Imaging of Congestion in Cardio-renal Syndrome

Purpose of Review: 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. Recent Findings: 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. Summary: 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.