Lower-extremity venous flow. The normal and the pulsatile venous Dppler flow

During breathing, in the normal subject, lower limb venous Doppler tracings may consist not only of waves correlated to respiratory activity but also related to cardiac activity. The venous flow velocity increases or decreases in relation to both the respiratory cycle phases and the heart cycle phases.

In right ventricular dysfunction venous pressure increases, so the respiratory dependence of the venous flow may be removed. In this case the spectrum of the femoral veins changes: a pulsatile flow appears (cardiac modulated flow, with a cyclic retrograde component).

This pulsatile venous flow is, however, not only present in right ventricular dysfunction but also noted in normal subjects without history of heart disease. In these subjects, perhaps in a low compliance system, the pulsatility flow is a reflection of the haemodynamic state of the lower extremity venous system.

The pulsatile venous flow in the lower limbs veins may be an indicator of right heart failure: in these cases, therefore, the clinician should consider a complete cardiological evaluation.

Lower-extremity venous flow. The normal and the pulsantile venous Doppler flow

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