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The Prevention of Hyponatremic Congestive Heart Failure

The Prevention of Hyponatremic Congestive Heart Failure Abstract During the past decade a serious and often irreversible syndrome has been recognized with increasing frequency in patients with long-standing congestive heart failure. Clinically these patients are characterized by extensive disease of the heart, prolonged histories of recurrent episodes of circulatory failure, and intractable edema. Chemically they present considerable reductions in the serum sodium and chloride concentrations and signs of increasing renal failure. Admission to the hospital is generally prompted by increasing edema and fastness to mercurial diuretics. The precise mechanism whereby prolonged congestive heart failure terminates in this therapeutic paradox remains obscure. The past 10 to 15 years have been noteworthy for the development of several concepts in the management of congestive heart failure. These therapeutic usages have appreciably prolonged the life of the cardiac patient. This very prolongation, however, by exposing tissues to the sequellae of perpetuated ischemia and anoxia, may have rendered these tissues subject to alterations References 1. Schroeder, H. A.: Studies on Congestive Heart Failure: Importance of Restriction of Salt as Compared to Water , Am. Heart J. 22:141 ( (Aug.) ) 1941.Crossref 2. Chasis, H.; Goldring, W.; Breed, E. S.; Schreiner, G. E., and Bolomey, A. A.: Salt and Protein Restriction: Effects on Blood Pressure and Renal Hemodynamics in Hypertensive Patients , J. A. M. A. 142:711 ( (March 11) ) 1950.Crossref 3. Newburgh, L. H.: Renal Tubule Work: Its Significance for the Clinician , Bull. New York Acad. Med. 24:137 ( (March) ) 1948. 4. Berliner, R. W., and Davidson, D. G.: Production of Hypertonic Urine in the Absence of Pituitary Antidiuretic Hormone , J. Clin. Invest. 35:690 ( (June) ) 1956. 5. Mudge, G. H.: Studies on Potassium Accumulation by Rabbit Kidney Slice: Effect of Metabolic Activity , Am. J. Physiol. 165:113 ( (April) ) 1951. 6. Gold, H., et al.: A System for the Routine Management of the Failing Heart , Am. J. Med. 3:665 ( (Dec.) ) 1947.Crossref 7. Schwartz, W. B., and Wallace, W. M.: Electrolyte Equilibrium During Mercurial Diuresis , J. Clin. Invest. 30:1089 ( (Oct.) ) 1951.Crossref 8. Levitt, M. F.: The Interpretation of the Laboratory Data in the Use of the Cation Exchange Resins , Bull. New York Acad. Sc. 57:298, 1953.Crossref 9. Friedberg, C. K.; Halpern, M., and Taymor, J.: The Effect of Intravenously Administered 6063, the Carbonic Anhydrase Inhibitor, 2-Acetylamino-1,3,4,-Thiadiazole-5-Sulfonamide, on Fluid and Electrolytes in Normal Subjects and Patients with Congestive Heart Failure , J. Clin. Invest. 31:1074 ( (Dec.) ) 1952.Crossref 10. Lauson, H. D., and Thompson, D. D.: Effects of Decrease in Glomerular Filtration Rate on Cation Excretion During Loading with Nonreabsorbable Anions , Fed. Proc. 12:83 ( (March) ) 1953. 11. Darrow, D. C.: Changes in Muscle Composition in Alkalosis , J. Clin. Invest. 25:324 ( (May) ) 1946.Crossref 12. Aikawa, J. K.; Felts, J. H., Jr.; Tyor, M. P., and Harrell, G. T.: The Exchangeable Potassium Content in Disease States , J. Clin. Invest. 31:743 ( (July) ) 1952.Crossref 13. Cooke, R. E.; Segar, W. F.; Check, D. B.; Coville, F. E., and Darrow, D. C.: Extrarenal Correction of Alkalosis Associated with Potassium Deficiency , J. Clin. Invest. 31:798 ( (Aug.) ) 1952.Crossref 14. Mudge, G. H., and Hardin, B.: Response to Mercurial Diuretics During Alkalosis: A Comparison of Acute Metabolic and Chronic Hypokalemic Alkalosis in the Dog , J. Clin. Invest. 35: 155 ( (Feb.) ) 1956.Crossref 15. Lown, B.; Weller, J. M.; Wyatt, N.; Hoigne, R., and Merrill, J. P.: Effects of Alterations of Body Potassium on Digitalis Toxicity , J. Clin. Invest. 31:648 ( (June) ) 1952. 16. Relman, A. S., and Schwartz, W. B.: The Nephropathy of Potassium Depletion: A Clinical and Pathological Entity , New England J. Med. 255:195 ( (Aug. 2) ) 1956.Crossref 17. Foye, L. V., Jr., and Feichtmeier, T. V.: Adrenal Cortical Carcinoma Producing Solely Mineralocorticoid Effect , Am. J. Med. 19:966 ( (Dec.) ) 1955.Crossref 18. Levitt, M. F.; Turner, L. B.; Sweet, A. Y., and Pandiri, D.: The Response of Bone, Connective Tissue, and Muscle to Acute Acidosis , J. Clin. Invest. 35:98 ( (Jan.) ) 1956.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

The Prevention of Hyponatremic Congestive Heart Failure

A.M.A. Archives of Internal Medicine , Volume 100 (3) – Sep 1, 1957

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1957.00260090020005
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Abstract

Abstract During the past decade a serious and often irreversible syndrome has been recognized with increasing frequency in patients with long-standing congestive heart failure. Clinically these patients are characterized by extensive disease of the heart, prolonged histories of recurrent episodes of circulatory failure, and intractable edema. Chemically they present considerable reductions in the serum sodium and chloride concentrations and signs of increasing renal failure. Admission to the hospital is generally prompted by increasing edema and fastness to mercurial diuretics. The precise mechanism whereby prolonged congestive heart failure terminates in this therapeutic paradox remains obscure. The past 10 to 15 years have been noteworthy for the development of several concepts in the management of congestive heart failure. These therapeutic usages have appreciably prolonged the life of the cardiac patient. This very prolongation, however, by exposing tissues to the sequellae of perpetuated ischemia and anoxia, may have rendered these tissues subject to alterations References 1. Schroeder, H. A.: Studies on Congestive Heart Failure: Importance of Restriction of Salt as Compared to Water , Am. Heart J. 22:141 ( (Aug.) ) 1941.Crossref 2. Chasis, H.; Goldring, W.; Breed, E. S.; Schreiner, G. E., and Bolomey, A. A.: Salt and Protein Restriction: Effects on Blood Pressure and Renal Hemodynamics in Hypertensive Patients , J. A. M. A. 142:711 ( (March 11) ) 1950.Crossref 3. Newburgh, L. H.: Renal Tubule Work: Its Significance for the Clinician , Bull. New York Acad. Med. 24:137 ( (March) ) 1948. 4. Berliner, R. W., and Davidson, D. G.: Production of Hypertonic Urine in the Absence of Pituitary Antidiuretic Hormone , J. Clin. Invest. 35:690 ( (June) ) 1956. 5. Mudge, G. H.: Studies on Potassium Accumulation by Rabbit Kidney Slice: Effect of Metabolic Activity , Am. J. Physiol. 165:113 ( (April) ) 1951. 6. Gold, H., et al.: A System for the Routine Management of the Failing Heart , Am. J. Med. 3:665 ( (Dec.) ) 1947.Crossref 7. Schwartz, W. B., and Wallace, W. M.: Electrolyte Equilibrium During Mercurial Diuresis , J. Clin. Invest. 30:1089 ( (Oct.) ) 1951.Crossref 8. Levitt, M. F.: The Interpretation of the Laboratory Data in the Use of the Cation Exchange Resins , Bull. New York Acad. Sc. 57:298, 1953.Crossref 9. Friedberg, C. K.; Halpern, M., and Taymor, J.: The Effect of Intravenously Administered 6063, the Carbonic Anhydrase Inhibitor, 2-Acetylamino-1,3,4,-Thiadiazole-5-Sulfonamide, on Fluid and Electrolytes in Normal Subjects and Patients with Congestive Heart Failure , J. Clin. Invest. 31:1074 ( (Dec.) ) 1952.Crossref 10. Lauson, H. D., and Thompson, D. D.: Effects of Decrease in Glomerular Filtration Rate on Cation Excretion During Loading with Nonreabsorbable Anions , Fed. Proc. 12:83 ( (March) ) 1953. 11. Darrow, D. C.: Changes in Muscle Composition in Alkalosis , J. Clin. Invest. 25:324 ( (May) ) 1946.Crossref 12. Aikawa, J. K.; Felts, J. H., Jr.; Tyor, M. P., and Harrell, G. T.: The Exchangeable Potassium Content in Disease States , J. Clin. Invest. 31:743 ( (July) ) 1952.Crossref 13. Cooke, R. E.; Segar, W. F.; Check, D. B.; Coville, F. E., and Darrow, D. C.: Extrarenal Correction of Alkalosis Associated with Potassium Deficiency , J. Clin. Invest. 31:798 ( (Aug.) ) 1952.Crossref 14. Mudge, G. H., and Hardin, B.: Response to Mercurial Diuretics During Alkalosis: A Comparison of Acute Metabolic and Chronic Hypokalemic Alkalosis in the Dog , J. Clin. Invest. 35: 155 ( (Feb.) ) 1956.Crossref 15. Lown, B.; Weller, J. M.; Wyatt, N.; Hoigne, R., and Merrill, J. P.: Effects of Alterations of Body Potassium on Digitalis Toxicity , J. Clin. Invest. 31:648 ( (June) ) 1952. 16. Relman, A. S., and Schwartz, W. B.: The Nephropathy of Potassium Depletion: A Clinical and Pathological Entity , New England J. Med. 255:195 ( (Aug. 2) ) 1956.Crossref 17. Foye, L. V., Jr., and Feichtmeier, T. V.: Adrenal Cortical Carcinoma Producing Solely Mineralocorticoid Effect , Am. J. Med. 19:966 ( (Dec.) ) 1955.Crossref 18. Levitt, M. F.; Turner, L. B.; Sweet, A. Y., and Pandiri, D.: The Response of Bone, Connective Tissue, and Muscle to Acute Acidosis , J. Clin. Invest. 35:98 ( (Jan.) ) 1956.Crossref

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1957

References