hi my name is tom cook i'm an emergency physician and i work with prisma health and the university of south carolina this is a short video on how to use color doppler to evaluate a patient for tricuspid regurgitation to get started we're going to use a b mode image and get an apical 4 chamber view of the heart and as you can see in this particular image the right side of the heart is here and we can clearly see the tricuspid valve at this point we're going to go ahead and use color doppler and when we turn on color doppler we notice a couple things right away the first is that we're given this color box and this is the only part on the screen where we're going to see color doppler images is this color box we can resize the shape of this box by touching it and when we do we get this little icon in the corner it's a circle with two arrows and we can grab that and change the height and width of the box and we'd really like to have the smallest box possible because the larger the box the more work the computer has to do so a smaller box will give you the most accurate color doppler images we also see on the left side of the screen there's a color bar the top of the color bar we see a red yellow color and this is the color that is given to all blood that is moving towards the transducer and on the bottom of the color bar we see it goes from dark blue to a light blue and these are the colors given to blood that is moving away from the transducer now we're going to focus our attention on the right atrium and we're going to look to see if we see any evidence of tricuspid regurgitation when we do that we can freeze the image and we see right here this blue color doppler image in the right atrium now of course physiologically we know that blood moves normally from the atria to the ventricles and since that blood flow would be going towards the apex it would be assigned a red color but we see blue in the right atrium now and this is an indication that blood is moving from the right ventricle into the right atrium and of course this is due to tricuspid regurgitation so in summary this is how you can use color doppler to assess your patients for tricuspid regurgitation and when we find this in the emergency department or with other physicians practicing at the bedside this is an indication that we should refer these patients to cardiologists for further evaluation you
