The inferior vena cava (IVC) is usually visible posterior to the posterior border of the heart on the lateral projection. The superior vena cava (SVC) usually forms the right border of the upper supracardiac mediastinum. Distension of the SVC or posterior bulging (see figure below) or visibility of the IVC in the right cardiophrenic angle may indicate increased right atrial pressure.
Enlargement of the inferior vena cava is indicated by bulging of the cava at the right cardiophrenic angle (arrow, left) and posteriorly (arrow, right) in this patient with severe tricuspid regurgitation.
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