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Click 77 year old female with right heart failure due to progressive tricuspid regurgitation causing liver congestion presenting as a pulsatile epigastric mass. [Contrast enhanced Computed Tomography (CT) examination-axial image .16 Slice MX8000 CT scanner, Philips medical systems. 200mAs, 120kVp (subject to dose modulation). Contrast 120mls Iohexol (Omnipaque, GE healthcare) at 3mls per second with bolus tracking to determine timing of arterial phase, 1.5mm collimation with 3mm reconstruction at 1.5 mm increments]. An Enlarged left lobe of liver overlying a normal sized abdominal aorta. Early contrast filling of hepatic vein tributaries due to tricuspid regurgitation. Arterial phase enhancement of hepatic and renal arteries.