From Echocardiography in ICU

The right ventricle is coupled with a low-impedance and highly distensible pulmonary vascular system, leading to low RV afterload and pre-load sensitivity to respiratory physiology. Under normal conditions, right-sided pressures are significantly lower than left-sided pressures. Ventricular interdependance plays a major role in the pathophysiology of the RV, due to the limited compliance of the pericardium and to the lower right-sided pressures. 

RV function is more difficult to assess than LV function, since consensual tools don't exist due to the complex RV shape (as EF for LV systolic function). The longitudinal contraction is predominant, and one mean to assess RV function is to look at the vertical motion of the tricuspid annulus in apical 4 chamber view.

In clinical practice, the most important indices to evaluate RV function will be:

-determination of RV size compared to LV size

-screening for abnormal septum motion (indice of RV overload)

-subjective evaluation of RV function: normal or abnormal

Parasternal long axis: RV enlargement and paradoxical septum:

Parasternal short axis: D-shaped septum throughout the cardiac cycle:

Apical 4 chamber: RV enlargement and dysfunction: