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A Patient with Abdominal Congestion

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Cardiorenal Syndrome in Heart Failure

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Abstract

The occurrence of abdominal congestion in acute decompensated heart failure (ADHF) and the relationship with increased intra-abdominal pressures (IAP) remain relatively understudied and unrecognized in heart failure. Literature from intensive care medicine, recognizes that an increase in IAP (defined as IAP > 8 mmHg), is an independent predictor for adverse outcome. A limited amount of data indicates that in ADHF, the prevalence of an IAP above 8 mmHg, can be as high as 60%. An increase in IAP does not necessarily require the presence of overt ascites. Therefore, the physical exam has a limited sensitivity and specificity to detect an increased IAP, and direct measurement via a urinary Foley catheter are necessary to documents its presence. An increased IAP in ADHF has been associated with worsening of renal function, due to both extrinsic renal compression and the co-existence of renal venous congestion. Interestingly, strategies that result in a resolution of the increased IAP in ADHF (e.g. paracentesis or ultrafiltration), have been shown to result in an improvement of renal function. This chapter focusses on the role of abdominal congestion in heart failure.

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Abbreviations

AHF:

acute heart failure

CHF:

Chronic Heart Failure

NP:

natriuretic peptides

WRF:

worsening of renal function

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Author information

Authors and Affiliations

  1. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium

    Pieter Martens

  2. Ziekenhuis Oost-Limburg, Genk University Hasselt, Genk, Belgium

    Wilfried Mullens

Authors
  1. Pieter Martens
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  2. Wilfried Mullens
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Corresponding author

Correspondence to Wilfried Mullens .

Editor information

Editors and Affiliations

  1. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang

  2. Department of Internal Medicine, UZ Leuven, Leuven, Belgium

    Frederik H. Verbrugge

  3. Ziekenhuis Oost-Limburg, Genk University Hasselt, Genk, Belgium

    Wilfried Mullens

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Martens, P., Mullens, W. (2020). A Patient with Abdominal Congestion. In: Tang, W., Verbrugge, F., Mullens, W. (eds) Cardiorenal Syndrome in Heart Failure. Springer, Cham. https://doi.org/10.1007/978-3-030-21033-5_13

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  • DOI: https://doi.org/10.1007/978-3-030-21033-5_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21032-8

  • Online ISBN: 978-3-030-21033-5

  • eBook Packages: MedicineMedicine (R0)

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