[Changes in aldosterone receptors in congestive heart disease. Report of a case]

It is presented a case with mitral and tricuspid rheumatic valvulopathy and refractory chronic congestive heart failure, which developed two episodes of severe hyponatremia and hyperkalemia, accompanied in at least one occasion of hyperpreninemia and hyperaldosteronism, after administration of 50 and 100 mg of sprionolactone for 2 and 3 weeks. It is believed that this severe effect of spironolactone was due to the presence of an alteration of aldosterone receptors acquired during the large period of congestive failure suffered by the patient. In as much as we have studied 4 similar cases in the last few months, a note of warning is done in the use of this drug in the treatment of this type of cardiac condition.