Amiodarone-Induced Hyponatremia Masked by Tolvaptan in a Patient with an Implantable Left Ventricular Assist Device.

Autor: Nakamura M; Department of Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center., Sunagawa O; Department of Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center., Kugai T; Department of Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center., Kinugawa K; Second Department of Internal Medicine, University of Toyama.
Jazyk: angličtina
Zdroj: International heart journal [Int Heart J] 2017 Dec 12; Vol. 58 (6), pp. 1004-1007. Date of Electronic Publication: 2017 Nov 17.
DOI: 10.1536/ihj.16-656
Abstrakt: A 43-year-old man was referred to our hospital in June 2014 because of severe heart failure. He was diagnosed with familial dilated cardiomyopathy and was administered oral tolvaptan and amiodarone for atrial and ventricular tachycardia. Since up-titration of carvedilol had failed and he was dependent on dobutamine, a left ventricular assist device (LVAD) was implanted. Tolvaptan and furosemide were both discontinued after LVAD implantation and he was discharged from the hospital. Thirteen months later, he was hospitalized for lethargy and hyponatremia of 108 mEq/L, with an antidiuretic hormone level of 2.5 pg/mL, which suggested syndrome of inappropriate antidiuretic hormone secretion (SIADH). We discontinued amiodarone and administered fludrocortisones. However, hyponatremia persisted for a few more days, eventually resulting in delirium and damage to the LVAD driveline. He received an urgent pump exchange and hyponatremia was gradually improved. We considered the possibility that amiodarone-induced SIADH was masked by tolvaptan therapy before LVAD implantation.
Databáze: MEDLINE