Combination of hypertonic saline and low-dose furosemide is an effective treatment for refractory congestive heart failure with hyponatremia

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• 作者：Daisuke Morisawa ; MD ; Shinichi Hirotani ; MD ; PhD ; ^{hirotani@hyo-med.ac.jp" class="auth_mail} ; Makiko Oboshi ; MD ; Masataka Sugahara ; MD ; Miho Fukui ; MD ; Tomotaka Ando ; MD ; Yoshitaka Okuhara ; MD ; Ayumi Nakabo ; MD ; Yoshiro Naito ; MD ; PhD ; Tohru Masuyama ; MD ; PhD ; FJCC
• 关键词：Diuretics ; Heart failure ; Hypertonic saline ; Hyponatremia
• 刊名：Journal of Cardiology Cases
• 出版年：May 2014
• 年：2014
• 卷：9
• 期：5
• 页码：179-182
• 全文大小：789 K

文摘

Hyponatremia often associates with heart failure. Although severe salt restriction is generally recommended in heart failure treatment, it may promote hyponatremia which is a risk factor for increased morbidity and mortality in heart failure patients. Therefore, it is not yet clear whether correction of hyponatremia is an effective treatment in congestive heart failure with hyponatremia. We experienced a successful case of refractory congestive heart failure with hyponatremia treated with hypertonic saline and furosemide. A 45-year-old man, suffering from dilated cardiomyopathy, was admitted to our hospital for heart failure worsening with hyponatremia. We started diuretics therapy without correction of hyponatremia, but his clinical status of heart failure was not improved. Therefore, we additionally started to correct hyponatremia by continuous injection of hypertonic saline. The correction of hyponatremia increased urinary volume dramatically, and improved cardiac output and clinical status of heart failure. This case strongly suggests that combination of hypertonic saline and furosemide could enhance diuretic effect, and improve the clinical status of heart failure in congestive heart failure patients with hyponatremia.

<Learning objective: Hyponatremia is a major problem associated with heart failure, but it is not yet clear whether correction of hyponatremia is an effective treatment in patients with congestive heart failure. We experienced a successful case of refractory congestive heart failure with hyponatremia treated with hypertonic saline and low dose furosemide. This case strongly suggests that aggressive correction of hyponatremia can be an effective treatment for refractory congestive heart failure with hyponatremia.>