Chronic Kidney disease patients with or without dialysis treatment may develop symptoms of heart failure. With the advent of technology, bedside ultrasonography can now be done to help identify the cause of congestion -- not only on OPD basis, but also at the emergency level. This case series report on 10 patients who are diagnosed case of CKD with no previous history of hemodialysis, presented with undifferentiated dyspnea and diagnosed as pulmonary congestion upon arrival at the Emergency department. These patients complained with difficulty breathing and triaged as ESI 1 under the Emergency department of Southern Philippines Medical Center, Davao city, Philippines. The result shows that majority of patients present with normal systolic function as evidence by the mean average ejection fraction of 52% and mean average fractional shortening of 28%. A mean average inter ventricular septum diameter of 1.5 cm (normal: 1.2 cm) finding is indicative of left ventricular hypertrophy in 90% of patients. In the pulmonary findings, it was observed that 100% of patients presented with B profile > 4 lung zones indicative of pulmonary edema. For the IVC diameter, 3 of the 10 (30%) patients presented with <2 cm IVC diameter amidst presenting signs and symptoms of pulmonary edema. This case series therefore concluded that most CKD patients presenting with heart failure still has preserved systolic function despite signs of failure, which suggest that dyspnea was caused by the complications of CKD.