Importance of early diagnosis and treatment of severe hyponatremia due to the use of diuretics in patients with heart disease such as hypertension and heart failure. presentation of a clinical case

Abstract

Heart disease is becoming more frequent and includes ischemic heart disease and heart failure as the predominant complication of the latter; which demand the use of medications that, fortunately, are very effective. Within the treatment of heart disease, both the use of diuretics of any kind and low-sodium diets must be handled with great care since their indiscriminate and inexperienced use can expose the patient to critical conditions that warrant urgent hospitalization; Hyponatremia can even lead to coma, first including headache, confusion, stupor, and seizures. We present the case of a 72-year-old female patient hospitalized for severe drowsiness after having been exposed to the intense sun for several hours, reporting significant sweating. She was admitted with clinical data of dehydration with serum values of sodium of 119 mmol/L, potassium of 4.6 mmol/L and chlorine of 85 mmol/L.. One of the most appropriate management of severe hyponatremia should be progressive doses of 0.9% saline solution, measuring serum sodium, potassium and chlorine every 4 hours, causing the patient's improvement successfully. On the other hand, management with a low-sodium diet even in heart failure is no longer recommended; It is suggested that the amount of sodium ingested should not be less than 5 g per day.