Strange things around the IVC
A medical student is looking for inferior vena cava in a nephrology clinic patient and finds something ‘weird’ adjacent to the IVC. He/she calls the nephrology fellow for help. Here […]
Pitfalls of inferior vena cava M-mode
Visual assessment of IVC collapse using B-mode (grayscale imaging) is generally favored over M-mode, although in theory, M-mode can provide an accurate measurement of the collapsibility index. There are several […]
IVC collapse: fact or artifact?
In clinical practice, size, and collapsibility of the IVC is used as a surrogate for right atrial pressure (RAP). In spontaneously breathing patients, inspiration causes negative intrathoracic pressure and collapses […]
What is LV foreshortening?
This is a commonly heard term in echocardiography. Foreshortening occurs when the ultrasound beam does not cut through the true apex of the left ventricle but transects above and anterior […]
Septal bounce in a lupus patient
Here is a subcostal view of the heart obtained from a young lupus patient presenting with symptoms of new onset heart failure. Nephrologists may encounter this type of presentation in […]
Pericardial cyst
Pericardial cysts are uncommon and represent approximately 5% of thoracic cysts. Most of these are asymptomatic and usually detected incidentally. However, in case of chest trauma, they can rupture leading […]
Fluid in the subcostal cardiac view
What does this subcostal view show? In a twitter poll, more than 50% thought its either pericardial effusion or a pericardial tumor. The correct answer is ascites. Subcostal view of […]
Did you ever see on POCUS what hyperkalemia does to the heart?
Hyperkalemia is probably the most common reason for an urgent nephrology consult. Most of us are familiar with the EKG changes associated with hyperkalemia, though surprisingly, only ~55% of patients […]
Do not mistake aorta for the IVC
Confusing the aorta with the inferior vena cava (IVC) is a classic POCUS pitfall, often dismissed as a “rookie mistake,” yet not unheard of even among experienced users, particularly when […]