Haemodynamic Congestion in Chronic Heart Failure Patients

Fluid balance is critical in heart failure patients. Fifty percent of heart failure patients are re-hospitalised with in six months of discharge from hospital despite best available guidelines. Chronic heart failure patients are in compensated state due to several adaptive changes in the body and physical exam may not correlate to pathophysiological changes occurring within the body leading to haemodynamic congestion. Physical exam and biomarkers have been less reliable to predict development of acute decompensation. Ultrasound evaluation of inferior vena cava diameter and inferior vena cava collapsibility index (IVCCI) has played a remarkable role in estimating and grading hemodynamic congestion in patients with heart failure. We believe echocardiographic assessment of inferior vena cava could predict future risk of HF decompensation and should be used as routine along with standard assessment in chronic heart failure patients.