August 10, 2026 · Clinical Pearl · HFrEF
POCUS in the Difficult Heart Failure Exam
POCUS is changing how we assess congestion in heart failure.
Volume assessment in hospitalized CHF patients is dynamic. A formal echocardiogram provides invaluable structural and functional information, but repeating a full echo simply to reassess volume status is often unnecessary.
Bedside point-of-care ultrasound (POCUS) can provide rapid, repeatable information. Looking at the IVC, its size, respiratory variation, and overall pattern, can complement the physical exam and help clinicians follow changes in venous congestion during diuresis.
Importantly, the IVC should not be interpreted in isolation. It is one piece of a broader assessment that includes symptoms, exam, weights, urine output, renal function, hemodynamics when appropriate, and other ultrasound findings.
At Sharp Chula Vista, we routinely incorporate bedside POCUS and IVC assessment into the care of our heart failure patients.
Important notice
This content is for educational purposes only and is not medical advice for any individual patient. Patients should discuss diagnosis and treatment decisions with their own physician, or request a clinical consultation.