Effects of Hyponatremia in Patient with Acute Coronary Syndrome


  • Sanjeev Kumar Dharmesh PG Student, Department of Medicine, G.R. Medical College & J.A. Group of Hospitals, Gwalior, Madhya Pradesh, India
  • Archana Gupta Professor, Department of Medicine, G.R. Medical College & J.A. Group Hospitals, Gwalior, Madhya Pradesh, India
  • Santosh Singh Yadav Associate Professor, Department of Cardiology, G.R. Medical College & J.A Group of Hospitals, Gwalior, Madhya Pradesh, India
  • Kanha Gupta Medical Student, G.R. Medical College & J.A Group of Hospitals, Gwalior, Madhya Pradesh, India




Introduction - Hyponatremia mostly occur very common in acute coronary syndrome and it is a bad prognostic indicator in patients with acute coronary syndrome. Also hyponatremia is a single independent predictor of adverse clinical outcomes on mortality in hospitalized patients due to severe heart failure1. In these patients with acute coronary syndrome hyponatremia has been related to the non-osmotic release of ADH, activation of RAS and then leading to catecholamine production. Coronary artery disease is the world’s most important cause of death. Electrolyte imbalance is common in hospitalized patients, especially in patients with heart failure. Hyponatremia is also common after myocardial infarction which increases the mortality and but there is very much clinical improvement followed by a rise in plasma Sodium at concentration. Hyponatremia is defined as plasma concentration of <135 mEq/L. Aim & Objective - To study the effects of hyponatremia in patients with acute coronary syndrome, To analyse prognostic significance of hyponatremia in patients with acute coronary syndrome. To access usefulness of hyponatremia in predicting short term mortality. To find association between hyponatremia and other risk factor like Ejection fraction, Hypertension, diabetes mellitus, type of infarction. Methodology - Prospective study, Study population: 105 patients admitted as acute coronary syndrome. Inclusion criteria: 100 clinically diagnosed cases of acute coronary syndrome. Patients with chest pain > 20 min and ST segment elevation in ECG. Exclusion Criteria: Patients with renal failure, Diabetic patients, Acute and chronic liver failure, COPD patients on beta agonists. Results - Acute coronary syndrome is an important cause of mortality and morbidity in the world. 105 cases of acute coronary syndrome was selected in our study conducted in Gajraraja Medical College, Gwalior, from 2020 to 2022 and was found that hyponatremia was a major prognostic factor in acute myocardial infarction. In my study middle aged population >40 years age are at more risk to developing coronary artery disease. It is relatively a small proportion of all MI. Studies show that 900 people under the age of 30 die every day from heart disease in India. Many risk factors like psychological stress, cocaine use, alcohol, APLA, family history, OCP, hypercoagulable states, etc have been attributed to the cause. In my study, the incidence of male and female were 81 and 24 respectively among the 105 patients. Hyponatremia is well known that it is a serum Sodium at level <135 mEq/L. The severity of hyponatremia was defined as mild(130-135mEq/L) and moderate to severe (<130mEq/L). Serum Sodium at levels were documented as follows: baseline measurement at the day of admission, the lowest Sodium at level during hospitalization i.e after 48 hrs of admission and during discharge. Conclusion - On concluding hyponatremia has significant prognostic value in short term and long term adverse events in patients diagnosed with ACS. It is a single predictive factor for prognosis of Acute Coronary syndrome. Prognosis worsen with increasing severity of hyponatremia. As seen in the study, mortality rate was higher with hyponatremia patients, both at admission and discharge. Among the patients in my study hyponatremia was more common in the 6th decade without any previous illness like diabetes mellitis, chronic kidney disease heart failure. The common cause of hyponatremia was ruled out of which acute myocardial infarction was the only cause for hyponatremia in the study population.




How to Cite

Sanjeev Kumar Dharmesh, Archana Gupta, Santosh Singh Yadav, & Kanha Gupta. (2023). Effects of Hyponatremia in Patient with Acute Coronary Syndrome. International Journal of Health and Clinical Research, 6(2), 32–37. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/5346