Emergency department right atrial pressure and intravascular volume estimation using right ventricular tissue doppler bedside ultrasonography

A 41 year old woman with a history of colon cancer metastatic to her lung and liver, presented to the emergency department severely dehydrated. Bedside ultrasonography revealed a tumor mass in her proximal inferior vena cava at the junction of the right atrium obstructing the ability to assess her volume status with inferior vena cava inspiratory collapse. Bedside emergency department cardiac tissue Doppler ultrasonography of the lateral right ventricle and pulse Doppler ultrasonography of the tricuspid valve was used to estimate her right atrial pressure and intravascular volume status.