RVSP Calculator: Estimates Right Ventricular Systolic Pressure from the TR jet velocity and Right Atrial Pressure (RAP). Equivalent to PASP in the absence of pulmonic stenosis.
2.5
Commonly: 3 (IVC < 2.1cm, >50% collapse), 15 (IVC > 2.1cm, <50% collapse), or 5-10 for intermediate cases.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Initial screening and follow-up of suspected Pulmonary Hypertension (PH) during transthoracic echocardiography (TTE).
To assess right ventricular afterload in patients with chronic heart failure or lung disease.
Terminology
In the absence of pulmonary valve or outflow tract stenosis, RVSP (Right Ventricular Systolic Pressure) is physiologically equivalent to PASP (Pulmonary Artery Systolic Pressure).
Section 2
Formula & Logic
Bernoulli Equation
The simplified Bernoulli equation (ΔP = 4v2) converts the peak velocity (v) of the Tricuspid Regurgitation (TR) jet into a pressure gradient. To find the absolute RV pressure, the Right Atrial Pressure (RAP) must be added back to this gradient.
RAP Estimation (ASE/NASCI guidelines)
01
RAP 3 mmHg: IVC ≤ 2.1 cm AND > 50% collapse with sniff.
02
RAP 15 mmHg: IVC > 2.1 cm AND < 50% collapse with sniff.
03
RAP 8-10 mmHg (Intermediate): If one feature is positive but not both.
Section 3
Pearls/Pitfalls
The Underestimation Risk
The RVSP calculation is fundamentally dependent on the quality of the TR jet. If the TR jet is "sub-maximal" or eccentric, the velocity will be underestimated, potentially missing significant pulmonary hypertension.
Beyond RVSP
A high RVSP on echo is a marker of concern, but not a diagnosis of Pulmonary Arterial Hypertension (PAH). The diagnosis of PAH strictly requires Right Heart Catheterization (RHC) to confirm a mean PAP ≥ 20 mmHg and PCWP ≤ 15 mmHg.
Section 4
Evidence Appraisal
Gold-Standard Guidelines
Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography.
Rudski LG et al. • J Am Soc Echocardiogr.. 2010;23(7):685-713. Detailed the standard parameters for RAP and RVSP estimation.
