Stephen Bird

Hi Linh,

This is a fairly common request and right heart failure / tricuspid regurgitation is a common cause of abnormal LFT’s in older patients.

I don’t get too excited by measurements and numbers in these patients as the diagnosis comes together nicely with subjective criteria.

I think the measurements of the IVC and hepatic veins you quote are perfectly good,

However I think you can simply observe that the IVC is always full and congested throughout the cardiac cycle and the hepatic veins are engorged.
The liver will be enlarged and the inferior edge of the liver will be rounded rather than angular.
The portal vein Doppler will be phasic rather than the usual monophonic pattern.
There is often some pleural effusion(s) and in more severe cases there may be ascites.
The PA chest x-ray will show enlargement of the right heart.


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