Boston Medical Center Ultrasound Decongestion Study in Heart Failure

Inclusion Criteria: * Patient with a primary diagnosis of acute on chronic decompensated heart failure who is admitted to inpatient or presents to the outpatient Boston Medical Center (BMC) Heart Failure Infusion clinic for decongestion treatment. * Willing and able to receive short abdominal and thoracic ultrasounds throughout hospitalization * Patients with right and/or left ventricular failure Exclusion Criteria: * Hemodynamic instability defined as systolic blood pressure \<85 mmHg or mean arterial pressure \<60 mm Hg for greater than 24 hours duration * Abdominal surgery in the past 1 month * Significant acute or chronic liver disease * End stage renal disease on dialysis * Advanced chronic kidney disease (CKD) \[Stage V CKD with glomerular filtration rate (GFR) \<15\] to exclude renal vein doppler ultrasound * Severe acute kidney injury (AKI) or requiring renal replacement therapy * Known abdominal thrombus in the inferior vena cava (IVC) or portal vein * Acute myocarditis * Acute valvular disease * Acute type 1 myocardial infarction * Medical condition precluding abdominal ultrasound due to significant discomfort or pain * Adults not able to provide consent (a simple teach back method of key aspects discussed in consent form will be utilized to verify if patient is able to adequately provide informed consent)