This in turn further hampers the delivery of oxygen and nutrients, creating a vicious cycle with consequent worsening of ascites.[5,6] Exacerbation of ascites may occur with the onset of splanchnic vasodilatation, renal hypoperfusion (causing overactivation of the renin-angiotensin-aldosterone system), and sodium retention leading to a hypervolemic state.[7–9] The impact of cardiac cirrhosis on the patient’s overall prognosis has yet to be well established, hence its management is primarily treatment of the underlying cardiac disease.[10]. Here, REN is linked to Ascites.