Disturbance in acid-base balance is commonly observed in patients with heart failure.

The most common disturbance is metabolic alkalosis combined with hypokalemia, as a result of the excessive use of loop diuretics. Occasionary, hypoxia due to pulmonary edema stimulates ventilation, resulting in respiratory alkalosis. When pulmonary edema develops, carbon dioxide retention occurs, resulting in respiratory acidosis.

Decreased tissue oxygen delivery may also produce lethal lactic acidosis. Compensatory mechanisms, coexistence of independent acid-base disorders and changes in electrolytes complicate acid-base balance in the individual patients. As acid-base disturbances have harmful effects on the cardiovascular system, precise diagnosis and proper treatment are highly important.

About the Authors

Kuwahara T, Kawai C. (1992) Acid-base disturbances in heart failure. Nippon Rinsho. 1992 Sep;50(9):2173-7. Saiseikai-Nakatsu Hospital, Osaka.