• POCUS is a rapid and focused tool for assessing RV strain, offering more timely insights than the physical exam alone and providing useful preliminary information to guide further cardiology evaluation and management.

• POCUS should be used as a rule-in tool, not a rule-out test, especially when clinical suspicion for RV strain is high. A normal or unclear POCUS exam does not exclude pathology and should not replace formal imaging when concern persists

• Always assess for RV strain from the standard windows (PLAX, PSAX, A4C, and subxiphoid 4-chamber/IVC) to ensure consistency and accuracy.

• On ultrasound, RV strain is characterized by RV dilation, septal flattening (from pressure or volume overload), and, in more advanced cases, reduced systolic function and IVC plethora.
• Be mindful of the limitations, both technical (e.g., foreshortening, off-axis views, poor acoustic windows) and interpretive (e.g., variability in qualitative assessment).