Congestion in heart failure, a prominent role in pathophysiology, and a therapeutic goal

Abstract

Systemic congestion plays a key role in the management of patients with heart failure (HF). Most of the patients admitted for acute decompensated heart failure show congestive signs and/or symptoms (clinical congestion). The medical community is being progressively aware of the active role of congestion in the pathophysiology of HF. Congestion can lead to organ damage, such as congestive kidney failure or endothelial dysfunction. When congestion remains after diuretic therapy (residual congestion), prognosis worsens. Even though, residual congestion is common among patients at discharge. Accordingly, the active search of remnant signs of congestion before discharge is nowadays a first-line therapeutic goal.

Keywords

• Heart failure. Residual congestion. Intraabdominal pressure. Cardiorenal syndrome. Impaired renal function. Clinical bedside ultrasound. CA125.