Imaging of the right heart

The right ventricle has lost its designation as the ‘forgotten ventricle’ over the past decade. Clinicians recognize its prognostic significance in a wide array of disease processes and imagers are now providing an assessment of right ventricular size and function in most studies. Despite this recognition, imaging the right heart presents numerous challenges to the imager. The shape of the chamber, the unique structure, and its coupling to the pulmonary circulation mandate a different approach to its evaluation as compared to the left ventricle. Imaging may be done by several modalities, each with their own strengths and limitations. Even more so than with the left ventricle, the findings must be interpreted in the context of loading conditions and clinical setting. This chapter will focus on the two main right heart imaging modalities—echocardiography and cardiac MRI.