The use of ultrasound to determine volume status and identify sites of edema in patients with heart failure

Abstract

The management of patients with congestive heart failure requires an accurate working diagnosis and frequent assessment of responses to treatment.  In addition, the prediction of short-term and long-term outcomes is important to both the clinician and the patient.  The development of pulmonary edema usually represents an acute deterioration of cardiac status and requires immediate attention.  The development of peripheral edema usually represents chronic heart failure and warrants evaluation and possibly therapeutic adjustments.  Noninvasive tests to identify sites of extravascular fluid formation can help the clinician manage his or her patients.  Lung ultrasound can identify B-lines that usually represent pulmonary edema.  Ultrasound studies of the inferior vena cava and its dimensions can help determine volume status and make decisions regarding fluid management.  This review outlines the use of ultrasound to determine sites of edema formation in patients with heart failure.

Key words: ultrasound, inferior vena cava, pulmonary edema, congestive heart failure