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Updated: Mar 10, 2026

Demystifying Venous Excess Ultrasound (VExUS): Image Acquisition and Interpretation
Published on: May 16, 2025
Involvement of systemic venous congestion in heart failure
J Rubio Gracia1, M Sánchez Marteles1, J I Pérez Calvo2
1Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.
Abstract:
Systemic venous congestion has gained significant importance in the interpretation of the pathophysiology of acute heart failure, especially in the development of renal function impairment during exacerbations. In this study, we review the concept, clinical characterisation and identification of venous congestion. We update current knowledge on its importance in the pathophysiology of acute heart failure and its involvement in the prognosis. We pay special attention to the relationship between abdominal congestion, the pulmonary interstitium as filtering membrane, inflammatory phenomena and renal function impairment in acute heart failure. Lastly, we review decongestion as a new therapeutic objective and the measures available for its assessment.
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