Evaluation of hyponatremia in heart failure patients admitted in critical care unit: single centre experience

Hyponatremia is a very common electrolyte disturbance in hospitalized patients of heart failure. Clinical profile of such patients with hyponatremia and common co-morbidities are subjects of current study where we made an attempt to evaluate severity, symptoms and in hospital outcome of such patients.

All patients presented to intensive coronary care unit (ICCU) with decompensated congestive cardiac failure (CCF) during three months period in 2012 were included in the study.

Out of total 1184 ICCU admissions, 650 were presented with decompensated heart failure. Serum sodium levels less than 135 mmol/L was found in 334 patients while severe hyponatremia less than 110 mmol/L was seen in 5.3%. Symptomatology ranged from mild irritability and intractable vomiting to seizures and unresponsiveness on neurologic evaluation. Male preponderance (64.40%) was noted. Common co-morbidities were hypertension (64.22%), Diabetes mellitus (32.41%), Ischemic Heart Disease (67.42%) and valvular heart disease (10.5%). Two diuretic molecules were co-administered in (39.70%). Females tolerated different grades of hyponatremia better than males with fewer symptoms and less mortality.

Hyponatremia is more common in male patients presenting with CCF however, female patients with CCF have less mortality and fewer symptoms. There is a direct relation of serum sodium concentration and in hospital mortality.