Figure 3.

Mistakes in the interpretation of hepatic vein Doppler when there is no simultaneous ECG trace. (A) Without ECG, S and D waves are misidentified and interpreted as an S > D pattern. The correct interpretation is S < D. Note that the S wave follows a QRS complex. (B) Without ECG, the waveform is interpreted as a D-only pattern (S reversal). The correct interpretation is a fusion of D and S waves, which can happen in hyperdynamic states. (C) Without ECG, the waveform is interpreted as normal, with S and D waves below the baseline. The correct interpretation is a D-only pattern with S reversal. There is no downward wave immediately following the QRS complex. Note the rhythm is irregular; the patient has atrial fibrillation. Abbreviation: ECG, electrocardiographic.