I've done 50+ vexus exams. I notice that I often get very irregular waveforms when my pulse wave doppler sample is in the proximal hepatic vein (near the IVC). I have often had to find a more distal / smaller segment. Otherwise the waveform is irregular and isn't really making any sense. What do you think of this? Am I doing something majorly incorrect? Any tips would be welcomed!
Yes, subxiphoid IVC-HV view often gives hazy waveforms difficult to interpret, especially if there is no simultaneous EKG. We mentioned about it here - pubmed.ncbi.nlm.nih.gov/38815571/ Key is to use the right lateral window to find a relatively straight segment of HV a little farther from HV-IVC junction.
