Echocardiogram of the pulmonary valve. Variability of the pattern and the related technical problems.

In order to examine the variability of the pattern due to the location and direction of the ultrasonic transducer, echocardiograms of the pulmonary valve were obtained from different precordial areas in 28 patients with various diseases and in 3 normal subjects. By higher positioning of the transducer, the diastolic slope became slower or upward and the 'a' wave became indiscernible, giving the pattern of pulmonary hypertension even in the normotensives. The anterior cusp was also detected by tilting of the transducer in some cases. Systolic time intervals (STI) of the right ventricle, however, were not influenced by the beam angle. The present data strongly suggests that the echocardiogram of the pulmonary valve should be carefully evaluated in the light of the spatial relationship of the echo beam and the valve in order to give the diagnostic importance.