case_images: PMC6304925_01
case_images: IVC on right upper quadrant ultrasound. Visualization of the hepatic vein dilatation (green) as well as the IVC dilatation (blue). Also visualized is the right atrium in the left lower corner.
case_images: CRIC2018-8396523.001.jpg
case_images: PMC6304925_01_CRIC2018-8396523.001.jpg
case_images: fig1
case_images: As part of hepatitis work-up, the patient underwent liver ultrasound, which revealed dilated IVC and hepatic veins (Figure 1).
case_images: (a) IVC on transthoracic echocardiogram. Dilated IVC measuring 3.12 cm. (b) IVC on M-mode. M-mode with inspiration with maximum diameter measuring 3.12 cm and minimum diameter of 2.5 cm.
case_images: CRIC2018-8396523.002.jpg
case_images: PMC6304925_01_CRIC2018-8396523.002.jpg
case_images: fig2
case_images: There were no significant valvular abnormalities except mild mitral and tricuspid regurgitation. RA was normal in size. The IVC diameter was increased at 2.7-3.0 cm and demonstrated <50% collapse with inspiration (Figures 2(a) and 2(b): 2D and M-mode images with markings).
case_images: Hepatic flow Doppler. Doppler signal marked S for systolic and D for diastolic. Informal visualization shows systolic velocity (Vs) of 0.32 m/sec and diastolic velocity (Vd) of 0.38 m/sec.
case_images: CRIC2018-8396523.003.jpg
case_images: PMC6304925_01_CRIC2018-8396523.003.jpg
case_images: fig3
case_images: Dilated hepatic vein was again demonstrated, and the Doppler-based hepatic vein flow pattern showed slightly greater diastolic velocity (Vd) than systolic velocity (Vs) (Figure 3).