Transthoracic echocardiogram (TTE) revealed large circumferential pericardial effusion and evidence for tamponade physiology with multichamber collapse and significant respirophasic
variation to the mitral inflow pattern (Figure 3).
An echocardiogram was performed which showed an ejection fraction of 55-60%, mild to moderate mitral regurgitation, peak systolic pulmonary artery pressure of 45 mmHg (moderately increased), normal-sized pulmonary arteries, moderate to severe tricuspid regurgitation, a mildly dilated right atrium, and a less than 50% variation in respirophasic
changes in the inferior vena cava and hepatic veins.
The onset of asystole during expiration may be an extreme example of a normal respirophasic
sinus arrhythmia in a vagotonic subject; however, that does not appear to be a sufficient explanation, as asystole could not be reproduced by breath-holding without concomitant use of the inhalers.
Gaspari, "Inferior vena cava displacement during respirophasic
ultrasound imaging," Critical Ultrasound Journal, vol.
One of the challenges of using PAC is the accuracy and precision of PAWP assessment due to the influence of respirophasic
effects of mechanical ventilation, end-expiratory versus mean digital measurements, the volume of balloon inflation, and increase extension of zones 1 and 2 (West) [70, 71].
HEPATIC VEIN CHANGES IN LIVER PATHOLOGY: In out of 15cases of liver mets, in 3(20%) cases we found loss of respirophasic pattern and also found changes in diameter (compressed) in hepatic vein.
In out of 5 cases of HCC, in 3 (60%) cases we found loss of respirophasic pattern in hepatic vein and in 1(20%) case we found decreased (compressed) diameter of hepatic vein.
(19) In 3 cases of liver cyst, in 1(33.3%) case, we found change in hepatic vein diameter and loss of respirophasic pattern because this was very closely situated to middle hepatic vein and was compressing it.
Present study revealed 13% cases involving IVC and decreased waveform and loss of respirophasic variation seen.
In this group of patient 66% cases revealed change in hepatic vein also where loss of respirophasic variation seen.
 in 1979 were the first to describe the sonographic relationship of IVC size and respirophasic
variation of IVC.