Use of conivaptan for the treatment of symptomatic hyponatremia in a patient with acute decompensated heart failure

June 2010
American Journal of Health-System Pharmacy;6/15/2010, Vol. 67 Issue 12, p1011
Academic Journal
Purpose. The successful use of conivaptan for the treatment of symptomatic hypervolemic hyponatremia in a patient with acute decompensated heart failure is reported. Summary. A 67-year-old woman with severe ischemic dilated cardiomyopathy was admitted to the hospital due to a heart failure exacerbation. She was initially managed with furosemide and milrinone, but her condition continued to worsen. By hospital day 10, her serum sodium concentration had decreased to 114 meq/L. A 96-hour trial of conivaptan was initiated, and the patient's serum sodium concentration increased to 125 meq/L, blood urea nitrogen level decreased from 34 to 15 g/dL, serum creatinine concentration decreased from 1.1 to 0.9 g/dL, and fluid balance was -9800 mL. After completion of the 96-hour trial of conivaptan, the patient quickly decompensated. Conivaptan was restarted three days later; again, the patient's sodium level quickly increased, and aquaresis occurred. By hospital day 24, the patient was stable enough to undergo a cardiac catheterization, and a stent was placed. On day 26, the patient died while being prepared for an upgrade to a biventricular implantable cardioverter defibrillator. Multiple trials have evaluated conivaptan for the treatment of heart failure. Conivaptan improves hyponatremia and hemodynamic parameters acutely and increases urine output but has failed to show improvement in heart failure symptoms in the published literature. No adverse cardiac effects resulted from the use of conivaptan in this patient. Conclusion. Treatment with i.v. conivaptan in a patient with symptomatic hyponatremia and acute decompensated heart failure resulted in marked diuresis and improvement of hyponatremia.


Related Articles

  • A case of Lamin C gene-mutation with preserved systolic function and ventricular dysrrhythmia. Kit Ng, Kevin; Kaye, Gerald // Australasian Medical Journal;2013, Vol. 6 Issue 2, p75 

    Lamin A/C gene-related cardiomyopathy is associated with progressive heart failure and malignant arrhythmias. Current guidelines advise the use of implantable defibrillators to prevent arrhythmogenic sudden cardiac death only in situations where there is evidence of severe left ventricular...

  • Postrenal biopsy AVM leading to severe hypertension and dilated cardiomyopathy. Sasaki, Nao; Joashi, Umesh C.; Vergara, Marcela; Saland, Jeffrey M.; Love, Barry A. // Pediatric Nephrology;Dec2009, Vol. 24 Issue 12, p2459 

    A 3-year-old girl with Alport syndrome presented with decompensated heart failure from hypertension-induced cardiomyopathy 6 months following renal biopsy. Selective renal angiography revealed a large left renal arteriovenous fistula (AVF) with poor perfusion to the left renal parenchyma. The...

  • Vanishing left ventricular thrombus in a woman with peripartum cardiomyopathy: a case report. Altuwaijri, Wafa A.; Kirkpatrick, Iain D. C.; Jassal, Davinder S.; Soni, Anita // BMC Research Notes;2012, Vol. 5 Issue 1, p1 

    Background: Peripartum cardiomyopathy (PPCM) is a rare cardiac disorder characterized by the development of heart failure in the last month of pregnancy or up to 5 months postpartum in women without other identifiable causes of cardiac failure. The combination of left ventricular (LV) systolic...

  • Cirrhotic cardiomyopathy. Soon Koo Baik; Fouad, Tamer R.; Lee, Samuel S. // Orphanet Journal of Rare Diseases;2007, Vol. 2, p15 

    Cirrhotic cardiomyopathy is the term used to describe a constellation of features indicative of abnormal heart structure and function in patients with cirrhosis. These include systolic and diastolic dysfunction, electrophysiological changes, and macroscopic and microscopic structural changes....

  • Aldosterone antagonists in the treatment of heart failure. Marcy, Todd R.; Ripley, Toni L. // American Journal of Health-System Pharmacy;1/1/2006, Vol. 63 Issue 1, p49 

    Purpose. The clinical benefits, adverse effects, pharmacokinetics, and recommendations for the appropriate use of the aldosterone antagonists spironolactone and eplerenone in patients with heart failure are reviewed. Summary. Heart failure is a clinical syndrome characterized by the functional...

  • Nesiritide. Fontana, Dee // Critical Care Nurse;Feb2006, Vol. 26 Issue 1, p39 

    The article reports a case in which a patient with acute decompensated heart failure (ADHF) was treated with nesiritide. Traditionally, the pharmacological approach to treating patients with ADHF has centered on the use of intravenous diuretics, inotropic agents and vasodilators. The symptoms...

  • Effect of deferiprone or deferoxamine on right ventricular function in thalassemia major patients with myocardial iron overload. Smith, Gillian C.; Alpendurada, Francisco; Carpenter, John Paul; Alam, Mohammed H.; Berdoukas, Vasili; Karagiorga, Markissia; Ladis, Vasili; Piga, Antonio; Aessopos, Athanassios; Gotsis, Efstathios D.; Tanner, Mark A.; Westwood, Mark A.; Galanello, Renzo; Roughton, Michael; Pennell, Dudley J. // Journal of Cardiovascular Magnetic Resonance (BioMed Central);2011, Vol. 13 Issue 1, p34 

    Background: Thalassaemia major (TM) patients need regular blood transfusions that lead to accumulation of iron and death from heart failure. Deferiprone has been reported to be superior to deferoxamine for the removal of cardiac iron and improvement in left ventricular (LV) function but little...

  • Prevalence of scarred and dysfunctional myocardium in patients with heart failure of ischaemic origin: A cardiovascular magnetic resonance study.  // Journal of Cardiovascular Magnetic Resonance (BioMed Central);2011, Vol. 13 Issue 1, p53 

    The article presents a study focusing on the prevalence of scarred and dysfunctional myocardium in patients with heart failure of ischaemic origin. As stated, in the study conducted on patients with left ventricular systolic dysfunction and ischaemic heart disease, about half of all segments had...

  • Heterozygous disruption of SERCA2a is not associated with impairment of cardiac performance in humans: implications for SERCA2a as a therapeutic target in heart failure. Mayosi, B. M.; Kardos, A.; Davies, C. H.; F.Gumedze; Hovnanian, A.; Burge, S.; Watkins, H. // Heart;Jan2006, Vol. 92 Issue 1, p105 

    Objective: To verify whether a deficiency in the cardiac sarcoplasmic reticulum pump SERCA2a causes cardiac dysfunction in humans. Design: Cardiac performance was measured in a serendipitous human model of primary SERCA2a deficiency, Darier's disease, an autosomal dominant skin disorder caused...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics