Electrolyte disturbances in patients with chronic heart failure--clinical, evolutive and therapeutic implications

Rev Med Chir Soc Med Nat Iasi. 2012 Jul-Sep;116(3):708-13.

Abstract

Patients with heart failure are, by definition, hemodynamic unstable. Often, this condition may be accentuated by medication (digitalis, diuretics, antiarrhythmics), so that they become more sensitive to electrolyte disturbances, reacting sometimes violently with severe and life threatening rhythm troubles.

Aim: the evaluation of the incidence of electrolyte disturbances 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 100 patients diagnosed with chronic heart failure NYHA II-IV classes, admitted in Cardiology Clinic during 2009-2011. We analyzed electrolytic disturbances occurred during different strategies of therapy.

Results: 100 patients with heart failure were admitted in Cardiology Clinic during 2009-2011, 75 males and 25 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 obtained data showed that electrolyte disturbances are frequent in patients with chronic heart failure, irrespectively of NYHA class. Hyperkalaemia, hypokalaemia and hyponatraemia are associated with diuretic therapy and may play a very important role in subsequent development of life-threatening arrhythmias.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / prevention & control
  • Arrhythmias, Cardiac / therapy
  • Chronic Disease
  • Diuretics / administration & dosage
  • Diuretics / adverse effects*
  • Female
  • Heart Failure / blood
  • Heart Failure / complications*
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy
  • Heart Failure / epidemiology
  • Hemodynamics
  • Humans
  • Hyperkalemia / chemically induced
  • Hypokalemia / chemically induced
  • Hyponatremia / chemically induced
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Romania / epidemiology
  • Water-Electrolyte Imbalance / blood
  • Water-Electrolyte Imbalance / chemically induced*
  • Water-Electrolyte Imbalance / diagnosis
  • Water-Electrolyte Imbalance / drug therapy
  • Water-Electrolyte Imbalance / epidemiology

Substances

  • Diuretics