Presentation
Heart failure. Abnormal liver function tests.
Patient Data
Age: 50 years
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There is a biphasic Doppler tracing of the portal vein. Other images showed an otherwise normal liver with no focal lesions or biliary dilatation, normal hepatic vein Doppler traces, and a normal sized spleen with no ascites.
Case Discussion
A biphasic Doppler trace of the portal vein in the presence of normal hepatic vein Doppler traces usually indicates raised right heart pressures secondary to tricuspid regurgitation. A normal portal vein Doppler trace should be monophasic with a little variation in maximum and minimum velocity, with no reversal of flow. In this particular case, when the line drops below the 0 cm/s level, there is reversal of flow.
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