Is There a Borderline High Pressure?

The t r jet is just an estimate of the p a pressure. And if you don't look at that right ventricle and how enlarged it is, or how it's functioning in the setting ofa borderline high pressure, you could be fooled into thinking everything is fine. If that right ventr is hypo contractile and it's dilated,  it's quite quite frankly, that patient cannot generate that higher p a pressure than you could be in trouble. You should always make sure you've adequately ruled shunt physiology as part of this.