Spontaneous contrast in the inferior vena cava in a patient with constrictive pericarditis

A 66 year old black man was examined because of fatigue and progressive right heart failure. A striking finding on his echocardiogram was intense and slow-moving contrast in the inferior vena cava. Cardiac catheterization revealed constrictive pericarditis, and pericardiectomy was performed. Postoperatively, spontaneous contrast was no longer present. This case helps explain the origin of spontaneous inferior vena cava contrast.