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Heart Disease (Expert Forum)
Enlarged Inferior Vena Cava
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Enlarged Inferior Vena Cava
by Ch, Oct 30, 2001 12:00AM
I just received a report from my doctor of a chest/abdominal CT scan that was ordered to investigate LUQ/flank pain. The report showed a prominent right atrium, a prominent splenic vein, and a slightly enlarged inferior vena cava, but significantly enlarged compared to a previous scan. Spleen is normal in size. My interntist indicated that a malfunctioning spleen can cause enlargement of the inferior vena cava, but that is rare and he considers these results insignificant. My cardiologist does as well. I haven't felt well for over a year, endocarditis has been suspected, but ruled out because of neg. blood cultures and echoes, and I'm trying to determine if I should push my doctors a little more. So, to my questions:
(1) What does it mean, if anything, to have a prominent right atrium, or a prominent splenic vein?
(2) Are there cardiac causes of an enlarged inferior vena cava? Can a prominent right atrium and an enlarged inferior vena cava be related? How can these be evaluated?
(3) Under what circumstances is an enlarged inferior vena cava considered insignificant? Is it prudent to check again in several months to see if the enlargement continues?
Thank you in advance for your time.
Ch
(1) What does it mean, if anything, to have a prominent right atrium, or a prominent splenic vein?
(2) Are there cardiac causes of an enlarged inferior vena cava? Can a prominent right atrium and an enlarged inferior vena cava be related? How can these be evaluated?
(3) Under what circumstances is an enlarged inferior vena cava considered insignificant? Is it prudent to check again in several months to see if the enlargement continues?
Thank you in advance for your time.
Ch
Doctor's Answer
by CCF-M.D.-CRC, Oct 30, 2001 12:00AM
Dear Ch,
(1) What does it mean, if anything, to have a prominent right atrium, or a prominent splenic vein?
A: "Prominent" is one of those words that doctors use to describe changes to structures that do not meet the criteria to be "abnormal" yet are larger than expected. In general "prominent" does not signify anything to be overly concerned about. A prominent right atrium and splenic vein could be due to the hydration status of the person during the test. It is possible with the first test you were slightly dehydrated making these structures smaller and with the second test more hydrated making them larger.
(2) Are there cardiac causes of an enlarged inferior vena cava? Can a prominent right atrium and an enlarged
inferior vena cava be related? How can these be evaluated?
A: Patients with heart failure can have enlarged vena cava and atrium. This is usually evaluated with an echocardiogram.
(3) Under what circumstances is an enlarged inferior vena cava considered insignificant? Is it prudent to check
again in several months to see if the enlargement continues?
A: If there are no associated symptoms then the enlargement is less likely to be significant. If symptoms arise then repeat evaluation may be indicated.
(1) What does it mean, if anything, to have a prominent right atrium, or a prominent splenic vein?
A: "Prominent" is one of those words that doctors use to describe changes to structures that do not meet the criteria to be "abnormal" yet are larger than expected. In general "prominent" does not signify anything to be overly concerned about. A prominent right atrium and splenic vein could be due to the hydration status of the person during the test. It is possible with the first test you were slightly dehydrated making these structures smaller and with the second test more hydrated making them larger.
(2) Are there cardiac causes of an enlarged inferior vena cava? Can a prominent right atrium and an enlarged
inferior vena cava be related? How can these be evaluated?
A: Patients with heart failure can have enlarged vena cava and atrium. This is usually evaluated with an echocardiogram.
(3) Under what circumstances is an enlarged inferior vena cava considered insignificant? Is it prudent to check
again in several months to see if the enlargement continues?
A: If there are no associated symptoms then the enlargement is less likely to be significant. If symptoms arise then repeat evaluation may be indicated.
