A clinical case of diuretic therapy-resistant edematous syndrome in an older patient with chronic heart failure and COVID 19
Patients with edematous syndrome are found in the clinical practice of various doctors specialties. Diuretics are an integral part of therapy for patients with chronic heart failure, pathologies of the liver or kidneys. However, adequate and effective treatment of edematous syndrome requires a differentiated approach to each individual patient, assessment and correction of various factors that could contribute to fluid retention. In the presented case a 74-year-old patient was admitted to the hospital with decompensated chronic heart failure against the background of COVID‑19 coronavirus infection. The examination revealed left-sided hydrothorax, hydropericardium, bilateral polysegmental viral pneumonia. Diuretics were used as part of complex therapy, which included glucocorticosteroids. However, the treatment of edematous syndrome with standard diuretic therapy was ineffective. After the correction of hypoalbuminemia, the appointment of replacement therapy with thyroid hormones, it was possible to achieve regression of hydropericardium, hydrothorax, and peripheral edema.
Keywords:edematous syndrome; chronic heart failure; diuretics; hypoproteinemia; hypothyroidism; coronavirus infection COVID 19
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Markelova E.S., Jakovlev A.A., Marzaeva E.V. A clinical case of diuretic therapy-resistant edematous syndrome in an older patient with chronic heart failure and COVID‑19. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2022. Т. 10, № 2. С. 60–6. DOI: https://doi.org/10.33029/2309-1908-2022-10-2-60-66 (in Russian)
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