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Heart Failure Patient With Hypervolemic Hyponatremia
Diagnosis
Hypervolemic hyponatremia in an elderly patient with acute decompensated heart failure*
In clinical studies of Vaprisol, the adverse event profile in elderly patients was similar to that seen in the general population.1
Why Vaprisol was chosen for treatment
- For this patient with hypervolemic hyponatremia resulting from CHF, IV furosemide failed to raise serum sodium to normal range
- Treatment with Vaprisol was initiated to provide aquaresis and a demonstrated increase in serum sodium
Initial Presentation
A 75-year-old woman was admitted to the hospital with hyponatremia secondary to acute decompensated congestive heart failure (CHF) of several days' onset, primarily attributed to medication noncompliance. Her ejection fraction (EF) was 20%.
Medical History
- Chronic ischemic cardiomyopathy
Medications
- Lisinopril
- Carvedilol
- Furosemide
- Aspirin
- Pravastatin
Patient's progression from admission to discharge
| LAB VALUES | |||
| Serum K+ (mEq/L) |
Serum Na+ (mEq/L) |
NOTES | |
| Admission | 4.0 | 124 | IV furosemide was started. |
| Day 3 | 4.0 | 126 | A 20-mg loading dose of Vaprisol was started followed by a continuous infusion of 20 mg/day because serum sodium remained below normal. |
| Day 4 | — | 130 | A second 24-hour continuous infusion of Vaprisol 20 mg/day was initiated. |
| Day 5 | 4.2 | 136 | Serum sodium increased and infusion of Vaprisol was discontinued. Patient was discharged to home on previous drug therapy and diuretics. |
*Vaprisol has not been shown to be effective for the treatment of the signs and symptoms of heart failure and is not approved for this indication. Safety data on use of Vaprisol in these patients is limited. Consider other treatment options.
