Ultrasound imaging of congestion in heart failure: examinations beyond the heart

Eur J Heart Fail. 2021 May;23(5):703-712. doi: 10.1002/ejhf.2032. Epub 2020 Nov 23.

Abstract

Congestion, related to pressure and/or fluid overload, plays a central role in the pathophysiology, presentation and prognosis of heart failure and is an important therapeutic target. While symptoms and physical signs of fluid overload are required to make a clinical diagnosis of heart failure, they lack both sensitivity and specificity, which might lead to diagnostic delay and uncertainty. Over the last decades, new ultrasound methods for the detection of elevated intracardiac pressures and/or fluid overload have been developed that are more sensitive and specific, thereby enabling earlier and more accurate diagnosis and facilitating treatment strategies. Accordingly, we considered that a state-of-the-art review of ultrasound methods for the detection and quantification of congestion was timely, including imaging of the heart, lungs (B-lines), kidneys (intrarenal venous flow), and venous system (inferior vena cava and internal jugular vein diameter).

Keywords: B-lines; Heart failure; Inferior vena cava; Intrarenal venous flow; Jugular vein; Ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Delayed Diagnosis*
  • Heart Failure*
  • Humans
  • Jugular Veins / diagnostic imaging
  • Ultrasonography
  • Vena Cava, Inferior / diagnostic imaging