Adult Echocardiography Practice Exam

What is the most reliable non-invasive method for estimating pulmonary artery pressure?

1. Tricuspid valve regurgitant jet velocity

2. Pulmonic valve systolic velocity

3. Pulmonary artery catheter

4. Thermodilution

The correct answer is: Pulmonary artery catheter

The most reliable non-invasive method for estimating pulmonary artery pressure is indeed the measurement of the tricuspid valve regurgitant jet velocity. This method uses Doppler echocardiography to assess the velocity of the regurgitant flow across the tricuspid valve during systole. The velocity of the tricuspid regurgitant jet is directly related to the pressure gradient between the right ventricle and the right atrium, which, when combined with the estimation of right atrial pressure, allows for the calculation of the pulmonary artery systolic pressure. This indirect assessment is widely used in clinical practice due to its non-invasive nature and its ability to provide valuable information about hemodynamics in patients with suspected pulmonary hypertension. In contrast, while the pulmonary artery catheter and thermodilution techniques are effective methods for direct measurement of pulmonary artery pressures, they are invasive procedures and not classified as non-invasive techniques. Therefore, they do not fit the criteria of the question effectively. Pulmonic valve systolic velocity does not provide sufficient information on pulmonary artery pressures as it mainly reflects the flow dynamics in the pulmonary valve rather than the pressures directly associated with the pulmonary artery system.