HYPONATREMIA: A CORRECTION DILEMMA

T. Tamilselvan*, Anju C. James, Arokia Rani C., Arya Jacob and Ashna Raj

ABSTRACT

Hyponatremia is a major problem associated with heart failure, with serum sodium concentration lower than 136 mmol/L. Hyponatremia has been reported as a risk factor for increased morbidity and mortality in patients with chronic heart failure. This case study, A 72-year-old female was admitted with the complaints of severe breathing difficulty and tiredness of 1-week duration. She had a past medical history of Diabetes mellitus and Hypertension. In last 2 years, she was suffering from DM with Nephropathy, Dilated Cardiomyopathy with Left Ventricular Dysfunction. The patient had a medication history of T.Amlodipine for hypertension and it may cause pedal edema and T.Losartan Potassium + Hydrochlorothiazide may cause hyponatremia. On admission, the patient has hypervolemic hyponatremia, after 2 days of treatment with Inj. Furosemide becomes euvolemic. Later the patient shows skin triggers which concluded hypovolemic hyponatremia and treated with inj. Furosemide and 3% hypertonic solution, it increases cardiac output through an increase in effective blood circulation volume, improve inappropriate elevation of AVP and enhance effects of diuretics. In conclusion, managing patient with heart failure associated with frequent hyponatremia is a difficult task which requires careful assessment and balancing of patient’s volemic condition and serum sodium level by properly adjusting the dose of dietary sodium, diuretic therapy along with fluid intake.

Keywords: Hyponatremia, Heart failure, Serum sodium.