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Congestive heart failure,increased urination,low sodium content,low blood pressure.

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Practicing since : 2002
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My mother was diagnised with Congesivr heart failurem she has been given isorbide dinitrate and adactone 50mg. But then she urinates a lot and her sodium content in the body drops and she forgets things. What should I do. She also has lbbb and most of the times low blood pressure. She is getting extremely breathless with wheezing inspite of these medications. What shoud I do?
Posted Thu, 12 Apr 2012 in Heart Failure
Answered by Dr. Robert Galamaga 46 minutes later
Hello and thanks for your query.

As far as congestive heart failure (CHF) goes - it can be sometimes a bit difficult to establish optimal medication regimens in the beginning. There is a challenge to balance blood pressure and pulse control, total body fluid volume balance and respiratory status.

The isosorbide works to improve blood flow to the heart muscle. It can lower the blood pressure a bit as well but that is a good thing for patients with CHF. Generally we prefer the blood pressure to be very well controlled - something like 100 to 110 over 60 to 70. The aldactone has been shown to improve the overall status of patients with CHF - it is a diuretic which helps with the fluid balance but sometimes can affect electrolyte levels.

The fact that you appreciate more shortness of breath is a cause of concern. I suggest you take her in for an evaluation of her respiratory status as this could be related to her fluid balance. I would make sure dhe drinks no more than 2 liters of fluid per day in addition to her food for now until she is evaluated.

CHF as I mentioned is a challenge to manage but once things are under control with her blood pressure and body fluid balance I think she will be fine. Her memory issues could be related to the electrolyte balance such as sodium as you mentioned. She will likely need some lab work as well to assess that.

I hope this information has been adequate and helpful. If you have followups, I'd be happy to address them.


Dr. Robert Galamaga
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