HYPONATREMIA - RISK FACTOR IN PATIENTS WITH CHRONIC HEART FAILURE - CLINICAL, EVOLUTIVE AND THERAPEUTIC IMPLICATIONS

Patients with heart failure are, by definition, hemodynamically unstable. This condition may be accentuated by medication (digitalis, diuretics, antiarrhythmics), so that they become more sensitive to electrolyte disturbances. Hyponatremia is the most common electrolyte disorder, particularly common in the intensive care unit. Aim: the evaluation of the incidence of hyponatremia in patients diagnosed with chronic heart failure in order to establish a correlation with the evolution, prognosis and therapeutic implications. Material and methods: We analyzed retrospectively 120 patients diagnosed with chronic heart failure NYHA II-IV classes, admitted in the Cardiology Clinic between 2009 and 2013. We analyzed electrolytic disturbances which occurred during different strategies of therapy. Results: 120 patients with heart failure were admitted in the Cardiology Clinic between 2009 and 2013, 92 males and 28 females. Diagnosis was established by classical criteria. Evaluation was very complex and included: complete clinical examination, electrocardiogram, echocardiography, chest ray examination and biochemical analyses especially hepatic, renal function and electrolyte status. Conclusions: The data obtained showed that electrolyte disturbances are frequent in patients with chronic heart failure, irrespective of NYHA class. Hyponatremia is usually associated with diuretic therapy and may play a very important role in the subsequent development of life-threatening complications. Patients with heart failure who develop hyponatremia during their evolution had a worse prognosis.