Point-of-care ultrasound in diagnosis and management of congestive nephropathy

Figure 4 The chain of venous congestion: Apical view of the heart is shown in the upper left corner where bulging of the interatrial septum into the left atrium can be noted suggestive of high right atrial pressure. Next image shows significantly dilated internal jugular vein followed by a plethoric inferior vena cava. Lower panel represents the commonly assessed Doppler parameters to assess systemic venous congestion, all of which are severely abnormal. Please see Figure 3 for the normal appearance of these waveforms and Figure 2 for venous excess ultrasound score grading. RA: Right atrium; RV: Right ventricle; LA: Left atrium; LV: Left ventricle; CA: Carotid artery; S: Systolic wave; D: Diastolic wave.