{"schemaVersion":1,"name":"EchoSuite","url":"https://echosuite.app","purpose":"Echocardiography education: acquisition-guided calculators and interactive 3D probe training.","guideURL":"https://echosuite.app/guides/","agentGuideURL":"https://echosuite.app/agents/","views":[{"id":"plax","name":"Parasternal long axis","url":"https://echosuite.app/#plax","guideURL":"https://echosuite.app/guides/views/plax/","acquisition":{"move":"Place the patient left lateral, set the probe beside the sternum, and aim through the LV long axis.","optimization":"Slide one interspace at a time and maximize LV length without showing papillary muscle.","contact":"3rd-4th interspace, immediately left of the sternum"}},{"id":"a4c","name":"Apical four chamber","url":"https://echosuite.app/#a4c","guideURL":"https://echosuite.app/guides/views/apical-four-chamber/","acquisition":{"move":"Place the probe at the true apical impulse and aim medially toward the base of the heart.","optimization":"Avoid foreshortening: center a pointed apex and maximize both ventricles and atria.","contact":"At the apical impulse, low and lateral on the left chest"}},{"id":"subcostal4c","name":"Subcostal four chamber","url":"https://echosuite.app/#subcostal4c","guideURL":"https://echosuite.app/guides/views/subcostal-four-chamber/","acquisition":{"move":"With the patient supine, flatten the probe below the xiphoid and aim toward the left shoulder using the liver as the window.","optimization":"Use held inspiration if helpful and keep both septa perpendicular to the beam.","contact":"Immediately inferior to the xiphoid, aimed beneath the costal margin"}},{"id":"ivc","name":"Subcostal IVC long axis","url":"https://echosuite.app/#ivc","guideURL":"https://echosuite.app/guides/views/inferior-vena-cava/","acquisition":{"move":"From subcostal four chamber, rotate counterclockwise to a sagittal plane and aim through the liver toward the RA.","optimization":"Show several centimeters of IVC entering the RA and include a full respiratory cycle.","contact":"Just right of midline, immediately inferior to the xiphoid"}},{"id":"abdAo","name":"Abdominal aorta long axis","url":"https://echosuite.app/#abdAo","guideURL":"https://echosuite.app/guides/views/abdominal-aorta/","acquisition":{"move":"Keep the probe sagittal, slide slightly left of midline, and angle posteriorly until the aorta lies over the vertebral body.","optimization":"Confirm a pulsatile thick-walled vessel anterior to the spine and follow it longitudinally.","contact":"Just left of midline, immediately inferior to the xiphoid"}},{"id":"ssn","name":"Suprasternal notch, aortic arch","url":"https://echosuite.app/#ssn","guideURL":"https://echosuite.app/guides/views/suprasternal-aortic-arch/","acquisition":{"move":"Extend the neck, place the probe in the notch, and aim toward the plane between the right nipple and left scapular tip.","optimization":"Trace the ascending, transverse, and descending arch and identify the branch vessels when possible.","contact":"In the suprasternal notch with the neck gently extended"}},{"id":"psaxAV","name":"Parasternal short axis, aortic valve level","url":"https://echosuite.app/#psaxAV","guideURL":"https://echosuite.app/guides/views/psax-aortic-valve/","acquisition":{"move":"Rotate about 90° clockwise from PLAX, then tilt superiorly toward the base until the aortic valve is centered.","optimization":"Avoid oblique cuts; 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excessive tilt loses chamber length.","contact":"At the apical impulse, low and lateral on the left chest"}},{"id":"a2c","name":"Apical two chamber","url":"https://echosuite.app/#a2c","guideURL":"https://echosuite.app/guides/views/apical-two-chamber/","acquisition":{"move":"From A4C, rotate roughly 60° counterclockwise without sliding off the apex.","optimization":"Exclude the right heart and maximize LV length; show the anterior and inferior walls.","contact":"At the apical impulse, low and lateral on the left chest"}},{"id":"a3c","name":"Apical three chamber (apical long axis)","url":"https://echosuite.app/#a3c","guideURL":"https://echosuite.app/guides/views/apical-three-chamber/","acquisition":{"move":"From A2C, rotate roughly another 60° counterclockwise to bring in the LVOT, aortic valve, and aorta.","optimization":"Align the LV, LVOT, aortic valve, and ascending aorta in one continuous long axis.","contact":"At the apical impulse, low and lateral on the left chest"}}],"calculators":[{"id":"aortic-stenosis","name":"Aortic stenosis · continuity & stress","category":"Stenosis","guideURL":"https://echosuite.app/guides/aortic-stenosis/","interactiveURL":"https://echosuite.app/calculators/#aortic-stenosis","formula":"AVA = LVOT area × LVOT VTI ÷ AV VTI","fields":[{"id":"method","label":"Measurement","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Resting continuity","value":"continuity"},{"label":"Stress comparison","value":"stress"}],"visibility":null,"maximum":null,"initial":"continuity"},{"id":"d","label":"LVOT diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity"]},"minimum":0,"maximum":15,"initial":""},{"id":"lvot","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity"]},"minimum":0,"maximum":400,"initial":""},{"id":"av","label":"Aortic valve VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler trace","steps":["Use the same aligned CW recording as the peak velocity.","Trace the outer edge of the dense envelope for the relevant phase.","Use the machine-reported VTI in centimeters."],"title":"Jet VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity"]},"minimum":0,"maximum":400,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity"]},"minimum":0,"maximum":4,"initial":""},{"id":"peak","label":"Peak AV velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity"]},"minimum":0,"maximum":12,"initial":""},{"id":"mean","label":"Mean AV gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the 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matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":500,"initial":""},{"id":"stressSV","label":"Stress · stroke volume","unit":"mL","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":500,"initial":""},{"id":"restAVA","label":"Rest · AVA","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":10,"initial":""},{"id":"stressAVA","label":"Stress · AVA","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":10,"initial":""},{"id":"restMean","label":"Rest · mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":200,"initial":""},{"id":"stressMean","label":"Stress · mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":200,"initial":""},{"id":"restET","label":"Rest · ejection time","unit":"ms","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":1500,"initial":""},{"id":"stressET","label":"Stress · ejection time","unit":"ms","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"minimum":0,"maximum":1500,"initial":""},{"id":"matched","label":"Stage acquisitions","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Matched & reliable","value":"yes"},{"label":"Not comparable","value":"no"},{"label":"Uncertain","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["stress"]},"maximum":null,"initial":"unknown"}],"reference":{"evidence":[{"label":"Continuity equation & acquisition","locator":"Sections on peak velocity, mean gradient and AVA · PDF pp. 4–11","supports":"Multiwindow CW acquisition, LVOT diameter and PW sampling, continuity-derived AVA, indexed AVA, and velocity/VTI ratio.","url":null},{"label":"Hemodynamic ranges","locator":"Table 3 · PDF p. 12","supports":"Peak velocity, mean gradient, AVA, indexed AVA, and velocity-ratio ranges and boundary conventions.","url":null},{"label":"Flow-aware discordance and stress 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Projection equation and ≥15% Q-change condition: Ferreira et al., Arq Bras Cardiol 2018;110:132–139, Methods/Discussion, doi:10.5935/abc.20180018.","url":"https://doi.org/10.5935/abc.20180018"}],"locator":"Continuity equation and acquisition pp. 4–11 · Table 3 p. 12 · discordant AS pp. 12–15 · integrated pathway and Figure 8 pp. 16–17","organization":"European Association of Cardiovascular Imaging and American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017ValveStenosisGuideline.pdf","year":2017}},{"id":"mitral-pht","name":"Mitral valve area · pressure half-time","category":"Stenosis","guideURL":"https://echosuite.app/guides/mitral-pht/","interactiveURL":"https://echosuite.app/calculators/#mitral-pht","formula":"MVA = 220 ÷ PHT","fields":[{"id":"pht","label":"Mitral pressure half-time","unit":"ms","kind":"number","optional":false,"help":{"mode":"CW Doppler deceleration slope","steps":["Record a complete inflow or regurgitant CW envelope.","Trace the deceleration slope using the machine PHT tool.","Average representative beats and use additional beats in atrial fibrillation."],"title":"Pressure half-time"},"visibility":null,"minimum":0,"maximum":2000,"initial":""}],"reference":{"evidence":[{"label":"Equation & acquisition","locator":"PHT method and Figure 8 · PDF pp. 6–8","supports":"MVA = 220/PHT, good-quality transmitral Doppler requirements, linear versus bimodal deceleration-slope tracing, and rhythm averaging.","url":null},{"label":"Current severity ranges","locator":"Table 1 · PDF p. 6","supports":"MVA, PHT, mean gradient at heart rate 60–80 bpm, and systolic PA-pressure ranges for progressive and severe rheumatic MS.","url":null},{"label":"Limitations & integration","locator":"MS hemodynamic discussion · PDF pp. 5–7","supports":"Effects of compliance, LV diastolic pressure, AR, MR, LA fibrosis, subvalvular disease and recent PBMV, plus the requirement for multiparametric grading.","url":null}],"locator":"MS multiparametric approach pp. 5–7 · Table 1 and PHT method p. 6 · Figure 3 p. 7","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for the Use of Echocardiography in the Evaluation of Rheumatic Heart Disease","url":"https://www.asecho.org/wp-content/uploads/2025/04/PIIS0894731722005211.pdf","year":2023}},{"id":"mitral-continuity","name":"Mitral valve area · continuity","category":"Stenosis","guideURL":"https://echosuite.app/guides/mitral-continuity/","interactiveURL":"https://echosuite.app/calculators/#mitral-continuity","formula":"MVA = LVOT area × LVOT VTI ÷ MV VTI","fields":[{"id":"d","label":"LVOT 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dense envelope for the relevant phase.","Use the machine-reported VTI in centimeters."],"title":"Jet VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""}],"reference":{"evidence":[{"label":"Equation & paired acquisition","locator":"Continuity method · PDF p. 6","supports":"MVA from LVOT cross-sectional area times LVOT VTI divided by mitral VTI, with RVOT/pulmonic substitution when isolated AR is present.","url":null},{"label":"Method limitations","locator":"Continuity method · PDF pp. 6–7","supports":"Compounded measurement error, limited validation, infrequent use, and invalidity with important MR or AR when an appropriate competent reference is not used.","url":null},{"label":"Severity & clinical role","locator":"Table 1 p. 6 · alternative-method recommendation p. 7","supports":"Current MVA grades and use only as a corroborating method when planimetry, PHT, and mean gradient are inconclusive.","url":null}],"locator":"Continuity equation and exclusions p. 6 · alternative 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along the jet centerline."],"title":"PISA radius"},"visibility":null,"minimum":0,"maximum":10,"initial":""},{"id":"va","label":"Aliasing velocity","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Shifted color scale · absolute cm/s","steps":["Use the same color-Doppler frame used for the radius.","Read the Nyquist limit after baseline shift, not the jet velocity.","Enter the absolute displayed value in cm/s."],"title":"Aliasing velocity"},"visibility":null,"minimum":0,"maximum":200,"initial":""},{"id":"vmax","label":"Peak mitral velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""},{"id":"theta","label":"Funnel angle θ","unit":"degrees","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":180,"initial":""}],"reference":{"evidence":[{"label":"Equation & angle correction","locator":"PISA method · PDF pp. 6–7","supports":"Flow-convergence method, transmitral peak velocity, and angle correction for the nonhemispheric convergence of the funnel-shaped rheumatic valve.","url":null},{"label":"Method limitations","locator":"PISA method · PDF p. 7","supports":"Technical complexity, multiple measurements, geometric assumptions, and lack of recommendation for routine use.","url":null},{"label":"Severity & clinical role","locator":"Table 1 p. 6 · alternative-method recommendation p. 7","supports":"Current MVA grades and use only as a corroborating method when planimetry, PHT, and mean gradient are inconclusive.","url":null}],"locator":"PISA method and angle correction pp. 6–7 · Table 1 p. 6 · alternative-method recommendation p. 7","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for the Use of Echocardiography in the Evaluation of Rheumatic Heart Disease","url":"https://www.asecho.org/wp-content/uploads/2025/04/PIIS0894731722005211.pdf","year":2023}},{"id":"tricuspid-stenosis","name":"Tricuspid stenosis · significance","category":"Stenosis","guideURL":"https://echosuite.app/guides/tricuspid-stenosis/","interactiveURL":"https://echosuite.app/calculators/#tricuspid-stenosis","formula":"TS reference findings: mean ≥5, PHT ≥190, VTI ≥60, area ≤1","fields":[{"id":"mean","label":"Mean tricuspid gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":null,"minimum":0,"maximum":300,"initial":""},{"id":"pht","label":"Pressure half-time","unit":"ms","kind":"number","optional":false,"help":{"mode":"CW Doppler deceleration slope","steps":["Record a complete inflow or regurgitant CW envelope.","Trace the deceleration slope using the machine PHT tool.","Average representative beats and use additional beats in atrial fibrillation."],"title":"Pressure half-time"},"visibility":null,"minimum":0,"maximum":2000,"initial":""},{"id":"vti","label":"Tricuspid inflow VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"area","label":"Valve area","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":25,"initial":""}],"reference":{"evidence":[{"label":"PHT area estimate","locator":"EAE/ASE valve stenosis 2009 · JASE p. 19 · doi:10.1016/j.echo.2008.11.029","supports":"The historical 190/PHT estimate is displayed independently without grading or replacing entered valve area. Right-heart compliance, relaxation, respiration and TR limit this method; the guideline notes less validation than for mitral PHT.","url":null},{"label":"Acquisition","locator":"TS hemodynamic section · PDF p. 14","supports":"CW alignment, respiratory and heart-rate effects, and averaging at least five beats.","url":null},{"label":"Significant-range findings","locator":"TS hemodynamic section and key points · PDF p. 14","supports":"Mean gradient at least 5 mmHg, inflow VTI at least 60 cm, PHT at least 190 ms, and valve area at most 1.0 cm².","url":null},{"label":"Integration & limitations","locator":"TS key points and recommendations · PDF p. 14","supports":"Multiparametric severity assessment, right-atrial and pulmonary-pressure context, associated valve disease, and reduced reliability of PHT-derived area.","url":null}],"locator":"Rheumatic TS anatomy and hemodynamics pp. 13–14 · key points and recommendations p. 14","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for the Use of Echocardiography in the Evaluation of Rheumatic Heart Disease","url":"https://www.asecho.org/wp-content/uploads/2025/04/PIIS0894731722005211.pdf","year":2023}},{"id":"pulmonic-stenosis","name":"Pulmonic stenosis · peak gradient","category":"Stenosis","guideURL":"https://echosuite.app/guides/pulmonic-stenosis/","interactiveURL":"https://echosuite.app/calculators/#pulmonic-stenosis","formula":"Peak ΔP = 4Vmax²","fields":[{"id":"v","label":"Peak pulmonic velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""}],"reference":{"evidence":[{"label":"Peak-gradient severity bands","locator":"Table 11 · p. 20","supports":"Mild, moderate and severe valvular pulmonic stenosis bands are peak velocity <3, 3–4 and >4 m/s, respectively, with corresponding peak gradients <36, 36–64 and >64 mmHg.","url":null},{"label":"Acquisition","locator":"§V.B.1.1 · pressure-gradient acquisition, pp. 19–20","supports":"Peak gradient from the simplified Bernoulli equation applied to the highest well-aligned continuous-wave velocity across the pulmonic valve; interrogate multiple windows and exclude subvalvular or supravalvular obstruction before attributing the gradient to the valve.","url":null}],"locator":"§V.B.1.1 · pp. 19–20; Table 11 · p. 20","organization":"European Association of Echocardiography and American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice","url":"https://www.asecho.org/wp-content/uploads/2025/04/2009_Echo-Assessment-of-Valve-Stenosis_note_added.pdf","year":2009}},{"id":"ar-pisa","name":"Aortic regurgitation · PISA","category":"Regurgitation","guideURL":"https://echosuite.app/guides/ar-pisa/","interactiveURL":"https://echosuite.app/calculators/#ar-pisa","formula":"EROA = 2πr²Vₐ ÷ Vmax; RVol = EROA × VTI","fields":[{"id":"r","label":"PISA radius","unit":"cm","kind":"number","optional":false,"help":{"mode":"Color Doppler · peak-flow frame","steps":["Zoom on the valve and center the flow-convergence region.","Shift the color baseline until the shell is as hemispheric as possible.","Measure from the regurgitant orifice to the first aliasing boundary along the jet centerline."],"title":"PISA radius"},"visibility":null,"minimum":0,"maximum":10,"initial":""},{"id":"va","label":"Aliasing 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regurgitant-fraction bands, including the two moderate subgrades.","url":null},{"label":"Limitations & severity integration","locator":"AR section pp. 34–37 · integrative approach pp. 41–42","supports":"Far-field and calcification limitations, nonhemispheric or multiple-jet limitations, and integration with anatomy, vena contracta, aortic flow reversal, LV remodeling, hemodynamics, and data quality.","url":null}],"locator":"AR PISA and flow-convergence method pp. 34–39 · Table 10 pp. 35–37 · Table 11 p. 38 · Figure 21 p. 39 · integrative pathway pp. 41–42","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"ar-continuity","name":"Aortic regurgitation · 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VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"mvD","label":"Mitral annulus diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"mvVti","label":"Mitral annulus VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"jetVti","label":"AR jet VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Continuous-wave 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41–42","supports":"Four quantitative AR bands and the requirement to reconcile quantitative results with the complete anatomic, color, Doppler, and LV response assessment.","url":null}],"locator":"Quantitative flow method pp. 7–8 · AR Table 10 pp. 35–37 · Table 11 p. 38 · integrative pathway pp. 41–42","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"mr-pisa","name":"Mitral regurgitation · PISA","category":"Regurgitation","guideURL":"https://echosuite.app/guides/mr-pisa/","interactiveURL":"https://echosuite.app/calculators/#mr-pisa","formula":"EROA = 2πr²Vₐ ÷ Vmax; RVol = EROA × VTI","fields":[{"id":"r","label":"PISA 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as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""},{"id":"vti","label":"MR VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler trace","steps":["Use the same aligned CW recording as the peak velocity.","Trace the outer edge of the dense envelope for the relevant phase.","Use the machine-reported VTI in centimeters."],"title":"Jet VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"sv","label":"Total LV stroke volume","unit":"mL","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic 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Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"mr-continuity","name":"Mitral regurgitation · continuity","category":"Regurgitation","guideURL":"https://echosuite.app/guides/mr-continuity/","interactiveURL":"https://echosuite.app/calculators/#mr-continuity","formula":"RVol = mitral SV − LVOT SV","fields":[{"id":"lvotD","label":"LVOT diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique 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flow through the regurgitant valve and a competent reference site.","url":null},{"label":"MR application & pitfalls","locator":"Pages 22–25 · Table 7","supports":"Mitral and LVOT sampling requirements, accumulated measurement error, and exclusions when another important regurgitant lesion is present.","url":null},{"label":"Severity integration","locator":"Pages 29–30 · Table 8 and Figure 18","supports":"EROA, regurgitant volume and regurgitant fraction bands plus the integrative MR grading framework.","url":null}],"locator":"Quantitative flow pp. 7–8; MR Table 7 pp. 22–25; Table 8 and Figure 18 pp. 29–30","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"tr-pisa","name":"Tricuspid 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regurgitant orifice to the first aliasing boundary along the jet centerline."],"title":"PISA radius"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["pisa"]},"minimum":0,"maximum":10,"initial":""},{"id":"va","label":"Aliasing velocity","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Shifted color scale · absolute cm/s","steps":["Use the same color-Doppler frame used for the radius.","Read the Nyquist limit after baseline shift, not the jet velocity.","Enter the absolute displayed value in cm/s."],"title":"Aliasing velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["pisa"]},"minimum":0,"maximum":200,"initial":""},{"id":"vmax","label":"TR Vmax","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the 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hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["vc"]},"minimum":0,"maximum":5,"initial":""},{"id":"vcQuality","label":"Single jet, neck well resolved","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Yes","value":"yes"},{"label":"Limited / multiple jets","value":"limited"},{"label":"Not assessed","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["vc"]},"maximum":null,"initial":"unknown"}],"reference":{"evidence":[{"label":"PISA acquisition & limitations","locator":"Table 13 pp. 46–47 · TR quantitation pp. 48–50","supports":"Baseline shift, 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This tool explicitly follows the table's ≥0.7 endpoint; narrative/flowchart wording uses >0.7. Severe PISA radius and other findings support integration.","url":null},{"label":"Integrative interpretation","locator":"Figure 31 p. 50 · integrative discussion p. 51","supports":"Lower validation than MR or AR, no validated four-grade subdivision, and indeterminate classification when image quality, quantitative findings, or clinical data are discordant.","url":null}],"locator":"TR Table 13 pp. 46–47 · Table 14 p. 48 · Figures 30–31 pp. 49–50 · TR quantitation pp. 48–51","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"pulmonic-regurg","name":"Pulmonic regurgitation · continuity","category":"Regurgitation","guideURL":"https://echosuite.app/guides/pulmonic-regurg/","interactiveURL":"https://echosuite.app/calculators/#pulmonic-regurg","formula":"RVol = RVOT SV − LVOT SV; RF = RVol ÷ RVOT SV","fields":[{"id":"rvotD","label":"RVOT diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"rvotVti","label":"RVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"lvotD","label":"LVOT diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"lvotVti","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"pht","label":"PR pressure half-time","unit":"ms","kind":"number","optional":true,"help":{"mode":"CW Doppler deceleration slope","steps":["Record a complete inflow or regurgitant CW envelope.","Trace the deceleration slope using the machine PHT tool.","Average representative beats and use additional beats in atrial fibrillation."],"title":"Pressure half-time"},"visibility":null,"minimum":0,"maximum":2000,"initial":""}],"reference":{"evidence":[{"label":"Continuity calculation & acquisition","locator":"PR section pp. 52–55 · Table 15 pp. 52–53","supports":"RVOT stroke-volume acquisition, subtraction of competent reference flow, regurgitant-fraction calculation, and limitations from diameter, VTI, rhythm, shunts, and additional regurgitant lesions.","url":null},{"label":"Quantitative and severe-supportive findings","locator":"Table 16 · PDF p. 56","supports":"Regurgitant-fraction ranges, jet-width ratio, branch pulmonary-artery flow reversal, and pressure half-time shorter than 100 ms as a severe-supportive finding.","url":null},{"label":"Integration & limitations","locator":"Table 16 p. 56 · Figure 35 and integrative pathway p. 57","supports":"Limited echocardiographic validation of quantitative PR, load dependence of pressure half-time, RV remodeling, and indeterminate classification when findings or data quality are discordant.","url":null}],"locator":"PR acquisition and quantitation pp. 52–55 · Table 15 pp. 52–53 · Table 16 p. 56 · Figure 35 p. 57","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation","url":"https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf","year":2017}},{"id":"lap-ee","name":"Left atrial pressure · E/e′","category":"Filling pressures","guideURL":"https://echosuite.app/guides/lap-ee/","interactiveURL":"https://echosuite.app/calculators/#lap-ee","formula":"Average E/e′ = E ÷ [(septal e′ + lateral e′)/2]; 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JACC 1997;30:1527–1533 · PMID 9362412","supports":"The PCWP regression uses lateral annular e′ and does not directly measure pressure. The legacy E/e′ + 4 estimate remains separately labelled.","url":null}],"locator":"Table 3 · PDF p. 5; Figure 3 · PDF p. 18","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"lap-mr","name":"Left atrial pressure · MR velocity","category":"Filling pressures","guideURL":"https://echosuite.app/guides/lap-mr/","interactiveURL":"https://echosuite.app/calculators/#lap-mr","formula":"LAP = SBP − 4(MR Vmax)²","fields":[{"id":"sbp","label":"Systolic blood pressure","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Contemporaneous cuff or invasive value","steps":["Use a pressure obtained in the same hemodynamic state as the echo.","Confirm the value is entered in mmHg.","Do not mix values acquired under different loading conditions."],"title":"Pressure measurement"},"visibility":null,"minimum":0,"maximum":300,"initial":""},{"id":"mrv","label":"MR Vmax","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""}],"reference":{"evidence":[{"label":"Equation and selected-patient validation","locator":"Gorcsan et al. 1991 · abstract and pp. 858–863","supports":"Peak brachial SBP minus 4 × peak MR velocity squared; distinct envelopes in 35 of 46 patients, compared with simultaneous mean wedge pressure. This is an estimate, not a grading threshold.","url":null},{"label":"Gradient foundation","locator":"Nishimura & Tajik · JACC 1988;11:317–321 · PMID 3339169","supports":"Simultaneous dual-catheter and Doppler validation of left-sided regurgitant pressure gradients.","url":null},{"label":"MR signal interpretation","locator":"ASE 2017 native regurgitation · journal p. 330 · Continuous Wave Doppler","supports":"MR velocity reflects the LV–LA pressure difference; peak velocity alone does not quantify regurgitant severity.","url":null}],"locator":"Am Heart J 121:858–863 · PMID 2000753","organization":"Gorcsan, Snow, Paulsen & Nixon · American Heart Journal","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Noninvasive estimation of left atrial pressure in patients with congestive heart failure and mitral regurgitation by Doppler echocardiography","url":"https://pubmed.ncbi.nlm.nih.gov/2000753/","year":1991}},{"id":"la-size","name":"LA size · volume index","category":"Filling pressures","guideURL":"https://echosuite.app/guides/la-size/","interactiveURL":"https://echosuite.app/calculators/#la-size","formula":"LAVi = biplane LA volume ÷ BSA","fields":[{"id":"volume","label":"Biplane LA volume","unit":"mL","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":1500,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. 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branch.","url":null}],"locator":"Section 13 · PDF pp. 18–19","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"diastolic-ph","name":"Pulmonary hypertension","category":"Filling pressures","guideURL":"https://echosuite.app/guides/diastolic-ph/","interactiveURL":"https://echosuite.app/calculators/#diastolic-ph","formula":"2025 ASE Figure 6 · E/A first, then LARS; lateral E/e′ if LARS unavailable","fields":[{"id":"ea","label":"Mitral E/A ratio","unit":"","kind":"number","optional":false,"help":{"mode":"PW Doppler at the mitral leaflet tips","steps":["Place the PW sample between the mitral leaflet tips.","Record at end-expiration with a clear E and A wave.","Measure the requested peaks or trace 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limitation of diastolic indices for graft-rejection diagnosis.","url":null}],"locator":"Table 7 p. 20 · Figure 5 p. 23","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"diastolic-lvad","name":"LV assist device","category":"Filling pressures","guideURL":"https://echosuite.app/guides/diastolic-lvad/","interactiveURL":"https://echosuite.app/calculators/#diastolic-lvad","formula":"2025 ASE Table 7 · Doppler, right-heart pressure and interatrial septal position","fields":[{"id":"ea","label":"Mitral E/A ratio","unit":"","kind":"number","optional":false,"help":{"mode":"PW Doppler at the mitral leaflet tips","steps":["Place the PW sample between the mitral leaflet tips.","Record at end-expiration 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20","supports":"E/A, RAP, PASP, E/e′, LAVi, and interatrial-septal position relationships.","url":null}],"locator":"Table 7 · PDF p. 20","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"fractional-shortening","name":"Fractional shortening","category":"Ventricular function","guideURL":"https://echosuite.app/guides/fractional-shortening/","interactiveURL":"https://echosuite.app/calculators/#fractional-shortening","formula":"FS = (LVIDd − LVIDs) ÷ LVIDd × 100","fields":[{"id":"lvidd","label":"LVIDd · end-diastole","unit":"mm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"lvids","label":"LVIDs · end-systole","unit":"mm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Linear shortening and acquisition","locator":"§1.1 · §2–2.2, pp. 6–7","supports":"Matched end-diastolic and end-systolic linear dimensions, phase definitions, and limitations with regional dysfunction or conduction abnormalities. Fractional shortening is distinct from volume-derived EF; no severity thresholds are applied.","url":null}],"locator":"§1.1 Linear measurements · §2–2.2, pp. 6–7","organization":"ASE / EACVI","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults","url":"https://www.asecho.org/wp-content/uploads/2025/04/2015_ChamberQuantificationREV.pdf","year":2015}},{"id":"lv-linear","name":"LV linear dimensions","category":"Ventricular function","guideURL":"https://echosuite.app/guides/lv-linear/","interactiveURL":"https://echosuite.app/calculators/#lv-linear","formula":"Indexed diameter = LVID ÷ BSA","fields":[{"id":"method","label":"Phase","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"End-diastole","value":"diastolicDiameter"},{"label":"End-systole","value":"systolicDiameter"}],"visibility":null,"maximum":null,"initial":"diastolicDiameter"},{"id":"diameter","label":"LV internal diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":4,"initial":""},{"id":"sex","label":"Reference sex","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Men","value":"men"},{"label":"Women","value":"women"}],"visibility":null,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Acquisition and interpretation","locator":"LV linear measurements §1.1; Supplemental Table 3","supports":"Method-specific acquisition and reference context. Arithmetic uses entered measurements; clinical interpretation remains subject to image quality and study context.","url":null}],"locator":"LV linear measurements §1.1; Supplemental Table 3","organization":"ASE / EACVI","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Cardiac Chamber Quantification in Adults","url":"https://www.asecho.org/wp-content/uploads/2025/04/2015_ChamberQuantificationREV.pdf","year":2015}},{"id":"lv-mass","name":"Wall thickness & mass","category":"Ventricular function","guideURL":"https://echosuite.app/guides/lv-mass/","interactiveURL":"https://echosuite.app/calculators/#lv-mass","formula":"LV mass = 0.8 × 1.04 × [(IVSd + LVIDd + PWd)³ − LVIDd³] + 0.6 g","fields":[{"id":"lvidd","label":"LVIDd","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"pwd","label":"PWd","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"ivsd","label":"IVSd","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":true,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":0,"maximum":4,"initial":""},{"id":"sex","label":"Reference sex","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Men","value":"men"},{"label":"Women","value":"women"}],"visibility":null,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Linear mass acquisition and calculation","locator":"ASE/EACVI 2015 · §4; ASE 2019 · p. 31 · V.A.1","supports":"IVSd, LVIDd and PWd at the same end-diastolic PLAX level, perpendicular to the LV long axis. The cube formula uses centimetres; index mass to BSA when available.","url":null},{"label":"Sex-specific wall thickness and mass","locator":"ASE/EACVI 2015 · Supplemental Table 3 · p. 39.e8","supports":"Separate men’s and women’s normal, mild, moderate and severe partitions for IVSd, PWd, linear-method LV mass and LV mass/BSA. These mass partitions are specific to the linear method.","url":null}],"locator":"Linear LV mass: §4. Sex-specific wall thickness and linear-method mass partitions: Supplemental Table 3, p. 39.e8. Technique: ASE 2019 Comprehensive TTE p. 31, V.A.1.","organization":"American Society of Echocardiography / EACVI","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults","url":"https://www.asecho.org/wp-content/uploads/2025/04/2015_ChamberQuantificationREV.pdf","year":2015}},{"id":"lv-volume-index","name":"LV volumes","category":"Ventricular function","guideURL":"https://echosuite.app/guides/lv-volume-index/","interactiveURL":"https://echosuite.app/calculators/#lv-volume-index","formula":"EDVi = EDV ÷ BSA · ESVi = ESV ÷ BSA","fields":[{"id":"method","label":"Volume method","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"2D biplane","value":"2d"},{"label":"Measured 3D","value":"3d"}],"visibility":null,"maximum":null,"initial":"2d"},{"id":"edv","label":"End-diastolic volume","unit":"mL","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":1500,"initial":""},{"id":"esv","label":"End-systolic volume","unit":"mL","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":1500,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":true,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":0,"maximum":4,"initial":""},{"id":"sex","label":"Reference sex","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Men","value":"men"},{"label":"Women","value":"women"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["2d"]},"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Biplane volume acquisition","locator":"ASE/EACVI 2015 · §1.2; ASE 2019 · p. 32 · V.C.1","supports":"Trace the compacted interface in LV-focused A4C and A2C at end-diastole and end-systole; avoid foreshortening and include papillary muscles and trabeculations in the cavity. Volumes and EF are not derived from linear dimensions.","url":null},{"label":"Sex-specific 2D volume partitions","locator":"ASE/EACVI 2015 · Supplemental Table 3 · p. 39.e8","supports":"Separate men's and women's normal, mild, moderate and severe bands for EDV, EDV/BSA, ESV and ESV/BSA. These 2D biplane volume partitions do not apply to 3D volumes.","url":null},{"label":"Biplane EF reference range","locator":"ASE/EACVI 2015 · Table 2 · p. 7","supports":"Biplane LVEF reference range 52–72% in men and 54–74% in women. The calculator reports EF without adding a mild–severe EF ladder.","url":null}],"locator":"2D volume partitions: Supplemental Table 3, p. 39.e8. Biplane acquisition: §1.2. Normal EF ranges: Table 2, p. 7. 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echo mPAP limitations and invasive confirmation requirements.","url":null},{"label":"Mean TR-gradient method · Aduen 2009","locator":"JASE 22:814–819 · doi:10.1016/j.echo.2009.04.007","supports":"Mean RV–RA systolic gradient plus RAP, compared with catheter-derived mean PA pressure. Trace the systolic TR envelope; peak-gradient arithmetic is a different method.","url":"https://pubmed.ncbi.nlm.nih.gov/19505794/"}],"locator":"Table 4 JASE pp. 161–163 · PAEDP pp. 165–166 · mPAP p. 166","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension","url":"https://www.asecho.org/wp-content/uploads/2026/08/ASE-Right-Heart-Guidelines-May-2025.pdf","year":2025}},{"id":"mpap-rvot","name":"Mean PA pressure · RVOT acceleration time","category":"Right heart & PA","guideURL":"https://echosuite.app/guides/mpap-rvot/","interactiveURL":"https://echosuite.app/calculators/#mpap-rvot","formula":"mPAP = 79 − 0.45 × RVOT AcT; if AcT <120 ms, also 90 − 0.62 × AcT","fields":[{"id":"act","label":"RVOT acceleration time","unit":"ms","kind":"number","optional":false,"help":{"mode":"PW Doppler just below the pulmonary valve","steps":["From the PA-bifurcation PSAX view, place a 1–2 mm PW sample in the distal RVOT just beneath the pulmonary valve.","Optimize scale, baseline, wall filter, and beam alignment so the entire systolic envelope is visible.","Trace the modal envelope for VTI; measure acceleration time from flow onset to peak velocity and interpret cautiously when heart rate is <60 or >100 bpm."],"title":"RVOT Doppler"},"visibility":null,"minimum":0,"maximum":2000,"initial":""},{"id":"hr","label":"Heart rate","unit":"bpm","kind":"number","optional":false,"help":{"mode":"Spectral Doppler timing","steps":["Use a sweep speed that clearly shows the interval boundaries.","Measure from the specified onset to offset.","Average representative beats using consistent rhythm handling."],"title":"Time interval"},"visibility":null,"minimum":0,"maximum":300,"initial":""}],"reference":{"evidence":[{"label":"Acquisition and heart-rate limitation","locator":"RVOT VTI and AcT · JASE pp. 158–159","supports":"Distal RVOT sample placement, onset-to-peak timing, >105-ms normal reference, and reduced reliability below 60 or above 100 bpm.","url":null},{"label":"Empirical equations","locator":"Table 4 · JASE pp. 161–163; mPAP p. 166","supports":"The 79−0.45×AccT equation and the alternate 90−0.62×AccT equation when AccT is below 120 ms.","url":null}],"locator":"Table 1 JASE p. 145 · RVOT AcT pp. 158–159 · Table 4 / mPAP p. 166","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension","url":"https://www.asecho.org/wp-content/uploads/2026/08/ASE-Right-Heart-Guidelines-May-2025.pdf","year":2025}},{"id":"pvr","name":"Pulmonary vascular resistance","category":"Right heart & PA","guideURL":"https://echosuite.app/guides/pvr/","interactiveURL":"https://echosuite.app/calculators/#pvr","formula":"PVR = 10 × TR Vmax ÷ RVOT VTI + 0.16","fields":[{"id":"trv","label":"TR Vmax","unit":"m/s","kind":"number","optional":false,"help":{"mode":"CW Doppler through the TR jet","steps":["Search RV inflow, apical four-chamber, and subcostal windows; use the highest well-aligned signal.","Trace the dense primary edge (‘chin’), not faint overgained noise, and reject truncated triangular envelopes when estimating pressure.","Average three representative beats; in atrial fibrillation average 5–10 beats and exclude post-pause or post-ectopic velocities."],"title":"TR velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""},{"id":"rvot","label":"RVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"PW Doppler just below the pulmonary valve","steps":["From the PA-bifurcation PSAX view, place a 1–2 mm PW sample in the distal RVOT just beneath the pulmonary valve.","Optimize scale, baseline, wall filter, and beam alignment so the entire systolic envelope is visible.","Trace the modal envelope for VTI; measure acceleration time from flow onset to peak velocity and interpret cautiously when heart rate is <60 or >100 bpm."],"title":"RVOT Doppler"},"visibility":null,"minimum":0,"maximum":400,"initial":""}],"reference":{"evidence":[{"label":"Equation and thresholds","locator":"PVR section and key points · JASE p. 167","supports":"The Abbas equation, normal PVR below 1.5 WU, and abnormal PVR above 2.0 WU.","url":null},{"label":"Clinical limitations","locator":"PVR recommendations · JASE p. 167","supports":"Unreliability above 8 WU, nonroutine-use recommendation, and the requirement not to substitute echo PVR for invasive hemodynamics.","url":null}],"locator":"Pulmonary Vascular Resistance section · JASE p. 167","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension","url":"https://www.asecho.org/wp-content/uploads/2026/08/ASE-Right-Heart-Guidelines-May-2025.pdf","year":2025}},{"id":"mpi","name":"RV myocardial performance index","category":"Right heart & PA","guideURL":"https://echosuite.app/guides/mpi/","interactiveURL":"https://echosuite.app/calculators/#mpi","formula":"PW: RV MPI = (TCO − ET) ÷ ET; TDI: RV MPI = (IVCT + IVRT) ÷ ET","fields":[{"id":"method","label":"Method","unit":"","kind":"selection","optional":false,"help":{"mode":"PW Doppler or tissue Doppler · method specific","steps":["Choose the same method used for the reference range: PW Doppler or lateral-tricuspid-annular tissue Doppler.","For PW Doppler, pair tricuspid closure-to-opening time with RVOT ejection time from beats having similar R–R intervals.","For tissue Doppler, measure IVCT, ejection time, and IVRT from the same lateral-annular beat; report the method with the result."],"title":"RV myocardial performance index"},"options":[{"label":"Pulsed-wave Doppler","value":"pw"},{"label":"Tissue Doppler","value":"tdi"}],"visibility":null,"maximum":null,"initial":"pw"},{"id":"tco","label":"Tricuspid closure-to-opening time","unit":"ms","kind":"number","optional":false,"help":{"mode":"PW Doppler or tissue Doppler · method specific","steps":["Choose the same method used for the reference range: PW Doppler or lateral-tricuspid-annular tissue Doppler.","For PW Doppler, pair tricuspid closure-to-opening time with RVOT ejection time from beats having similar R–R intervals.","For tissue Doppler, measure IVCT, ejection time, and IVRT from the same lateral-annular beat; report the method with the result."],"title":"RV myocardial performance index"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["pw"]},"minimum":0,"maximum":2000,"initial":""},{"id":"ivct","label":"Isovolumic contraction time","unit":"ms","kind":"number","optional":false,"help":{"mode":"PW Doppler or tissue Doppler · method specific","steps":["Choose the same method used for the reference range: PW Doppler or lateral-tricuspid-annular tissue Doppler.","For PW Doppler, pair tricuspid closure-to-opening time with RVOT ejection time from beats having similar R–R intervals.","For tissue Doppler, measure IVCT, ejection time, and IVRT from the same lateral-annular beat; report the method with the result."],"title":"RV myocardial performance index"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["tdi"]},"minimum":0,"maximum":2000,"initial":""},{"id":"ivrt","label":"Isovolumic relaxation time","unit":"ms","kind":"number","optional":false,"help":{"mode":"PW Doppler or tissue Doppler · method specific","steps":["Choose the same method used for the reference range: PW Doppler or lateral-tricuspid-annular tissue Doppler.","For PW Doppler, pair tricuspid closure-to-opening time with RVOT ejection time from beats having similar R–R intervals.","For tissue Doppler, measure IVCT, ejection time, and IVRT from the same lateral-annular beat; report the method with the result."],"title":"RV myocardial performance index"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["tdi"]},"minimum":0,"maximum":2000,"initial":""},{"id":"et","label":"Ejection time","unit":"ms","kind":"number","optional":false,"help":{"mode":"PW Doppler or tissue Doppler · method specific","steps":["Choose the same method used for the reference range: PW Doppler or lateral-tricuspid-annular tissue Doppler.","For PW Doppler, pair tricuspid closure-to-opening time with RVOT ejection time from beats having similar R–R intervals.","For tissue Doppler, measure IVCT, ejection time, and IVRT from the same lateral-annular beat; report the method with the result."],"title":"RV myocardial performance index"},"visibility":null,"minimum":0,"maximum":2000,"initial":""}],"reference":{"evidence":[{"label":"Method-specific calculation","locator":"Table 3 and RV MPI section · PDF pp. 15–17","supports":"PW and tissue-Doppler acquisition, interval definitions, R–R matching, and the RV MPI equations.","url":null},{"label":"Method-specific grades and limitations","locator":"Table 1 p. 4 · RV MPI key points p. 18","supports":"Separate PW and tissue-Doppler reference bands plus load, rhythm, and intermethod limitations.","url":null}],"locator":"Table 1 p. 4 · Table 3 and RV MPI section pp. 15–18","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension","url":"https://www.asecho.org/wp-content/uploads/2026/08/ASE-Right-Heart-Guidelines-May-2025.pdf","year":2025}},{"id":"effusion-size","name":"Pericardial effusion · size","category":"Pericardium","guideURL":"https://echosuite.app/guides/effusion-size/","interactiveURL":"https://echosuite.app/calculators/#effusion-size","formula":"Maximum echo-free separation at end-diastole (mm)","fields":[{"id":"separation","label":"Maximum end-diastolic separation","unit":"mm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.1,"maximum":100,"initial":""}],"reference":{"evidence":[{"label":"Method and interpretation","locator":"Section 5.5 and Table 10 · Classification of pericardial effusion","supports":"Largest end-diastolic echo-free separation: small <10 mm, moderate 10–20 mm, large >20 mm; evaluate distribution and hemodynamic findings separately.","url":null}],"locator":"Section 5.5 and Table 10 · Classification of pericardial effusion","organization":"European Society of Cardiology","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"2025 ESC Guidelines for the Management of Myocarditis and Pericarditis","url":"https://academic.oup.com/eurheartj/article/46/40/3952/8234483","year":2025}},{"id":"mitral-respiratory","name":"Mitral inflow · respiratory variation","category":"Pericardium","guideURL":"https://echosuite.app/guides/mitral-respiratory/","interactiveURL":"https://echosuite.app/calculators/#mitral-respiratory","formula":"Inspiratory fall = (Eₑ − Eᵢ) / Eₑ × 100","fields":[{"id":"expiration","label":"Expiratory Eₑ","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":500,"initial":""},{"id":"inspiration","label":"Inspiratory Eᵢ","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":500,"initial":""}],"reference":{"evidence":[{"label":"Method and interpretation","locator":"Tamponade pp. 988–991, Figures 36–37; constriction pp. 993–995, Figures A20/A24","supports":"Expiration-denominator variation: mitral >25% / tricuspid >40% for constriction, versus >30% / >60% in tamponade; integrate the complete examination.","url":null}],"locator":"Tamponade pp. 988–991, Figures 36–37; constriction pp. 993–995, Figures A20/A24","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Clinical Recommendations for Multimodality Cardiovascular Imaging of Patients with Pericardial Disease","url":"https://www.asecho.org/wp-content/uploads/2025/04/2013_Multimodality-CV-Imaging-for-Pericardial-Disease.pdf","year":2013}},{"id":"tricuspid-respiratory","name":"Tricuspid inflow · respiratory variation","category":"Pericardium","guideURL":"https://echosuite.app/guides/tricuspid-respiratory/","interactiveURL":"https://echosuite.app/calculators/#tricuspid-respiratory","formula":"Inspiratory rise = (Eᵢ − Eₑ) / Eₑ × 100","fields":[{"id":"expiration","label":"Expiratory Eₑ","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":500,"initial":""},{"id":"inspiration","label":"Inspiratory Eᵢ","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":500,"initial":""}],"reference":{"evidence":[{"label":"Method and interpretation","locator":"Tamponade pp. 988–991, Figures 36–37; 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Doppler flow recordings pp. 988–991","supports":"Inspiratory LVOT velocity reduction and respiratory changes in ejection; no standalone numerical cutoff is assigned here.","url":null}],"locator":"Figure 38, journal p. 990; Doppler flow recordings pp. 988–991","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Clinical Recommendations for Multimodality Cardiovascular Imaging of Patients with Pericardial Disease","url":"https://www.asecho.org/wp-content/uploads/2025/04/2013_Multimodality-CV-Imaging-for-Pericardial-Disease.pdf","year":2013}},{"id":"hepatic-expiratory-reversal","name":"Hepatic vein · expiratory reversal","category":"Pericardium","guideURL":"https://echosuite.app/guides/hepatic-expiratory-reversal/","interactiveURL":"https://echosuite.app/calculators/#hepatic-expiratory-reversal","formula":"Reversal ratio = expiratory diastolic reverse velocity / expiratory diastolic forward velocity","fields":[{"id":"reverse","label":"Expiratory Dᵣ reversal","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":500,"initial":""},{"id":"forward","label":"Expiratory D forward","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":500,"initial":""}],"reference":{"evidence":[{"label":"Method and interpretation","locator":"Section F · Pericardial Constriction, journal pp. 561–562; Figure 7","supports":"Expiratory hepatic diastolic reversal / forward ratio ≥0.8 and the reversed medial/lateral e′ relationship as supportive constrictive findings.","url":null}],"locator":"Section F · Pericardial Constriction, journal pp. 561–562; Figure 7","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"annulus-reversus","name":"Annulus reversus · medial / lateral e′","category":"Pericardium","guideURL":"https://echosuite.app/guides/annulus-reversus/","interactiveURL":"https://echosuite.app/calculators/#annulus-reversus","formula":"Annular e′ ratio = medial e′ / lateral e′","fields":[{"id":"medial","label":"Medial e′","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":50,"initial":""},{"id":"lateral","label":"Lateral e′","unit":"cm/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0.01,"maximum":50,"initial":""}],"reference":{"evidence":[{"label":"Method and interpretation","locator":"Section F · Pericardial Constriction, journal pp. 561–562; Figure 7","supports":"Expiratory hepatic diastolic reversal / forward ratio ≥0.8 and the reversed medial/lateral e′ relationship as supportive constrictive findings.","url":null}],"locator":"Section F · Pericardial Constriction, journal pp. 561–562; Figure 7","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis","url":"https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf","year":2025}},{"id":"qpqs","name":"Qp/Qs · Doppler stroke volumes","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/qpqs/","interactiveURL":"https://echosuite.app/calculators/#qpqs","formula":"Qp/Qs = (RVOT CSA × RVOT VTI) ÷ (LVOT CSA × LVOT VTI)","fields":[{"id":"pd","label":"RVOT maximal-systolic diameter at PW site","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"rvot","label":"RVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"ad","label":"LVOT maximal-systolic diameter at PW site","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"lvot","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""}],"reference":{"evidence":[{"label":"Pulmonary-to-systemic flow ratio","locator":"pp. 929–930 · Doppler shunt quantification","supports":"Each outflow stroke volume is its cross-sectional area times matched systolic VTI. Qp/Qs is RV outflow stroke volume divided by LV outflow stroke volume. Circular-area assumptions and semilunar regurgitation limit the estimate.","url":null},{"label":"Adult shunt context · AHA/ACC 2025","locator":"ACHD guideline · §4.1 / Table 25","supports":"A Qp/Qs of at least 1.5 is interpreted with chamber loading, PVR and the full congenital assessment. The app’s greater-than-2 interval is a flow-reporting descriptor, not a universal defect severity or closure rule.","url":"https://doi.org/10.1161/CIR.0000000000001402"}],"locator":"Pulsed Doppler shunt-flow quantification · pp. 929–930","organization":"ASE / SCAI","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Echocardiographic assessment of atrial septal defect and patent foramen ovale","url":"https://www.asecho.org/wp-content/uploads/2025/04/2015_ASD-PFO.pdf","year":2015}},{"id":"asd","name":"ASD · anatomy, shunt & Doppler","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/asd/","interactiveURL":"https://echosuite.app/calculators/#asd","formula":"Qp/Qs = (Dpulmonary² × VTIpulmonary) / (DLVOT² × VTILVOT); atrial mean ΔP is directly traced","fields":[{"id":"method","label":"Clinical question","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Shunt flow · Qp/Qs","value":"flow"},{"label":"Atrial Doppler mean","value":"mean"}],"visibility":null,"maximum":null,"initial":"flow"},{"id":"pd","label":"RVOT diameter at the PW sample","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["flow"]},"minimum":0.01,"maximum":8,"initial":""},{"id":"rvot","label":"RVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["flow"]},"minimum":0.01,"maximum":150,"initial":""},{"id":"ad","label":"LVOT diameter at the PW sample","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["flow"]},"minimum":0.01,"maximum":8,"initial":""},{"id":"lvot","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["flow"]},"minimum":0.01,"maximum":150,"initial":""},{"id":"context","label":"Atrial physiology","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Not established","value":"unknown"},{"label":"Isolated ASD","value":"isolated"},{"label":"Complex CHD / atrial egress","value":"complex"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["mean"]},"maximum":null,"initial":"unknown"},{"id":"mean","label":"Traced atrial mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["mean"]},"minimum":0,"maximum":50,"initial":""}],"reference":{"evidence":[{"label":"Anatomy and acquisition","locator":"Silvestry et al. JASE 2015;28:910–958 · pp. 912–916, 924–930 · doi:10.1016/j.echo.2015.05.015","supports":"Defect morphology, surrounding structures and outflow stroke-volume ratio. Subcostal orthogonal imaging helps avoid apical dropout; significant semilunar regurgitation limits flow estimation.","url":null},{"label":"Current pediatric imaging","locator":"Lopez et al. JASE 2024;37:119–170 · p. 142 · doi:10.1016/j.echo.2023.11.015","supports":"Subcostal/right parasternal septal imaging, full-cycle PW direction, orthogonal size/rims and relationships to veins and AV valves.","url":null},{"label":"Context for the 1.5 reference","locator":"2025 ACHD guideline §4.1.1 · doi:10.1016/j.jacc.2025.09.006; 2026 ACC pediatric shunt guidance · doi:10.1016/j.jacc.2025.11.020","supports":"Shunt ratio is interpreted with right-heart enlargement and population-specific hemodynamics. This tool does not implement closure eligibility or a PVR estimate.","url":null},{"label":"Restriction is lesion-specific","locator":"Atrial septal defect morphology and stenting in HLHS after hybrid palliation, 2017 · PMID 28889828","supports":"A selected HLHS cohort combined Doppler gradient and clinical signs. It does not validate universal mild/moderate/severe bands for all ASDs; none are applied here.","url":null}],"locator":"ASE/SCAI 2015 pp. 912–916, 924–930, 932–935 · ASE pediatric TTE 2024 p. 142 · ACC pediatric guidance 2026","organization":"ASE / SCAI · ACC / AHA","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"ASD anatomy, Doppler flow and integrated assessment","url":"https://doi.org/10.1016/j.echo.2015.05.015","year":2026}},{"id":"vsd-pressure","name":"VSD · size & right-heart pressure","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/vsd-pressure/","interactiveURL":"https://echosuite.app/calculators/#vsd-pressure","formula":"RVSP = SBP − 4V²; RVEDP = LVEDP − 4Ved²; relative size = VSD / AoV","fields":[{"id":"method","label":"Clinical question","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"RV systolic pressure","value":"systolic"},{"label":"RV end-diastolic pressure","value":"diastolic"},{"label":"Anatomical size","value":"size"}],"visibility":null,"maximum":null,"initial":"systolic"},{"id":"sbp","label":"Systolic blood pressure","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Contemporaneous cuff or invasive value","steps":["Use a pressure obtained in the same hemodynamic state as the echo.","Confirm the value is entered in mmHg.","Do not mix values acquired under different loading conditions."],"title":"Pressure measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["systolic"]},"minimum":0.01,"maximum":300,"initial":""},{"id":"v","label":"Peak VSD velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["systolic"]},"minimum":0.01,"maximum":10,"initial":""},{"id":"lvedp","label":"Independent LVEDP","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Contemporaneous cuff or invasive value","steps":["Use a pressure obtained in the same hemodynamic state as the echo.","Confirm the value is entered in mmHg.","Do not mix values acquired under different loading conditions."],"title":"Pressure measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["diastolic"]},"minimum":0.01,"maximum":100,"initial":""},{"id":"vd","label":"End-diastolic VSD velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["diastolic"]},"minimum":0.01,"maximum":10,"initial":""},{"id":"defect","label":"Largest VSD dimension","unit":"mm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["size"]},"minimum":0.01,"maximum":100,"initial":""},{"id":"aov","label":"Aortic annulus diameter","unit":"mm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["size"]},"minimum":0.01,"maximum":100,"initial":""}],"reference":{"evidence":[{"label":"Anatomy, shunt and chamber response","locator":"Budts et al. 2021 · VSD sections, Figures 6–7","supports":"Multiple windows and colour sweeps define location, borders, number, shunt direction and associated lesions; CMR can quantify Qp/Qs and ventricular volumes.","url":null},{"label":"Systolic pressure estimate","locator":"Noninvasive evaluation of RV and PA systolic pressures · simultaneous Doppler/catheter study · PMID 8465730","supports":"Cuff systolic pressure minus the VSD Doppler gradient estimates RV systolic pressure in the appropriate setting. Pressure is not a defect-size grade.","url":null},{"label":"Sloped CW limitation","locator":"Schamberger et al. JASE 2001;14:1197–1202 · doi:10.1067/mje.2001.116351","supports":"In sloped spectra, peak instantaneous gradient may exceed the peak-to-peak difference and underestimate right-sided systolic pressures.","url":null},{"label":"Anatomical reference bands","locator":"User-supplied VSD pocket reference, page 13 · retained teaching convention","supports":"VSD/AoV <⅓, ⅓–½ and >½. Other references use different boundaries; these bands are labelled and do not produce a universal severity grade.","url":null},{"label":"Published use of the size convention","locator":"Edraki et al. 2022 · pmVSD closure protocol · p. 2 · doi:10.1186/s12872-022-02757-9","supports":"A retrospective perimembranous-VSD closure cohort of 146 patients under 18 used the same annular fractions. This documents a population-specific convention, not a universal VSD severity scale or closure criterion.","url":null},{"label":"End-diastolic method","locator":"Existing VSD method · instantaneous simplified Bernoulli pressure balance","supports":"Requires independent LVEDP and the same end-diastolic timing. No guideline grading threshold or validation claim is attached to this retained method.","url":null}],"locator":"VSD anatomy and imaging · pp. e61–e64 · doi:10.1093/ehjci/jeaa314","organization":"EACVI / ESC / AEPC · primary Doppler studies","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Imaging the adult with simple shunt lesions","url":"https://doi.org/10.1093/ehjci/jeaa314","year":2021}},{"id":"pda-pressure","name":"PDA · shunt & PA pressure","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/pda-pressure/","interactiveURL":"https://echosuite.app/calculators/#pda-pressure","formula":"Systolic ΔP = 4Vsys²; estimated PASP = SBP − ΔP; estimated mPAP = MAP − complete-cycle mean ΔP","fields":[{"id":"method","label":"Clinical question","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"PA systolic pressure","value":"systolic"},{"label":"Mean PA pressure","value":"mean"},{"label":"Ductal gradient only","value":"gradient"}],"visibility":null,"maximum":null,"initial":"systolic"},{"id":"direction","label":"Observed ductal flow","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Not established","value":"unknown"},{"label":"All left → right","value":"lr"},{"label":"Bidirectional","value":"bi"},{"label":"All right → left","value":"rl"}],"visibility":null,"maximum":null,"initial":"unknown"},{"id":"v","label":"Peak systolic PDA velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["gradient","systolic"]},"minimum":0.01,"maximum":10,"initial":""},{"id":"sbp","label":"Systolic blood pressure","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Contemporaneous cuff or invasive value","steps":["Use a pressure obtained in the same hemodynamic state as the echo.","Confirm the value is entered in mmHg.","Do not mix values acquired under different loading conditions."],"title":"Pressure measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["systolic"]},"minimum":0.01,"maximum":300,"initial":""},{"id":"mean","label":"Complete-cycle mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["mean"]},"minimum":0,"maximum":250,"initial":""},{"id":"map","label":"Mean arterial pressure","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Contemporaneous cuff or invasive value","steps":["Use a pressure obtained in the same hemodynamic state as the echo.","Confirm the value is entered in mmHg.","Do not mix values acquired under different loading conditions."],"title":"Pressure measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["mean"]},"minimum":0.01,"maximum":250,"initial":""}],"reference":{"evidence":[{"label":"Locate the duct and record the whole cycle","locator":"Lopez et al. JASE 2024;37:119–170 · pp. 162–163 · doi:10.1016/j.echo.2023.11.015","supports":"High parasternal sagittal and suprasternal color sweeps; assess restriction and direction throughout the cycle. Abdominal holodiastolic reversal has other causes.","url":null},{"label":"Conditional pressure estimates","locator":"Musewe et al. Circulation 1987;76:1081–1091 · PMID 2959394; Lu et al. 1991 · PMID 1806337","supports":"Small simultaneous Doppler/catheter studies support systolic and mean estimates in appropriate PDA flow. Right-to-left velocity did not correlate with pressure in the Musewe series; this tool restricts subtraction to continuous left-to-right flow.","url":null},{"label":"Geometry and timing limitations","locator":"Duct-geometry study 1987 · PMID 3329223; Spach et al. Circulation 1980;61:110–122 · doi:10.1161/01.CIR.61.1.110","supports":"Duct configuration can distort Bernoulli estimates; instantaneous pressure separation and shunt direction change during the cardiac cycle.","url":null},{"label":"Hemodynamic significance is multiparametric","locator":"ASE targeted neonatal echo 2024 · pp. 185–188, Table 5 p. 197 · doi:10.1016/j.echo.2023.11.016; 2025 ACHD guideline §4.1.5 · doi:10.1016/j.jacc.2025.09.006","supports":"Assess chamber/flow response and systemic runoff in their population context. Adult decisions incorporate net shunt, LV effects and PVR; no automated significance, PAH grade or closure recommendation is supplied.","url":null}],"locator":"ASE pediatric TTE 2024 pp. 162–163 · TNE 2024 pp. 185–188, Table 5 · Musewe et al. 1987","organization":"ASE · AHA / ACC · primary Doppler studies","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"PDA acquisition, pressure estimation and whole-shunt assessment","url":"https://doi.org/10.1016/j.echo.2023.11.015","year":2025}},{"id":"coarctation","name":"Coarctation · anatomy & gradients","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/coarctation/","interactiveURL":"https://echosuite.app/calculators/#coarctation","formula":"Peak ΔP = 4V₂²; corrected peak ΔP = 4(V₂² − V₁²); mean from systolic CW trace","fields":[{"id":"method","label":"Available measurement","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Corrected peak","value":"corrected"},{"label":"Peak only","value":"peak"},{"label":"Traced mean","value":"mean"}],"visibility":null,"maximum":null,"initial":"corrected"},{"id":"v1","label":"Proximal peak velocity V₁","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Position the PW sample gate at the required anatomical station.","Align with flow and save a complete, unaliased envelope.","Measure the reproducible dense peak from zero in velocity units, not VTI."],"title":"Pulsed-wave peak velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["corrected"]},"minimum":0.01,"maximum":10,"initial":""},{"id":"v2","label":"Coarctation peak velocity V₂","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["corrected","peak"]},"minimum":0.01,"maximum":10,"initial":""},{"id":"mean","label":"Traced systolic mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["mean"]},"minimum":0,"maximum":300,"initial":""}],"reference":{"evidence":[{"label":"Adult significance, not a severity scale","locator":"2025 ACHD guideline · Table 25","supports":"Mean Doppler and corrected maximum instantaneous gradients >20 mmHg are suggestive features; interpret lower gradients cautiously with LV dysfunction, severe AS or collaterals and elevated gradients after repair.","url":null},{"label":"Acquisition and downstream flow","locator":"ASE / EACVI Thoracic Aorta 2015 · pp. 162–163, Figure 51 · doi:10.1016/j.echo.2014.11.015","supports":"Suprasternal arch imaging and Doppler, delayed abdominal systolic upstroke and persistent forward diastolic flow; multimodality assessment of the whole aorta.","url":null},{"label":"Doppler versus catheter gradients","locator":"Egbe et al. 2023 · PMID 37660667 · PMC10805228","supports":"Only modest echo–catheter correlations in 121 adults. Peak, corrected peak and mean are distinct measurements; no regression conversion is implemented.","url":null},{"label":"Reporting anatomy and associated disease","locator":"ASE adult echo reporting 2025 · congenital lesions table · doi:10.1016/j.echo.2025.06.001","supports":"Describe narrowing, branch relationship, arch dimensions, diastolic continuation, abdominal Doppler and residual aortic complications.","url":null}],"locator":"Coarctation section · Table 25 and footnotes · doi:10.1016/j.jacc.2025.09.006","organization":"ACC / AHA / HRS / ISACHD / SCAI · ASE / EACVI","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"2025 Guideline for the Management of Adults With Congenital Heart Disease","url":"https://doi.org/10.1016/j.jacc.2025.09.006","year":2025}},{"id":"fontan-gradient","name":"Fontan · circulation & gradients","category":"Shunts & congenital","guideURL":"https://echosuite.app/guides/fontan-gradient/","interactiveURL":"https://echosuite.app/calculators/#fontan-gradient","formula":"Doppler mean ΔP = time average of 4v(t)² over the traced interval","fields":[{"id":"site","label":"Measured site","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Fenestration","value":"fen"},{"label":"Fontan–PA connection","value":"ana"},{"label":"IVC–Fontan connection","value":"ivc"},{"label":"Glenn connection","value":"glenn"},{"label":"Branch pulmonary artery","value":"pa"}],"visibility":null,"maximum":null,"initial":"fen"},{"id":"mean","label":"Traced mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":null,"minimum":0,"maximum":100,"initial":""}],"reference":{"evidence":[{"label":"Site-specific adult reference","locator":"EACVI 2018 · p. 1094, Fontan circulation · doi:10.1093/ehjci/jey102","supports":"Fenestration mean 4–8 mmHg is a contextual reference; a cavopulmonary connection mean of 3 mmHg may be important. No universal Fontan severity grade is supplied.","url":null},{"label":"Map connections and acquire the correct spectrum","locator":"Klug & Kwon · ASE Echo May/June 2025 · pp. 24–27, Fontan Imaging Tips (educational article)","supports":"Identify the operation, examine both Glenns when present, optimize low-velocity flow, use PW at connections and CW for the fenestration mean.","url":null},{"label":"Fenestration gradient is an imperfect surrogate","locator":"Sanders et al. · Pediatr Cardiol 2025;46:2047–2053 (online 2024) · PMID 39395055 · doi:10.1007/s00246-024-03651-1","supports":"Retrospective 59-patient comparison; echo within six months of catheterization. Limited agreement does not support treating Doppler as direct catheter pressure or applying a regression conversion.","url":null},{"label":"Whole-circulation assessment","locator":"2025 ACHD guideline · Fontan palliation section · doi:10.1016/j.jacc.2025.09.006; AHA Fontan statement 2019 · doi:10.1161/CIR.0000000000000696","supports":"Evaluate ventricular/valvar function, pathway and venous obstruction, collaterals, rhythm and end-organ effects; unexplained deterioration may require expert invasive assessment.","url":null}],"locator":"EACVI 2018 p. 1094 · ASE Echo May/June 2025 pp. 24–27 · Sanders et al. 2025","organization":"EACVI · ASE · AHA / ACC","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Fontan circulation: imaging, acquisition and hemodynamic limitations","url":"https://doi.org/10.1093/ehjci/jey102","year":2025}},{"id":"aortic-prosthesis","name":"Aortic prosthesis · EOA, DVI, PPM","category":"Prosthetic valves","guideURL":"https://echosuite.app/guides/aortic-prosthesis/","interactiveURL":"https://echosuite.app/calculators/#aortic-prosthesis","formula":"EOA = LVOT area × LVOT VTI ÷ prosthesis VTI; DVI = LVOT VTI ÷ prosthesis VTI; iEOA = EOA ÷ BSA","fields":[{"id":"lvot","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"av","label":"Prosthesis VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler trace","steps":["Use the same aligned CW recording as the peak velocity.","Trace the outer edge of the dense envelope for the relevant phase.","Use the machine-reported VTI in centimeters."],"title":"Jet VTI"},"visibility":null,"minimum":0,"maximum":400,"initial":""},{"id":"d","label":"LVOT diameter","unit":"cm","kind":"number","optional":true,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":true,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":0,"maximum":4,"initial":""},{"id":"bmi","label":"Body mass index","unit":"kg/m²","kind":"number","optional":true,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":0,"maximum":120,"initial":""},{"id":"at","label":"Acceleration time","unit":"ms","kind":"number","optional":true,"help":{"mode":"Spectral Doppler timing","steps":["Use a sweep speed that clearly shows the interval boundaries.","Measure from the specified onset to offset.","Average representative beats using consistent rhythm handling."],"title":"Time interval"},"visibility":null,"minimum":0,"maximum":2000,"initial":""},{"id":"et","label":"Ejection time","unit":"ms","kind":"number","optional":true,"help":{"mode":"Spectral Doppler timing","steps":["Use a sweep speed that clearly shows the interval boundaries.","Measure from the specified onset to offset.","Average representative beats using consistent rhythm handling."],"title":"Time interval"},"visibility":null,"minimum":0,"maximum":2000,"initial":""}],"reference":{"evidence":[{"label":"EOA and DVI calculation","locator":"Section IC(iii)(b–c) · PDF pp. 7–9","supports":"Continuity-derived effective orifice area, LVOT sampling, and Doppler velocity index.","url":null},{"label":"Acceleration indices","locator":"Table 5 · JASE p. 19","supports":"Acceleration time and AT/ET ranges for normal, possible, and significant stenosis patterns.","url":null},{"label":"BMI-specific aortic PPM","locator":"Table 7 · JASE p. 20","supports":"Indexed EOA thresholds for BMI below 30 and BMI at least 30 kg/m².","url":null}],"locator":"EOA and DVI pp. 7–9 · Table 5 JASE p. 19 · Table 7 p. 20","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging","url":"https://www.asecho.org/wp-content/uploads/2024/01/PIIS0894731723005333.pdf","year":2024}},{"id":"aortic-prosthesis-screen","name":"Surgical aortic prosthesis · obstruction","category":"Prosthetic valves","guideURL":"https://echosuite.app/guides/aortic-prosthesis-screen/","interactiveURL":"https://echosuite.app/calculators/#aortic-prosthesis-screen","formula":"2024 ASE Table 5 · pair flow-dependent and flow-independent SAVR findings","fields":[{"id":"v","label":"Peak velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""},{"id":"mean","label":"Mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":null,"minimum":0,"maximum":300,"initial":""},{"id":"dvi","label":"DVI · LVOT VTI ÷ prosthesis VTI","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":2,"initial":""},{"id":"eoaReference","label":"EOA vs expected valve reference","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Not available","value":"unknown"},{"label":"Within 1 SD","value":"within"},{"label":"1 to <2 SD below","value":"oneSD"},{"label":"≥2 SD below","value":"twoSD"}],"visibility":null,"maximum":null,"initial":"unknown"},{"id":"at","label":"Acceleration time","unit":"ms","kind":"number","optional":false,"help":{"mode":"Spectral Doppler timing","steps":["Use a sweep speed that clearly shows the interval boundaries.","Measure from the specified onset to offset.","Average representative beats using consistent rhythm handling."],"title":"Time interval"},"visibility":null,"minimum":0,"maximum":2000,"initial":""},{"id":"ratio","label":"AT/ET ratio","unit":"","kind":"number","optional":false,"help":{"mode":"Spectral Doppler timing","steps":["Use a sweep speed that clearly shows the interval boundaries.","Measure from the specified onset to offset.","Average representative beats using consistent rhythm handling."],"title":"Time interval"},"visibility":null,"minimum":0,"maximum":30,"initial":""}],"reference":{"evidence":[{"label":"SAVR obstruction ranges","locator":"Table 5 · JASE p. 19","supports":"Peak velocity, mean gradient, DVI, reference-relative EOA, acceleration time, and AT/ET ranges.","url":null},{"label":"Required parameter concordance","locator":"Table 5 footnote · JASE p. 19","supports":"Significant stenosis should include at least one flow-dependent and one flow-independent parameter.","url":null},{"label":"Acquisition and differential","locator":"Key recommendations · PDF p. 21","supports":"Multiple Doppler windows and exclusion of high flow, PPM, sub/supravalvular obstruction, and pressure recovery.","url":null}],"locator":"Figure 13 and Table 5 · JASE p. 19 · recommendations p. 21","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging","url":"https://www.asecho.org/wp-content/uploads/2024/01/PIIS0894731723005333.pdf","year":2024}},{"id":"aortic-prosthesis-serial","name":"Aortic prosthesis · serial comparison","category":"Prosthetic valves","guideURL":"https://echosuite.app/guides/aortic-prosthesis-serial/","interactiveURL":"https://echosuite.app/calculators/#aortic-prosthesis-serial","formula":"Compare current mean gradient, DVI and EOA with a stable postimplant baseline","fields":[{"id":"method","label":"Comparison","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"TAVI · change from baseline","value":"tavi"},{"label":"Bioprosthesis · hemodynamic deterioration","value":"bioprosthesis"}],"visibility":null,"maximum":null,"initial":"tavi"},{"id":"baselineMean","label":"Baseline mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":200,"initial":""},{"id":"currentMean","label":"Current mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":200,"initial":""},{"id":"baselineDVI","label":"Baseline DVI","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":2,"initial":""},{"id":"currentDVI","label":"Current DVI","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":2,"initial":""},{"id":"baselineEOA","label":"Baseline EOA","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":10,"initial":""},{"id":"currentEOA","label":"Current EOA","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":10,"initial":""},{"id":"comparable","label":"Study conditions","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Stable / comparable","value":"yes"},{"label":"Different / uncertain","value":"no"}],"visibility":null,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Acquisition and interpretation","locator":"Tables 5–6, pp.19–20; baseline and acquisition context","supports":"Method-specific acquisition and reference context. Arithmetic uses entered measurements; clinical interpretation remains subject to image quality and study context.","url":null}],"locator":"Tables 5–6, pp.19–20; baseline and acquisition context","organization":"ASE","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Evaluation of Prosthetic Valve Function","url":"https://www.asecho.org/wp-content/uploads/2024/01/PIIS0894731723005333.pdf","year":2024}},{"id":"mitral-prosthesis","name":"Mitral prosthesis · EOA, DVI, PPM","category":"Prosthetic valves","guideURL":"https://echosuite.app/guides/mitral-prosthesis/","interactiveURL":"https://echosuite.app/calculators/#mitral-prosthesis","formula":"EOA = LVOT area × LVOT VTI ÷ MV prosthesis VTI; DVI = MV prosthesis VTI ÷ LVOT VTI","fields":[{"id":"method","label":"Measurement","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"EOA & DVI","value":"continuity"},{"label":"Patient–prosthesis mismatch","value":"ppm"}],"visibility":null,"maximum":null,"initial":"continuity"},{"id":"lvot","label":"LVOT VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Pulsed-wave Doppler","steps":["Place the sample volume at the specified annulus or outflow tract.","Align the Doppler beam with flow and record a clean envelope.","Trace the modal velocity envelope and use the reported VTI."],"title":"Pulsed-wave VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity","ppm"]},"minimum":0,"maximum":400,"initial":""},{"id":"mv","label":"Mitral prosthesis VTI","unit":"cm","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler trace","steps":["Use the same aligned CW recording as the peak velocity.","Trace the outer edge of the dense envelope for the relevant phase.","Use the machine-reported VTI in centimeters."],"title":"Jet VTI"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity","ppm"]},"minimum":0,"maximum":400,"initial":""},{"id":"d","label":"LVOT diameter","unit":"cm","kind":"number","optional":false,"help":{"mode":"2D echo · inner-edge measurement","steps":["Use the specified view and cardiac phase.","Align the calipers perpendicular to the structure’s long axis.","Measure inner edge to inner edge and avoid oblique foreshortening."],"title":"Diameter"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity","ppm"]},"minimum":0,"maximum":15,"initial":""},{"id":"bsa","label":"Body surface area","unit":"m²","kind":"number","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["continuity","ppm"]},"minimum":0,"maximum":4,"initial":""},{"id":"bmi","label":"Body mass index","unit":"kg/m²","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["ppm"]},"minimum":0,"maximum":100,"initial":""},{"id":"motion","label":"Valve structure & motion","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Normal","value":"normal"},{"label":"Abnormal","value":"abnormal"},{"label":"Uncertain","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["ppm"]},"maximum":null,"initial":"unknown"},{"id":"eoaReference","label":"EOA vs model / size reference","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Within 1 SD","value":"within"},{"label":"Outside 1 SD","value":"outside"},{"label":"Not known","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["ppm"]},"maximum":null,"initial":"unknown"},{"id":"volumeMatch","label":"Continuity volume matching","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Valid · no significant MR / AR","value":"valid"},{"label":"Limited","value":"limited"},{"label":"Uncertain","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["ppm"]},"maximum":null,"initial":"unknown"},{"id":"baseline","label":"Stable postoperative baseline","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Stable","value":"stable"},{"label":"New change","value":"changed"},{"label":"Not known","value":"unknown"}],"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["ppm"]},"maximum":null,"initial":"unknown"}],"reference":{"evidence":[{"label":"Mitral EOA, DVI and PPM","locator":"Section III.B(i) · JASE pp. 24–25","supports":"EOA from LVOT stroke volume / mitral VTI; inverse VTI ratio for DVI. Table 7 supplies BMI-adjusted mitral PPM bands, requiring normal structure/motion and EOA within 1 SD of the model/size reference.","url":null},{"label":"Limitations","locator":"Section III.B(i) · JASE pp. 24–25","supports":"Important MR can underestimate LVOT-based mitral EOA; significant AR also breaks volume matching. PHT-derived EOA is invalid. Integrate prosthesis type, size, flow, rhythm and baseline.","url":null}],"locator":"EOA and DVI JASE pp. 9–10 · mitral evaluation pp. 24–25 · Table 7 p. 20 (BMI-adjusted PPM and prerequisites) · Table 11 p. 27","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging","url":"https://www.asecho.org/wp-content/uploads/2024/01/PIIS0894731723005333.pdf","year":2024}},{"id":"mitral-prosthesis-screen","name":"Mitral prosthesis · obstruction","category":"Prosthetic valves","guideURL":"https://echosuite.app/guides/mitral-prosthesis-screen/","interactiveURL":"https://echosuite.app/calculators/#mitral-prosthesis-screen","formula":"Integrate velocity, gradient, DVI, EOA and PHT","fields":[{"id":"v","label":"Peak velocity","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Continuous-wave Doppler","steps":["Align the CW cursor as parallel as possible to the jet.","Acquire a dense, complete envelope without truncation.","Measure the highest absolute velocity on the selected envelope."],"title":"Peak jet velocity"},"visibility":null,"minimum":0,"maximum":12,"initial":""},{"id":"mean","label":"Mean gradient","unit":"mmHg","kind":"number","optional":false,"help":{"mode":"Complete traced CW envelope","steps":["Align through the valve or shunt and record a complete envelope.","Trace the modal velocity envelope using the machine tool.","Use the machine-calculated mean gradient in mmHg."],"title":"Mean gradient"},"visibility":null,"minimum":0,"maximum":300,"initial":""},{"id":"dvi","label":"DVI · prosthesis VTI ÷ LVOT VTI","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":15,"initial":""},{"id":"eoa","label":"EOA","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":25,"initial":""},{"id":"pht","label":"Pressure half-time","unit":"ms","kind":"number","optional":false,"help":{"mode":"CW Doppler deceleration slope","steps":["Record a complete inflow or regurgitant CW envelope.","Trace the deceleration slope using the machine PHT tool.","Average representative beats and use additional beats in atrial fibrillation."],"title":"Pressure half-time"},"visibility":null,"minimum":0,"maximum":2000,"initial":""},{"id":"hr","label":"Heart rate at Doppler acquisition","unit":"bpm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":300,"initial":""}],"reference":{"evidence":[{"label":"Mitral obstruction ranges","locator":"Table 11 · JASE p. 27","supports":"Individual peak velocity, mean gradient, DVI, EOA and pressure half-time reference bands; integrate findings without an invented abnormal-parameter count.","url":null},{"label":"Required reporting context","locator":"Table 10 JASE p. 27 · key recommendations p. 29","supports":"Heart rate, prosthesis type and size, chamber response, pulmonary pressure, and comparison with baseline.","url":null}],"locator":"Tables 10–11 JASE p. 27 · Table 12 p. 28 · recommendations p. 29","organization":"American Society of Echocardiography","snapshot":"1 October 2026","status":"Exact guideline locator mapped · clinical sign-off pending","title":"Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging","url":"https://www.asecho.org/wp-content/uploads/2024/01/PIIS0894731723005333.pdf","year":2024}},{"id":"bsa","name":"Body surface area · height and weight","category":"Right heart & PA","guideURL":"https://echosuite.app/guides/bsa/","interactiveURL":"https://echosuite.app/calculators/#bsa","formula":"Mosteller: BSA = √(height × weight / 3600)","fields":[{"id":"height","label":"Height · H","unit":"cm","kind":"number","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":30,"maximum":250,"initial":""},{"id":"weight","label":"Weight · W","unit":"kg","kind":"number","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"visibility":null,"minimum":0.3,"maximum":400,"initial":""},{"id":"formula","label":"Formula","unit":"","kind":"selection","optional":false,"help":{"mode":"Record the units, date and measurement source","steps":["Use measured height and weight where feasible. Record the units, date and whether a value was reported or estimated.","Fluid status and weight changes affect BSA. Document any substituted weight; do not silently replace measured weight with ideal or dry weight.","Use the unit named by the field. BSA is in m²; height and weight can be converted in the Body surface area calculator. Keep the formula with serial indexed results."],"title":"Height and weight"},"options":[{"label":"Mosteller","value":"mosteller"},{"label":"Du Bois","value":"dubois"},{"label":"Haycock","value":"haycock"},{"label":"Gehan & George","value":"gehan"}],"visibility":null,"maximum":null,"initial":"mosteller"}],"reference":{"evidence":[{"label":"Mosteller","locator":"N Engl J Med 1987;317:1098 · doi:10.1056/NEJM198710223171717","supports":"BSA = √(H × W / 3600). H in cm, W in kg, BSA in m². The app defaults to this equation; this is not a claim that every echo reference uses it.","url":null},{"label":"Du Bois & Du Bois","locator":"Arch Intern Med 1916;17:863–871 · doi:10.1001/archinte.1916.00080130010002","supports":"BSA = 0.007184 × H^0.725 × W^0.425; H in cm and W in kg.","url":null},{"label":"Haycock, Schwartz & Wisotsky","locator":"J Pediatr 1978;93:62–66 · PMID:650346","supports":"BSA = 0.024265 × H^0.3964 × W^0.5378; H in cm and W in kg. The primary study included infants, children and adults.","url":null},{"label":"Gehan & George","locator":"Cancer Chemother Rep 1970;54:225–235 · PMID:5527019","supports":"BSA = 0.0235 × H^0.42246 × W^0.51456; H in cm and W in kg.","url":null},{"label":"Body size and indexed valve area","locator":"EACVI/ASE aortic stenosis focused update 2017 · section 1.3 · doi:10.1016/j.echo.2017.02.009","supports":"BSA indexing has limitations in obesity: aortic valve area does not grow in proportion to excess weight. Do not infer stenosis severity from an indexed value alone.","url":null},{"label":"Chamber indexing in obesity","locator":"Zong et al. JASE 2014;27:1267–1274 · PMID:25193637","supports":"The choice of body-size normalization affects recognition of left-heart enlargement in obesity. Retain raw measurements alongside indexed results.","url":null}],"locator":"Du Bois 1916 · Gehan & George 1970 · Haycock 1978 · Mosteller 1987","organization":"Primary BSA publications","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"Height–weight estimates of body surface area","url":"https://pubmed.ncbi.nlm.nih.gov/3657876/","year":null}},{"id":"wave-relations","name":"Wave relationships","category":"Ultrasound physics","guideURL":"https://echosuite.app/guides/wave-relations/","interactiveURL":"https://echosuite.app/calculators/#wave-relations","formula":"Period = 1/f; wavelength = c/f; pulse duration = period × cycles","fields":[{"id":"freq","label":"Transmit frequency","unit":"MHz","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"c","label":"Sound speed","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"cycles","label":"Cycles per pulse","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":100,"initial":""}],"reference":{"evidence":[{"label":"Wave relationships","locator":"§16.1 · equation 16.1","supports":"Period is the reciprocal of frequency; wavelength is propagation speed divided by frequency. A burst of n cycles has duration n times the period. Particle oscillation is distinct from propagation of the disturbance.","url":null}],"locator":"§16.1 · wave period, frequency and speed; equation 16.1","organization":"OpenStax · Rice University","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"University Physics Volume 1 · Traveling waves","url":"https://openstax.org/books/university-physics-volume-1/pages/16-1-traveling-waves","year":2016}},{"id":"pulse-repetition","name":"Pulse repetition and Nyquist","category":"Ultrasound physics","guideURL":"https://echosuite.app/guides/pulse-repetition/","interactiveURL":"https://echosuite.app/calculators/#pulse-repetition","formula":"PRPmin ≈ 13 × depth; PRF = 1/PRP; Nyquist = PRF/2; duty = PD/PRP","fields":[{"id":"method","label":"Start from","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Depth limit","value":"depth"},{"label":"Known PRF","value":"prf"}],"visibility":null,"maximum":null,"initial":"depth"},{"id":"depth","label":"Sample depth","unit":"cm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["depth"]},"minimum":0,"maximum":null,"initial":""},{"id":"prf","label":"Pulse repetition frequency","unit":"kHz","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["prf"]},"minimum":0,"maximum":null,"initial":""},{"id":"pd","label":"Pulse duration · PD","unit":"µs","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"shift","label":"Peak Doppler shift · |Δf|","unit":"kHz","kind":"number","optional":true,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Range and sampling","locator":"Chapter 1 · pulse timing and PW Doppler","supports":"Round-trip time limits conventional unambiguous PRF. Nyquist is half the PRF; CW removes pulsed aliasing while losing sample-depth selection.","url":null},{"label":"Duty factor","locator":"ASE Echocardiography Formula Review Guide Part 2 · principles of waves and sound","supports":"Duty factor is pulse duration divided by repetition period. The 13 µs/cm depth relation is a rounded soft-tissue approximation, not a scanner setting.","url":null}],"locator":"Chapter 1 · Figures 1.3 and 1.6; PW Doppler and Nyquist, pp. 3–6","organization":"Cambridge University Press","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"Manual of Neurosonology · Ultrasound principles","url":"https://assets.cambridge.org/97811076/59155/excerpt/9781107659155_excerpt.pdf","year":2016}},{"id":"pulse-geometry","name":"Pulse length and near field","category":"Ultrasound physics","guideURL":"https://echosuite.app/guides/pulse-geometry/","interactiveURL":"https://echosuite.app/calculators/#pulse-geometry","formula":"λ = c/f; SPL = cycles × λ; axial limit ≈ SPL/2; N ≈ D²/(4λ)","fields":[{"id":"method","label":"Explore","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Pulse length","value":"pulse"},{"label":"Near field","value":"near"}],"visibility":null,"maximum":null,"initial":"pulse"},{"id":"freq","label":"Transmit frequency · f","unit":"MHz","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"c","label":"Sound speed · c","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"cycles","label":"Cycles per pulse · n","unit":"","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["pulse"]},"minimum":1,"maximum":100,"initial":""},{"id":"diameter","label":"Active aperture diameter · D","unit":"mm","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["near"]},"minimum":0,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Near-field model","locator":"§2.4 Beam characteristics; WHO EHC 22 §2.2.1","supports":"N ≈ D²/(4λ) for a flat circular aperture with D much greater than wavelength. Near-field interference and far-field divergence do not specify electronic array focusing.","url":null},{"label":"Pulse and axial separation","locator":"ASE Formula Review Guide Part 2 · principles of waves and sound","supports":"Wavelength is sound speed divided by frequency; SPL is cycles times wavelength; the ideal axial separation estimate is SPL/2.","url":null}],"locator":"§2.4 · circular-element near-field distance N = D²/(4λ)","organization":"Evident · Ultrasound education","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"Ultrasonic beam characteristics","url":"https://ims.evidentscientific.com/en/learn/ndt-tutorials/flaw-detection/beam-characteristics","year":null}},{"id":"doppler-equation","name":"Doppler equation","category":"Ultrasound physics","guideURL":"https://echosuite.app/guides/doppler-equation/","interactiveURL":"https://echosuite.app/calculators/#doppler-equation","formula":"Δf = 2fₜv cosθ/c; v = |Δf|c/(2fₜ cosθ)","fields":[{"id":"method","label":"Solve for","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Velocity","value":"velocity"},{"label":"Frequency shift","value":"shift"}],"visibility":null,"maximum":null,"initial":"velocity"},{"id":"shift","label":"Shift magnitude · |Δf|","unit":"kHz","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["velocity"]},"minimum":0,"maximum":null,"initial":""},{"id":"velocity","label":"Blood speed · v","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["shift"]},"minimum":0,"maximum":null,"initial":""},{"id":"tx","label":"Transmit frequency · fₜ","unit":"MHz","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""},{"id":"angle","label":"Beam-to-flow angle · θ","unit":"°","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":90,"initial":""},{"id":"c","label":"Sound speed · c","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":null,"minimum":0,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Alignment in echocardiography","locator":"ASE Comprehensive TTE (2019), p. 42","supports":"Detected velocity depends on cosine of the beam-to-flow angle. Improve alignment and compare windows rather than using angle correction; choose a well-acquired maximum-velocity signal.","url":null},{"label":"Equation and sign","locator":"Cambridge, Manual of Neurosonology (2016), pp. 4–5, Fig. 1.5","supports":"Frequency shift is proportional to transmitted frequency, flow speed and cosine of the angle. Perpendicular flow has zero axial shift.","url":null},{"label":"Two Doppler interactions","locator":"OpenStax College Physics 2e §17.7, Doppler-shifted ultrasound and Example 17.8","supports":"A moving scatterer first receives sound and then acts as a moving source. In the low-speed approximation each contributes half of the total echo shift.","url":null}],"locator":"ASE Comprehensive TTE · spectral Doppler, p. 42; Manual of Neurosonology (2016), Fig. 1.5","organization":"ASE","snapshot":"1 October 2026","status":"Source mapped · clinical sign-off pending","title":"Doppler equation and cardiac spectral acquisition","url":"https://www.asecho.org/wp-content/uploads/2019/01/2019_Comprehensive-TTE.pdf","year":2019}},{"id":"acoustic","name":"Acoustic impedance and intensity","category":"Ultrasound physics","guideURL":"https://echosuite.app/guides/acoustic/","interactiveURL":"https://echosuite.app/calculators/#acoustic","formula":"Z = ρc; R = ((Z₂ − Z₁) ÷ (Z₂ + Z₁))²; I = P ÷ A","fields":[{"id":"method","label":"Calculate","unit":"","kind":"selection","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"options":[{"label":"Impedance","value":"impedance"},{"label":"Reflection","value":"reflection"},{"label":"Intensity","value":"intensity"}],"visibility":null,"maximum":null,"initial":"impedance"},{"id":"density","label":"Density · ρ","unit":"kg/m³","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["impedance"]},"minimum":0,"maximum":null,"initial":""},{"id":"c","label":"Sound speed · c","unit":"m/s","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["impedance"]},"minimum":0,"maximum":null,"initial":""},{"id":"z1","label":"Medium 1 · Z₁","unit":"MRayl","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["reflection"]},"minimum":0,"maximum":null,"initial":""},{"id":"z2","label":"Medium 2 · Z₂","unit":"MRayl","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["reflection"]},"minimum":0,"maximum":null,"initial":""},{"id":"power","label":"Acoustic power · P","unit":"W","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["intensity"]},"minimum":0,"maximum":null,"initial":""},{"id":"area","label":"Beam area · A","unit":"cm²","kind":"number","optional":false,"help":{"mode":"Enter the measured value in the displayed unit","steps":["Confirm the variable matches the selected formula.","Use the unit displayed beside the field.","Keep measurements from the same representative hemodynamic state."],"title":"Measurement"},"visibility":{"afSecondary":false,"all":true,"field":"method","range":null,"rules":[],"values":["intensity"]},"minimum":0,"maximum":null,"initial":""}],"reference":{"evidence":[{"label":"Acoustic relationships","locator":"§17.7 · impedance and intensity reflection; §17.3 · power per area","supports":"Z = density × sound speed. 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