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Figure 2 Example of a Pulmonary Valvular Stenosis Patient With Restrictive RV Physiology

(A) Continuous-wave (CW) Doppler recording showed the antegrade pulmonary flow in late diastole (yellow arrow) which was coincident with premature pulmonary valve opening during atrial systole (indicated by P-wave of electrocardiographic tracing). A CW Doppler instead of pulsed-wave (PW) Doppler recording was shown to illustrate severe pulmonary stenosis (estimated peak pulmonary valve gradient >100 mm Hg). (B, C) Prominent diastolic flow reversals (white arrows) seen after atrial systole in hepatic vein (B) and superior vena cava (C). (D) Prominent diastolic flow reversal (red) in the hepatic vein could be better visualized with color M-mode technique. (E) A PW Doppler recording of tricuspid inflow showed a short E-wave deceleration time with a high A-wave velocity. (F) A PW tissue Doppler imaging trace at the lateral tricuspid annulus showed depressed peak systolic (Sa) and early diastolic (Ea) velocities. RV = right ventricular.