuite.app/guides/views/subcostal-four-chamber/) · [Open in Probe Lab](https://echosuite.app/#subcostal4c)
- [Subcostal IVC long axis acquisition guide](https://echosuite.app/guides/views/inferior-vena-cava/) · [Open in Probe Lab](https://echosuite.app/#ivc)
- [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/)
- [Right-heart echocardiography: views, measurements and calculators](https://echosuite.app/learn/right-heart-echo/)

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