What is IVC plethora in an echo report?

What is IVC plethora in an echo report?

IVC stands for inferior vena cava. It is the large blood vessel returning deoxygenated blood from the lower part of the body to the heart. It joins the right atrium, the right upper chamber of the heart. Plethora means it is enlarged and full of blood. During echocardiography, the ultrasound imaging of heart, inferior vena cava can be seen as collapsing in inspiration. Inspiration is breathing in. When we breathe in, pressure in the chest cavity drops and blood is sucked into the heart from the large veins, including inferior vena cava. That is why inferior vena cava collapses in inspiration. Collapse of IVC on inspiration is the normal finding.

High right atrial pressure in disease conditions is transmitted back to the IVC. When inferior vena cava is enlarged and full of blood due to high pressure in the right atrium, it cannot collapse in inspiration. It remains full through out the breathing cycle. This is known as plethora of inferior vena cava or in short as IVC plethora. So IVC plethora indicates high pressure in the right atrium, common cause of which is heart failure. There are other conditions like a narrowing of the tricuspid valve, which can also raise the pressure in the right atrium. Tricuspid valve is the valve between the right upper and lower chambers.