Assessment can be challenging due to shape and extensive trabeculations.

Important for critical care - CO has to equal CO of left heart and function is arguably more important given the RV's sensitivity to fluid balance, positive pressure ventilation and many crit care pathologies.

RV - inflow and outflow regions.

Contracts longitudinally, radially (free wall towards septum) and rotation pulled by LV.

Pulmonary vasculature is a low pressure system so RV is less muscular than LV.

Ejection of SV continues into its relaxation so outflow is semi continuous.

Dilates acutely in response to increased afterload and is able to become hypertrophied in 48hrs.

RV is perfused in both systole and diastole so function is dependent on adequate MAP.

Key features of RV peristaltic movement:

• Infundibular expansion occurs just prior to contraction.
• Infundibular contraction occurs 20-50ms after contraction of RV free wall.
• Longitudinal shortening contributes most to RV free wall contraction.
• Transverse shortening (RV free wall moving towards septum) also occurs.
• LV contributes to RV ejection by bulging into RV cavity.
• Low pressure within pulmonary vasculature encourages blood flow to continue forwards even after RV pressure has decreased to value below that of the PA.

RV and PA must be viewed as a coupled unit - RV-PA coupling.