case_images: PMC9994287_01
case_images: (A) Hepatic vein Doppler waveform at the initiation of ultrafiltration therapy demonstrating only diastolic (D) wave below the baseline indicating severe congestion. (B) Follow up waveform demonstrating both systolic (S) and diastolic (D) waves below the baseline, indicating improved venous return. Note the correlation with accompanying EKG.
case_images: pocusj-07-15340-g001.jpg
case_images: PMC9994287_01_pocusj-07-15340-g001.jpg
case_images: pocusj-07-15340-g001
case_images: S1C). VExUS scan demonstrated D-only pattern on hepatic vein Doppler, which means there is flow towards the heart only during diastole (severe congestion, Figure 1A). Similarly, portal vein Doppler was suggestive of severe congestion with 100% pulsatility and possible flow reversal during systole (Figure 2A). Both S (systolic) and D (diastolic) waves were below the baseline on the hepatic vein tracing indicating near-normal venous return (Figure 1B) and the portal vein pulsatility has substantially improved to ~30% (Figure 2B).
case_images: (A) Portal vein Doppler waveform at the initiation of ultrafiltration therapy demonstrating pulsatile pattern consistent with severe congestion. (B) Follow up waveform demonstrating considerable improvement in thepulsatility (almost normal, continuous pattern).
case_images: pocusj-07-15340-g002.jpg
case_images: PMC9994287_01_pocusj-07-15340-g002.jpg
case_images: pocusj-07-15340-g002
case_images: S1C). VExUS scan demonstrated D-only pattern on hepatic vein Doppler, which means there is flow towards the heart only during diastole (severe congestion, Figure 1A). Similarly, portal vein Doppler was suggestive of severe congestion with 100% pulsatility and possible flow reversal during systole (Figure 2A). Both S (systolic) and D (diastolic) waves were below the baseline on the hepatic vein tracing indicating near-normal venous return (Figure 1B) and the portal vein pulsatility has substantially improved to ~30% (Figure 2B).