[Conventional and Doppler echocardiography in the differential diagnosis of right heart failure]

Abstract

In the differential diagnosis of isolated right heart failure 1- and 2-dimensional echocardiography and Doppler echocardiography have proved to be of an increasing significance. In right ventricular dysplasia associated ventricular arrhythmias and regional abnormalities in wall motion of the right ventricle are characteristic. The evaluation of pulmonary heart disease has been extended by the estimation of pulmonary artery pressure using doppler echocardiography. In isolated right heart infarction, echocardiography can detect regional wall motion abnormalities and potential complications like intracavitary mural thrombi. In addition to pericardial calcification on chest x-ray and "dip and plateau" sign on pressure wave form, the abnormal diastolic hemodynamics can be demonstrated studying motion of interventricular septum and posterior left ventricular wall by echocardiography. Separating patients with restrictive cardiomyopathy may be difficult, if demonstration of the characteristic findings--increase of ventricular wall thickness, small ventricular cavities--is impossible. The evaluation of isolated tricuspid valve diseases has become possible non-invasively by Doppler echocardiography. In the diagnosis of the rare right atrial myxomas 2-D-echocardiography is the method of choice.