Assessment of Right Atrial Pressure From IVC Dimensions by Echocardiography

Assessment of inferior vena caval dimensions by echocardiography is very useful in knowing the volume status of the individual and indirectly assessing the right atrial pressure. When the IVC is collapsed, that means right atrial pressure is low and person is likely to be hypovolemic. Especially in a person with hypotension this is very important in guiding fluid management. On the other way round, when the IVC is enlarged, or rather plethoric, then you know right atrial pressure is high and even if there is hypotension, you cannot give much fluid to such a case. So this is the importance of assessing IVC, which we will see a little more in detail. Assessment of inferior vena cava by echocardiography is usually done from the subcostal view. This is the subcostal view. You can see the inferior vena cava, right atrium and part of the hepatic vein. This is the liver parenchyma. Imaging of the IVC from the right axillary region is resorted to in persons who have undergone surgery and the anterior portion is covered with dressing as in thoracic surgery, that is sternotomy surgeries and also when abdominal surgeries have been done and the epigastric region where you keep the probe for subcostal view is also covered by dressings. While estimating right ventricular systolic pressure or RVSP, from tricuspid regurgitation gradient, usually we add 10 mm of mercury to the observed tricuspid regurgitation gradient to get the estimated right ventricular systolic pressure or RVSP. But this ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs