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Pain Management 2018
Internal Medicine 2018
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 52
March 26-28, 2018
Vienna, Austria
JOINT EVENT
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Volume 4
H
yponatremia is the most common electrolyte imbalance
managed by hospitalists. Although a rare entity, a relationship
between hyponatremia and cardiac tamponade has been reported
in a few published reports that highlight the normalization of
sodium levels following pericardial drainage. This is the case of
a 57-year-old lady with rapidly progressive stage IV pulmonary
adenocarcinoma who presented two months following diagnosis
with findings of significant hyponatremia. Upon admission, she
was afebrile, hypotensive and tachycardic. Her laboratory studies
revealed a sodium level of 119 mEq/L, as well as hypokalemia
and hypochloremia. Although her presentation was consistent
with Syndrome of Inappropriate Antidiuretic Hormone, her
hyponatremiadidnot improvedespiteadequatemanagementwith
fluid restriction and salt tabs. During hospitalization, she was also
found to have a large pericardial effusion with echocardiographic
evidence consistent with tamponade physiology that required
an emergent pericardial window. Her sodium levels normalized
immediately following pericardial drainage, suggesting a
correlation between her hyponatremia and cardiac tamponade.
A handful of published reports present a similar scenario in
which pericardial drainage resulted in immediate resolution
of the hyponatremia, particularly in patients with underlying
malignancies. It is suggested that a decreased cardiac output
stimulates antidiuretic hormone release and suppresses atrial
natriuretic factor release, causing volume retention, increased
heart rate and increased peripheral resistance. Following
pericardiocentesis, there is marked diuresis and a normalization
in sodium concentration. Cardiac tamponade should be included
in the differential of hyponatremia in patients with active
malignancy, since prompt management with pericardial drainage
can result in marked improvement of hyponatremia.
Biography
Paula Hernandez has completed her MD from the University of Puerto Rico
Medical Sciences Campus. She is the currently in her first year of internal
medicine residency at the University of South Florida Morsani School of
Medicine in Tampa. She has published 4 papers in reputed journals and is
currently engaged in diverse scholarly activities. She is interested in pursu-
ing a cardiology fellowship and continuing research on imaging cardiology.
Paulah@health.usf.
Cardiac tamponade as a cause for hyponatremia in patients
with active malignancy
Paula Hernandez Burgos
University of South Florida, USA
Paula Hernandez Burgos, Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-003