THREE patients who received conventional therapy for heart failure at the St. Louis City Hospital regained compensation but died within a few days without apparent cause. Anorexia, lethargy, and, eventually, stupor preceded the death of each. Analysis of their records and clinical course suggested that an electrolyte imbalance had been precipitated during the treatment of the cardiac failure. Later, when similar patients were treated in a comparable manner, acidosis was discovered and dramatically corrected by the judicious use of sodium lactate. This experience led us to study the blood chemical pattern in patients with congestive heart failure before and during treatment with digitalis, ammonium chloride, mercurial diuretics, and a low-salt diet.
METHOD OF STUDY
Twenty-four patients in severe congestive heart failure were studied during the winter months when environmental temperatures could be controlled. Most of these patients had hypertensive or arteriosclerotic heart disease, or both. An attempt was made to
BERGNER GE, HUTCHINSON JH, KOEHLER JW, CZEBRINSKI EL. METABOLIC PROBLEMS ARISING IN THE MANAGEMENT OF CONGESTIVE HEART FAILURE. AMA Arch Intern Med. 1951;88(3):387–394. doi:10.1001/archinte.1951.03810090118012