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Updated: Jun 3, 2026
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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
Effect of positional changes on inferior vena cava size
Farouk Mookadam1, Tahlil A Warsame, Hyun Suk Yang
1Cardiovascular Diseases & Internal Medicine, Mayo Clinic Arizona, 13400 E Shea Blvd., Scottsdale, AZ 85259-5499, USA. mookadam.farouk@mayo.edu
Summary
The inferior vena cava (IVC) is significantly larger when patients are in the supine position compared to the left lateral position. This positional difference in IVC diameter is important for echocardiographic measurements.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
Background:
- The American Society of Echocardiography recommends imaging the inferior vena cava (IVC) in the left lateral position.
- However, many laboratories routinely assess IVC size from the supine position.
- The impact of patient positioning on IVC dimensions is not extensively documented.
Purpose of the Study:
- To investigate the effect of positional changes on the diameter of the inferior vena cava (IVC).
- To compare IVC measurements obtained in the supine versus the left lateral decubitus positions.
Main Methods:
- Forty-three patients with normal echocardiographic findings were enrolled.
- Subcostal echocardiographic views were used to measure IVC dimensions.
- Hepatic vein (HV) Doppler flow and tricuspid regurgitation (TR) velocity were also assessed.
Main Results:
- IVC systolic and diastolic dimensions were significantly larger in the supine position compared to the left lateral position (P < 0.001 for both).
- Mean IVC systolic diameter was 17.2 mm (supine) vs. 10.9 mm (left lateral).
- Mean IVC diastolic diameter was 16.2 mm (supine) vs. 9.9 mm (left lateral).
- No significant positional influence was observed on HV systolic and diastolic peak velocities.
Conclusions:
- Inferior vena cava diameter is consistently larger in the supine position, irrespective of the cardiac cycle.
- This difference may be attributed to increased intra-abdominal pressure and liver compression of the IVC in the left lateral position.
- Patient positioning significantly impacts IVC size, a crucial consideration for accurate echocardiographic assessment.
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