Healing the orphaned heart: heart failure in a patient with glucose-6-phosphate dehydrogenase deficiency.
Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency are not represented in clinical trials for heart failure. Moreover, many of the recommended medications can cause haemolysis in this group of patients. We present the case of a 71-year-old woman with G6PD deficiency admitted for acute non-ischemic heart failure with reduced ejection fraction. Our experience showed that a combination of ethacrynic acid and spironolactone is safe and effective for relief of volume overload in this group of patients. Studies are needed to determine whether the morbidity and mortality benefits of established heart failure regimens extend to patients with G6PD deficiency.
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Percy Guanzon
PG
Balderia
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Supakanya
S
Wongrakpanich
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Monil
M
Patel
Department of Cardiology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Marjorie
M
Stanek
D000368:Aged; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004976:Ethacrynic Acid / Q000627:therapeutic use; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications*; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D019808:Losartan / Q000627:therapeutic use; D008790:Metoprolol / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use
D004232:Diuretics; D013148:Spironolactone; D008790:Metoprolol; D019808:Losartan; D004976:Ethacrynic Acid