Plethoric IVC in the ED — does it mean congestion?
You scan the subcostal view and the IVC is big… barely moving with respiration. The reflex is: “They’re fluid-overloaded / congested.” Sometimes that’s true. Often it’s not. A plethoric IVC is best treated as a clue to elevated right‐sided filling pressure (RAP) or altered transmission of pressure—not a standalone diagnosis of “congestion.” What “plethoric IVC” […]