Imaging of Congestion in Cardio-renal Syndrome

Both cardiac and renal dysfunction can lead to water overload - commonly referred to as "congestion". Identification of congestion is difficult, especially when clinical signs are subtle.

As an extension of an echocardiographic examination, ultrasound can be used to identify intravascular (inferior vena cava diameter dilation, internal jugular vein distension or discontinuous venous renal flow) and tissue congestion (pulmonary B-lines). Combining assessment of cardiac structure, cardiac and renal function and measures of congestion informs the management of heart and kidney disease, which should improve patient outcomes. In this manuscript, we describe imaging techniques to identify and quantify congestion, clarify its origin, and potentially guide the management of patients with cardio-renal syndrome.