PHTN2

Pulmonary Hypertension by Echo - ASE 2025 + ESC/ERS 2022

Screening (ASE 2025): TRV >= 2.9 m/s suggests PH; or TRV >= 2.8 m/s with at least 2 adjunctive echo signs suggests PH. Adjunctive signs include RV enlargement, abnormal LV eccentricity index (>1.1), mid-systolic notching or short AccT, PR end-diastolic velocity >2.2 m/s, and signs of elevated RAP (IVC >2.1 cm or RA area >18 cm2). When TR jet is adequate, RVSP = 4*TRV^2 + RAP.

Required inputs

TR jet adequate for RVSP reporting? Yes No or poor signal

Peak TR velocity (m/s)

RAP estimate (mmHg) (3, 8, or 15 typical)

Adjunctive signs (check all present)

RV enlargement (Category A) LV eccentricity index > 1.1 (Category A) Mid-systolic notching or short AccT (Category B) PR end-diastolic velocity > 2.2 m/s (Category B) Elevated RAP sign: IVC > 2.1 cm or RA area > 18 cm2 (Category C)

ESC/ERS 2022 probability uses categories A/B/C. Signs from at least 2 categories are needed to modify probability.

Optional advanced inputs (AccT, RVOT VTI, mPAP and PVR)

RVOT Acceleration Time (ms)

RVOT VTI (cm)

Early PR velocity (m/s) (optional mPAP)

v1.1 Updated 2025-08-21 - Now includes ESC/ERS 2022 echo probability. ASCII-only text to avoid HTML entities.