You can best see pulmonic insufficiency (PI) from the parasternal short-axis, the parasternal RV outflow, and the subcostal views. PI appears in diastole, as blood flow entering the RVOT from the pulmonic valve.

This parasternal short-axis view shows a trivial jet of PI in the RVOT in diastole. An enhanced velocity map is used. Red and orange indicate laminar blood flow moving toward the transducer.

A larger PI jet seen in this diastolic parasternal short-axis view uses an enhanced velocity map. The PI jet moves toward the transducer and is of high velocity, as indicated by oranges, yellows and aliased blues. The mosaic of colors represents turbulent blood flow. The red, distal to the pulmonic valve, represents the origin of the regurgitant jet in the pulmonary artery. Color flow visualization of the PI jet facilitates PW Doppler sample volume placement.