{"id":12773,"date":"2015-01-24T08:49:06","date_gmt":"2015-01-24T08:49:06","guid":{"rendered":"http:\/\/cardiophile.org\/?p=12773"},"modified":"2015-01-24T08:49:06","modified_gmt":"2015-01-24T08:49:06","slug":"plethora-of-inferior-vena-cava-ivc","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/plethora-of-inferior-vena-cava-ivc\/","title":{"rendered":"Plethora of inferior vena cava (IVC)"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Plethora of inferior vena cava (IVC)<\/span><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/uSBUsqxQyUw\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<figure id=\"attachment_31498\" aria-describedby=\"caption-attachment-31498\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-31498 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/IVC-Plethora.jpg\" alt=\"IVC plethora\" width=\"1200\" height=\"1268\" \/><figcaption id=\"caption-attachment-31498\" class=\"wp-caption-text\"><strong><span style=\"color: #0000ff;\">IVC plethora<\/span><\/strong><\/figcaption><\/figure>\n<p style=\"text-align: left;\"><span style=\"color: #0000ff;\">IVC plethora is lack of the normal inspiratory collapse of a <a href=\"https:\/\/johnsonfrancis.org\/professional\/grossly-dilated-inferior-vena-cava-ivc\/\">dilated IVC<\/a> on echocardiography.<\/span> Normally the IVC diameter decreases about 50% during inspiration. IVC plethora is seen in right heart failure and constrictive pericarditis [1,2]<span style=\"font-size: 13.3333px;\">.<\/span>\u00a0IVC plethora indicates high right atrial pressure and an overfilled and less compliant venous system. While calculating the estimated right ventricular systolic pressure (RVSP) from tricuspid regurgitation (TR) gradient, corrections have to be applied in cases of IVC plethora. Usually 10 mm Hg is added to TR gradient to get the RVSP. But when the IVC is grossly dilated and not showing inspiratory collapse, 20 mm Hg has to be added to the TR gradient to get the estimated RVSP.<\/p>\n<p>Himelman RB and colleagues described IVC plethora as an important echocardiographic sign in cardiac tamponade [3]. They described a less than fifty percent decrease in inferior vena caval diameter on inspiration or with sniff as IVC plethora. But IVC plethora may not occur in low pressure cardiac tamponade in which right atrial pressure is less than 12 mm Hg [4].<\/p>\n<p>It may be noted that during positive pressure ventilation, inspiration is generated by positive pressure and hence inferior vena cava expands rather than collapses [5].<\/p>\n<p><strong><span style=\"color: #0000ff;\">References<\/span><\/strong><\/p>\n<ol>\n<li>Himelman RB, Lee E, Schiller NB. Septal bounce, vena cava plethora, and pericardial adhesion: informative two-dimensional echocardiographic signs in the diagnosis of pericardial constriction.\u00a0J Am Soc Echocardiogr. 1988 Sep-Oct;1(5):333-40.<\/li>\n<li>Himelman RB, Lee E, Kircher B, Schiller NB. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/3192844\">Echocardiography. 1989;6:159168.<\/a><\/li>\n<li>Himelman RB, Kircher B, Rockey DC, Schiller NB. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/3192844\">Inferior vena cava plethora with blunted respiratory response: a sensitive echocardiographic sign of cardiac tamponade<\/a>. J Am Coll Cardiol 1988;12: 1470-7.<\/li>\n<li>Fowler NO. Inferior vena cava plethora as an echocardiographic sign of cardiac tamponade.\u00a0J Am Coll Cardiol. 1988 Dec;12(6):1478-9.<\/li>\n<li>Stone MB,\u00a0Huang JV.\u00a0Inferior Vena Cava Assessment : Correlation with CVP and Plethora in Tamponade. Global Heart. 2013; 8:323\u2013327.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Plethora of inferior vena cava (IVC plethora) is lack of the normal inspiratory collapse of the IVC on echocardiography.<\/p>\n","protected":false},"author":1,"featured_media":31498,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[25,8],"tags":[1406,1407,1960,2022,2023,3459,3966,3967,4024],"class_list":["post-12773","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-echocardiogram-library-echocardiogram-library","category-echocardiogram-library","tag-estimated-right-ventricular-systolic-pressure","tag-estimated-rvsp","tag-ivc-plethora","tag-lack-of-the-normal-inspiratory-collapse-of-inferior-vena-cava","tag-lack-of-the-normal-inspiratory-collapse-of-the-ivc","tag-rvsp","tag-tr","tag-tr-gradient","tag-tricuspid-regurgitation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - 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