Interesting #VExUS #POCUS case. Awaiting input from @ThinkingCC @ArgaizR & other sonophiles
Thread/
Middle aged pt with heart failure EF<30% with worsening renal function, low urine output. 1st Image - EPSS: increased as expected (likely some degree of error; anatomic M-mode NA)
Thread/
Middle aged pt with heart failure EF<30% with worsening renal function, low urine output. 1st Image - EPSS: increased as expected (likely some degree of error; anatomic M-mode NA)
Portal vein #POCUS
Max 30% pulsatility
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Max 30% pulsatility
Hepatic vein. See S>D
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Renal vein #POCUS. Difficult as usual due to inability to hold breath but seems continuous to me. RI is high, don& #39;t know why....may be a reflection of high SVR in heart failure?
My working diagnosis at this point was likely ATN...less likely congestive renal failure. Doesn& #39;t seem to be a grossly forward flow issue. Lowest systolic BP in 24 hrs - 110 mmHg
But the surprise was that CVP was 26 mmHg on right heart cath!! Something doesn& #39;t make sense...