Can echos be wrong?
Yes. The echo estimates the pulmonary artery pressure, and can either underestimate or overestimate the true pressure. The gold standard is the right heart catheterization. However when echos are done carefully by experience echo cardiographers the pressures estimated by echo usually correlate fairly closely to those obtained during cardiac catheterization. Echos can also provide some additional useful information regarding size and function of the right ventricle, severity of leakage of the tricuspid valve, and extent of distension of the inferior vena cava (large vein in the abdomen that returns blood to the heart).
