HF and Intensive Care: Review Article
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Christopoulou E. · Liamis G. · Naka K. · Touloupis P. · Gkartzonikas I. · Florentin M.
Abstract
Abstract
Background: Heart failure (HF)is considered an epidemic disease with considerable morbidity, mortality and immense healthcare costs. Electrolyte abnormalities are often encountered in patients with HF posing a diagnostic and therapeutic challenge for clinicians. Hyponatremia affects up to one third of HF patients and represents an unfavorable prognostic factor.
Summary: Low sodium levels in HF are mainly attributed to the neurohormonal activation secondary to decreased effective circulating volume. However, patients with HF often have several co-morbidities which may cause or exacerbate the pre-existing hyponatremia. Factors that provoke HF, such as alcohol overconsumption, may also be involved in hyponatremia development. Furthermore, drugs which are frequently prescribed to HF patients, especially diuretics, are potential culprits of hyponatremia and should always be addressed, since their withdrawal may reverse hyponatremia. Despite the great prevalence and the deleterious effects hyponatremia in these patients, it is often overlooked and consequently undertreated. In this review we present the mechanisms involved in the development of hyponatremia focusing on those besides neurohormonal activation. We also discuss the proper management of this electrolyte disorder which is frequently complex in patients with HF.
Key Messages: Hyponatremia in patients with HF is not only the result of neurohormonal activation; several co-morbidities and frequently used drugs should also be addressed. Hence, a holistic approach is required both for the diagnosis and optimal treatment.
S. Karger AG, Basel
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