The presence of decompensated heart failure continues to be a condition with high rates of hospitalization, impact on the health system, and quality of life for those who suffer it. The mainstay of treatment in these cases are diuretics. However, the resistance to this pharmacological group may occasionally occur, generating an inadequate negative fluid balance and persistence of congestion with negative clinical outcomes. Hypertonic saline solution with high doses of diuretic emerges as a therapeutic option for this group of patients with probable physiological, and clinical benefits on hospitalization and re-admission rates due to heart failure decompensation. A review of the most relevant aspects and benefits of this combination is discussed in this article.

The presence of decompensated heart failure continues to be a condition with high rates of hospitalization, impact on the health system, and quality of life for those who suffer it. The mainstay of treatment in these cases are diuretics. However, the resistance to this pharmacological group may occasionally occur, generating an inadequate negative fluid balance and persistence of congestion with negative clinical outcomes. Hypertonic saline solution with high doses of diuretic emerges as a therapeutic option for this group of patients with probable physiological, and clinical benefits on hospitalization and re-admission rates due to heart failure decompensation. A review of the most relevant aspects and benefits of this combination is discussed in this article.

La Cardiomiopatía hipertrófica presenta diferentes espectros de presentación, entre ellos la obstrucción al tracto de salida del Ventrículo izquierdo. El fenotipo más común es la variante septal asimétrica, siendo infrecuente encontrar la variante medio apical. Por otra parte, existen mutaciones puntuales asociadas a la Cardiomiopatía hipertrófica siendo la variante de la Filamina C una condición poco usual en estos pacientes. A continuación, se presenta el caso de un paciente sexo masculino de 23 años con diagnóstico de Cardiomiopatía hipertrófica variante medio apical, en quien se documenta variante de la Filamina C, ante la inadecuada respuesta y persistencia de sintomatología frente al manejo médico, se realizó el procedimiento de miectomía con abordaje transapical, con posterior mejoría de sintomatología clínica y obstrucción al tracto...