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RVSP Calculator

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

Verified

Last Review: 2026-07-17

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).

How it Works

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.

Clinical Pearls

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.

The Evidence

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.

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

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).

How it Works

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.

Clinical Pearls

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.

The Evidence

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.

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

JAMAJul 21, 2026
Errors in Figures

Clinical Context

We think this might be relevant to the clinical guidance for RVSP (Right Ventricular Systolic Pressure).

WHO NewsJul 15, 2026
New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

Clinical Context

We think this might be relevant to the clinical guidance for RVSP (Right Ventricular Systolic Pressure).

WHO NewsJul 15, 2026
Global childhood immunization coverage inches forward despite conflict and hesitancy – UNICEF, WHO

Clinical Context

We think this might be relevant to the clinical guidance for RVSP (Right Ventricular Systolic Pressure).