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In patients with heart failure and cardiorenal syndrome, lingering congestion is associated with worse outcomes. As such, titrating diuretic or ultrafiltration therapy based on objective assessment of volume status plays a crucial role in the management of these patients. Conventional physical examination findings and parameters such as daily weight measurement are not always reliable in this setting. Recently, point of care ultrasonography (POCUS) has emerged as an attractive enhancement to bedside clinical examination in assessing fluid volume status. Specifically, Doppler ultrasound of the major abdominal veins gives additional information about end-organ congestion when used in conjunction with inferior vena cava ultrasound. Moreover, these Doppler waveforms can be monitored in real time to gauge the efficacy of decongestive therapy. Herein, we present a case that illustrates the utility of POCUS in the management of a patient with heart failure exacerbation., Competing Interests: The author declares that no conflict of interest exists., (Copyright (c) 2022 Abhilash Koratala.)

Point of care ultrasonography can be a valuable adjunct to conventional physical examination in patients with hyponatremia that aids in clinical decision making. It can address the shortcomings of traditional volume status assessment such as the inherent low sensitivity of 'classic' signs such as lower extremity edema. Herein, we present a case of a 35-year-old woman where discrepant clinical findings led to confusion in the accurate assessment of volume status but addition of point of care ultrasonography helped to guide the therapy., Competing Interests: The authors have declared that no conflict of interest exists., (Copyright (c) 2022 Mahmud Saqib, Abhilash Koratala.)