A CASE OF SEVERE HYPOALBUMINEMIA ASSOCIATED WITH CHRONIC CONGESTIVE HEART FAILURE: THE ROLE OF THE TRICUSPID REGURGITATION

Authors

  • Ioana Dana ALEXA University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Adina Carmen ILIE University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Anca MOROSANU University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Irina CRACANA “Dr. C.I. Parhon” Hospital, Iaşi
  • Ramona ONUTU “Dr. C.I. Parhon” Hospital, Iaşi
  • Ana VOICA “Dr. C.I. Parhon” Hospital, Iaşi
  • A. LUCA University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

Keywords:

HYPOALBUMINEMIA, CONGESTIVE HEART FAILURE, TRICUSPID REGURGITATION.

Abstract

Hypoalbuminemia is considered an independent predictor of mortality, especially in elderly patients. It is common in patients with congestive heart failure, when is due to several mechanisms: increased volume of distribution, significant stasis in the mesenteric circulation and altered protein metabolism in the liver. These alterations are even more pregnant when tricuspid regurgitation is associated or aggravated by different risk factors (recent infections, anemia, hyperthyroidism). We present the case of an elderly patient with severe hypoproteinemia and important hypoalbuminemia associated with congestive heart failure and aggravation of tricuspid regurgitation. The differential diagnosis concluded that hypoalbuminemia was influenced by tricuspid regurgitation as it enhanced liver dysfunction and enteral protein absorption due to increased stasis in mesenteric system. On the other hand, hypoalbuminemia contributed to the progression of heart failure by favoring myocardial edema, volume overload, and diuretic resistance. This is why correct management of this situation should include removal of subclinical excess of fluid and renutrition. A multidisciplinary approach is needed in order to achieve a good control of the symptoms and a significant improvement of quality of life.

Author Biographies

  • Ioana Dana ALEXA, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Discipline of Internal Medicine, Nephrology and Geriatrics

  • Adina Carmen ILIE, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Discipline of Internal Medicine, Nephrology and Geriatrics

  • Anca MOROSANU, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Discipline of Internal Medicine, Nephrology and Geriatrics

  • Irina CRACANA, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Clinical Geriatrics

  • Ramona ONUTU, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Clinical Geriatrics

  • Ana VOICA, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Clinical Geriatrics

  • A. LUCA, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    PhD Student

References

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Additional Files

Published

2018-05-14

Issue

Vol. 118 No. 1 (2014): The Medical-Surgical Journal

Section

INTERNAL MEDICINE - PEDIATRICS

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