Dilatation of the inferior vena cava may indicate a preclinical stage before the appearance of physical signs of cardiac function deterioration. The aim of this case study was to explore the relationship between inferior vena cava diameter fluctuations and the onset of physical signs associated with cardiac decompensation in a 97-year-old home-dwelling patient with heart failure. The patient's vital signs, physical findings and inferior vena cava measurements were assessed at the same time of day over four visits at 2-week intervals. The maximum inferior vena cava diameters (cm) were 1.0 at the first observation, 1.5 at the second, and 1.7 at both the third and fourth observations. Bilateral lower-limb oedema was observed at the third visit, which had extended to the trunk by the fourth visit. The temporal relationship between inferior vena cava dilatation and the appearance of oedema suggests that inferior vena cava enlargement precedes the overt signs of fluid retention. These findings imply that serial assessment of inferior vena cava diameter may offer early detection of cardiac functional decline in home-based heart failure management.
Oohashi et al. (Sat,) studied this question.