TTE views to assess the tricuspid valve

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Parasternal long axis, right chamber view

From parasternal long axis view, if you tilt the probe toward the patient's left flanc, you will visualize the right chambers. The right ventricle is on the top, closest to the probe. It is separated from the right atrium by the tricuspid valve.

This view is useful to look at the dynamics of the tricuspid valve. When you put color Doppler on the tricuspid valve, you may be able to have a good alignement of the doppler beam with the regurgitant jet to allow you to measure the pressure gradient between RV and RA.

Schema PSL right chambers.jpg


Parasternal short axis, level of the aortic valve

In this view you can see the RV outflow tract and the tricuspid valve. There are good chances that the ultrasound beam aligns with the tricuspid regurgitant jet. 
Schema PSS aorta.jpg

Apical 4 chamber view

Apical 4 chamber is a good view to look at the tricuspid valve. To focus on the tricuspid valve you can tilt the probe toward the patient's left shoulder. You can also translate the probe medially and one or two intercostal spaces higher. 
Schema apical 4 chamber.jpg

Apical 4 chamber view, color Doppler on tricuspid valve

Tricuspid regurgitation appears as a blue systolic jet from RV to RA. In this example you can see trace TR.

Subcostal 4 chamber view

This view is not the best to study the tricuspid valve since the probe is far from this  structure, but it can still be useful when it is the only window available.
Schema subcostal 4 chamber.jpg
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