Venous excess ultrasound score detects systemic venous congestion in a left ventricular assist device patient: A case report

Figure 1 Severely abnormal venous Doppler waveforms during the episode of haemodynamic instability. A: Demonstrating hepatic vein systolic flow reversal; B: Marked portal vein pulsatility > 50% (middle); C: Monophasic intrarenal venous flow (right), consistent with severe systemic venous congestion (VExUS score 3).

Figure 2 Following left ventricular assist device speed reduction and haemodynamic stabilization. A-C: Portal vein flow demonstrated improvement with pulsatility index about 40 (B) despite the limited fluid bolus, whereas hepatic (A) and intrarenal (C) venous Doppler waveforms remained severely abnormal, indicating persistent systemic venous congestion.