Presentation
Pain in the right upper abdomen with mild breathlessness.
Patient Data
The liver is enlarged with decreased echogenicity. Hepatic veins are engorged. The inferior vena cava is dilated. The common bile duct and gall bladder are edematous. Bilateral pleural effusions are visible. The contractility of the heart appears decreased.
Case Discussion
Ultrasound can be a helpful non-invasive modality to diagnose congestive heart failure in the emergency department. A constellation of findings of congestive hepatopathy, like decreased liver echogenicity with dilated hepatic veins and inferior vena cava, should alert the sonologist 1. A subcostal view of the heart may also find pericardial effusion and compromised contractility of the heart. Following ultrasound clues, NT-proBNP levels confirmed the diagnosis of CHF. Early diagnosis can be life-saving.
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