Duplex Doppler ultrasonography of lower limb veins: detection of cardiac abnormalities

Abstract

Aim: We describe the detection of right sided cardiac abnormalities by Doppler ultrasonography of the lower limb veins. We also attempt to quantify the degree of tricuspid regurgitation (TR) by analysis of the femoral vein Doppler waveform (DW).

Materials and methods: The DWs of the lower limb veins were examined in 276 patients over a 17-month period. The detection of abnormal pulsatile DW was compared with echocardiography on these patients. The reports of chest radiographs (CXR) obtained on 104 of the 276 patients were reviewed.

Results: Abnormal cardiac pulsatility of the DW was detected in nine patients (3.3%), with abnormally high retrograde velocity peak (RVP) recordings. These abnormal RVPs are compared to RVPs in a normal control group. The RVPs in the abnormal group revealed a statistically significant (Pearson's r = 0.9113) correlation with the degree of TR observed on echocardiography. All nine patients (100%) demonstrated cardiac enlargement on CXR compared to 16 of the 95 (16.8%) with a normal DW and available report of recently performed CXR.

Conclusion: Doppler ultrasonography of lower limb veins is a frequently performed examination in most Radiology departments. We describe a simple, effective and reproducible ultrasound technique enabling detection of an underlying cardiac abnormality that may provide an estimation of the degree of TR. These important signs should alert the examining radiologist to the presence of an underlying cardiac dysfunction that may require further appropriate cardiac evaluation.McClure, M. J. (2000). Clinical Radiology 55, 533-536.