Which statement best describes the role of RAP in the RVSP formula?

Which statement best describes the role of RAP in the RVSP formula?

• A. It is added to the squared velocity term.
• B. It is squared.
• C. It is multiplied by V.
• D. It is the coefficient multiplying 4.

Answer: (B)

The key idea is that RVSP comes from converting the tricuspid regurgitation jet velocity into a pressure gradient and then adding the right atrial pressure to get the full right ventricular systolic pressure. The velocity term uses the simplified Bernoulli relationship: the pressure difference across the tricuspid valve is 4 times the square of the velocity (4V^2). To obtain RVSP, you add the right atrial pressure to this gradient. So RAP’s role is to be added to the squared velocity term. It is not squared itself, not multiplied by the velocity, and not the coefficient multiplying 4. For example, if V = 3 m/s, 4V^2 = 36 mmHg; adding RAP of 10 mmHg gives an RVSP of about 46 mmHg.

The key idea is that RVSP comes from converting the tricuspid regurgitation jet velocity into a pressure gradient and then adding the right atrial pressure to get the full right ventricular systolic pressure. The velocity term uses the simplified Bernoulli relationship: the pressure difference across the tricuspid valve is 4 times the square of the velocity (4V^2). To obtain RVSP, you add the right atrial pressure to this gradient. So RAP’s role is to be added to the squared velocity term. It is not squared itself, not multiplied by the velocity, and not the coefficient multiplying 4. For example, if V = 3 m/s, 4V^2 = 36 mmHg; adding RAP of 10 mmHg gives an RVSP of about 46 mmHg.