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

AIM: We describe the detection of right sided cardiac abnormalities by Dopp ler ultrasonography of the lower limb veins. We also attempt to quantify th e degree of tricuspid regurgitation (TR) by analysis of the femoral vein Do ppler 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 wa s compared with echocardiography on these patients, The reports of chest ra diographs (CXR) obtained on 104 of the 276 patients were reviewed. RESULTS: Abnormal cardiac pulsatility of the DW was detected in nine patien ts (3.3%), with abnormally high retrograde velocity peak (RVP) recordings. These abnormal RVPs are compared to RVPs in a normal control group. The RVP s in the abnormal group revealed a statistically significant (Pearson's r = 0.9113) correlation with the degree of TR observed on echocardiography, Al l 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 perf ormed CXR, CONCLUSION: Doppler ultrasonography of lower limb veins is a frequently per formed examination in most Radiology departments. We describe a simple, eff ective and reproducible ultrasound technique enabling detection of an under lying cardiac abnormality that may provide an estimation of the degree of T R, These important signs should alert the examining radiologist to the pres ence of an underlying cardiac dysfunction that may require further appropri ate cardiac evaluation. (C) 2000 The Royal College of Radiologists.