Tag: hyponatremia

What Evidence of Congestive Heart Failure is a Diagnosis Based

What Evidence of Congestive Heart Failure is a Diagnosis Based on?

While all cardiac conditions carry similar symptoms of chest pain and difficulty breathing, congestive heart failure generally presents with a very specific set of symptoms and lab results, giving doctors a very firm set of clues upon which to base a definite diagnosis.

Dyspnea, or difficulty breathing, coupled with severe pitting edema (when the body retains fluid to the point of holding the imprint of an object that is pressed into the skin for several minutes) are generally the first pieces of evidence pointing to congestive heart failure. Heart failure results in the heart not being able to efficiently pump blood throughout the body; as a result, fluid accumulates rather than being excreted and causes the body to swell as if it were a water balloon. Non-pitting edema, or fluid retention that does not hold an imprint, is not caused by heart failure and indicates that another diagnosis needs to be made. The patient may produce a frothy pink sputum when they cough.

In addition to the symptoms related to the fluid accumulation general weakness and malaise, particularly during times of physical exertion are frequent complaints of patients suffering from congestive heart failure, and should not be ignored. This is caused by a lack of nutrients and oxygen from the blood to the body tissues, and may result in permanent damage to the organs if they are left without these vital elements for a prolonged period of time. Anuria, or a lack of urination, is also evidential of heart failure as fluid accumulates in the tissues rather than being properly excreted. Patients may suffer from a changed mental status due to toxins accumulating in the body.

Once the physician suspects heart failure based on the physical evidence, blood samples will be sent to the laboratory. Beta-natriuretic peptide, or BNP, is an excellent screening tool in suspected cases of heart failure. This hormone is produced in greater quantities by the failing heart muscle as fluid levels rise, with a level between one hundred and five hundred pg/mg suggesting congestive heart failure and greater than five hundred being fairly diagnostic; however, an elevated BNP should not be considered to be sufficient evidence upon which to base a positive diagnosis, as conditions such as renal failure, ventricular strain, tumors or hypoxia can also cause BNP levels to rise. Arterial blood gases may be tested to determine the degree of hypoxemia. A decreased erythrocyte sedimentation rate, proteinuria (protein in the urine), and a mild azotemia (elevated blood urea level) can be seen in early to moderate disease. An increased serum creatinine, hyperbilirubinemia (increased bilirubin in the blood) and dilutional hyponatremia (decreased serum sodium levels) are evidence the patient is suffering from a more advanced case of heart failure.

Radiology will also wish to perform imaging studies to evaluate the condition of the heart. A chest x-ray will generally reveal cardiomegaly (enlargement of the heart) and pleural effusion (fluid around the heart). An echocardiogram may be performed to evaluate the internal structures of the heart to evaluate for any structural abnormalities, as in the case of mitral stenosis. This provides evidence to determine the underlying cause of congestive heart failure, particularly in suspected cases of valvular heart disease.

Physicians are like detectives, if you will. Once these tests have all been run they will gather these pieces of evidence together and put them together to form a fairly accurate picture of the patient’s condition, allowing for an accurate diagnosis leading to proper treatment.

Discovering Hyponatremia and Preventing It!

How many people really know without reaching for a dictionary what hyponatremia is? The bad news is that most people are unaware of what it is, yet it is a very dangerous condition that occurs quite often. Much more often than it really should in fact. To blame for the heightened occurrences is the fact that most people do not understand the proper fluid levels that should be maintained during exercise. This is particularly important during those exercises that are quite intensive such as marathons and endurance activities.

Hyponatremia is so important because it involves the blood sodium levels in the body. It is important that these levels be maintained in a proper proportion in order for the body to remain healthy. If the levels are adjusted through extreme sweating or even an over abundance of water consumption then Hyponatremia can occur which creates several problems. If you are seeing a sports medicine doctor and discussing participating in an endurance activity be sure to thoroughly ask about hyponatremia so that you can avoid it as much as possible.

Hyponatremia is important because it occurs when sodium levels are greatly decreased. This occurs in the normal process of sweating. However, creating the actual problem is when athletes consume large amounts of water continuously, which further reduces the ratio of the blood sodium levels. This lowered ratio is what creates the problems of hyponatremia. However, the solution is sometimes quite easy, but unless you have discussed the problem with your doctor, you are unlikely to know.

Symptoms of hyponatremia are as subtle as a nauseated feeling, some small muscle cramps, possibly being disoriented and even a bit confused mentally. This is quite often mistaken for just simply being dehydrated which will prompt many people to reach for more water to drink, which ultimately makes the problem much worse. Extreme cases of hyponatremia include symptoms such as comas, seizures and in the most extreme cases, death is possible.

In order to really prevent and treat hyponatremia it is vital that you drink a sports drink that contains sodium, or else eat a food with sodium especially higher levels of sodium to quickly restore the proper levels to the body. In addition, cutting back on the plain water consumption until sodium levels are higher is also advised. If you are having severe symptoms, it is best to see a doctor immediately, preferably a sports medicine doctor who is knowledgeable about treatment options.

In order to prevent hyponatremia there are a few things that you can easily do. The first is ensuring that you are keeping a sports energy drink on hand to continuously drink. While drinking water is important as well, the sports energy drink will help replenish sodium levels while the water will flush more sodium from the body.
If you do not have hypertension discuss with your doctor increasing your sodium intake levels for a few days before the endurance event. Only increase your sodium levels under the watchful eye of your doctor or you could create problems with hypertension where none previously existed.

Additionally, it is best to always drink plenty of fluids. The best guideline to use is a cup of fluids, which is 8 ounces for each 20 minutes of activity. If you are engaging in an hour-long endurance activity that would translate into 3 cups of fluids.

Additionally, it is best to only replace fluids that you lose. This means that you should avoid adding additional fluids to your body that are not needed. For example if you lose 2 pounds from fluid loss, you should replace the fluids that were lost. This would not mean drinking more than 4 cups of fluids at a maximum to replace the missing fluids.

With proper precautions, you can avoid having a problem with hyponatremia and instead enjoy participating safely in the endurance activity of your choice. With careful medical treatment and proper prevention, it is not a problem that will force you to stop engaging in sports; rather it can make you more aware of your bodies nutritional requirements.

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