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Updated: Aug 15, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
[Clinical reasoning and decision-making in practice. A patient with shortness of breath and hyponatraemia]
L J Top1, R O B Gans, J G Zijlstra
1Universitair Medisch Centrum Groningen, afd. Interne Geneeskunde, Postbus 30.001, 9700 RB Groningen.
Abstract:
A 61-year-old man with no significant medical history was referred by the general practitioner with progressive dyspnoea despite treatment with steroids and antibiotics. The patient had severe hyponatraemia. Eventually hypervolemic hyponatraemia due to ischemic cardiac failure was diagnosed. After recompensation by fluid restriction and lisdiuretics coronary bypass surgery was carried out. The patient was discharged free of symptoms. This case is a reminder that heart failure may not present itself in a classical manner but as hypervolemic hyponatraemia.
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