Adult Echocardiography Practice Exam

A dilated inferior vena cava (IVC) suggests what condition if it does not reduce in size with inspiration?

1. Heart failure

2. Constrictive pericarditis

3. Pulmonary hypertension

4. Normal physiology

The correct answer is: Heart failure

A dilated inferior vena cava (IVC) that does not reduce in size with inspiration is indicative of heart failure. In a healthy individual, the IVC should collapse during inspiration due to increased negative intrathoracic pressure, which enhances venous return to the right atrium. However, in the setting of heart failure, the ability of the heart to accommodate increased venous return is compromised. As a result, the IVC remains dilated and does not demonstrate the normal collapse seen with inspiration. In heart failure, elevated central venous pressure leads to increased volume in the IVC. This condition suggests that there is congestion due to poor ventricular filling or significant fluid overload. The lack of inspiratory collapse reinforces the diagnosis as it highlights the hemodynamic impairment associated with heart failure. Monitoring changes in IVC size with respiration is a valuable echocardiographic assessment that can aid in identifying patients who are experiencing volume overload or heart failure. The other potential conditions may influence IVC size but exhibit different characteristics. For example, constrictive pericarditis would often show respiratory variation but in a different manner, and pulmonary hypertension may cause a dilated IVC as well, but the dynamic response during respiration may vary. Normal physiology does not sustain