To assess prevalence of right ventricle dysfunction in critically ill patient. To assess impact of RV dysfunction on short term (ICU stay, hospital stay, or mortality ≤30 days) and long term outcome (>30 days).

To assess the accuracy of different parameters of RV dysfunction.

1. Inclusion criteria:

   - Adult patients who admitted to critical care of Internal medicine department after obtaining consent during the period between august 2023 and august 2024.

2. Exclusion criteria:

   1. Children below 18 yr.
   2. Patients who could not be scanned within 48h after ICU admission.

3. Sample Size Calculation:

   200 patients 2.4.4 Study tools (in detail, e.g., lab methods, instruments, steps, chemicals, ):

   Beside history and clinical examination , The following data will be obtained:

   Demographic and historical data: the patient age, sex, history of hypertension, chronic obstructive pulmonary disease, IHD, cause of critical care unit admission and indication of mechanical ventilation( PEEP).

   Clinical examination data: pulse, blood pressure, respiratory rate, temperature , BMI, and thorough chest, cardiac examination data will be obtained.

   Volume state of the patient: CVP measurement, input and output fluid chart. APACHE IV score, Use of vasopressors, Use of sedatives. Investigation : Arterial blood gas analysis, pulse oxygen saturation, CBC, and renal function test and electrolytes, serum lactate and troponin.

   12 lead ECG for RV strain patterns.

Inclusion Criteria:

• Adult patients who admitted to critical care of Internal medicine department after obtaining consent during the period between august 2023 and august 2024.

Exclusion Criteria:

1. Children below 18 yr.
2. Patients who could not be scanned within 48h after ICU admission.

- Adult patients who admitted to critical care of Internal medicine department after obtaining consent during the period between august 2023 and august 2024.