Last updated on 16th Oct 2021 - By Dwayne Michaels

How Abnormal CHLORIDE affects heart?

Hypochloraemia (low chloride) is a common electrolyte abnormality in patients with heart failure (HF). Hypochloremia is an electrolyte disturbance in which there is an abnormally low level of the chloride ion in the blood.

Electrolyte imbalance is an abnormality in the concentration of electrolytes in the body. The most serious electrolyte disturbances involve abnormalities in the levels of sodium, potassium or calcium.

Other electrolyte imbalances are less common and often occur in conjunction with major electrolyte changes. Electrolytes play a vital role in maintaining homeostasis in the body.

They help to regulate heart and neurological function, fluid balance, oxygen delivery, acidbase balance and much more. Electrolyte imbalances can develop by consuming too little or too much electrolyte as well as excreting too little or too much electrolyte.

Chloride, after sodium, is the second most abundant electrolyte in the blood, and most abundant in the extracellular fluid. Most of the chloride in the body is from salt (NaCl) in the diet. Chloride is part of gastric acid (HCl), which plays a role in absorption of electrolytes, activating enzymes, and killing bacteria.

The levels of chloride in the blood can help determine if there are underlying metabolic disorders. Overall, treatment of chloride imbalances involve addressing the underlying cause rather than supplementing or avoiding chloride. The two types of chloride problems are :

Hyperchloremia (high levels of chloride):

Causes:

Hyperchloremia, or high chloride levels, is usually associated with excess chloride intake (e.g., saltwater drowning), fluid loss (e.g., diarrhea, sweating), and metabolic acidosis. Hyperchloremia is an electrolyte disturbance in which there is an elevated level of the chloride ions in the blood.

The normal serum range for chloride is 96 to 106 mEq/L, therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration.

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Symptoms:

Hyperchloremia does not have many noticeable symptoms and can only be confirmed with testing, yet, the causes of hyperchloremia do have symptoms. Symptoms of the above stated abnormalities may include:

• Cardiovascular dysfunction - due to increased sodium chloride intake
• Weakness - due to loss of fluids
• Thirst - due to loss of fluids
• Dehydration - due to diarrhea, vomiting, sweating
• Hypertension - due to increased sodium chloride intake
• High blood sugar - due to diabetes
• Hyperchloremic metabolic acidosis - due to severe diarrhea and/or kidney failure
• Respiratory alkalosis - due to renal dysfunction
• Edema - due to influx in sodium in the body
• Kussmaul breathing - due to high ion concentrations, loss of fluids, or kidney failure

Treatment:

Treat the underlying cause, which commonly includes increasing fluid intake.

Hypochloremia (low levels of chloride):

Causes:

Hypochloremia, or low chloride levels, are commonly associated with gastrointestinal (e.g., vomiting) and kidney (e.g., diuretics) losses. Greater water or sodium intake relative to chloride also can contribute to hypochloremia.

Symptoms:

Patients are usually asymptomatic with mild hypochloremia. Symptoms associated with hypochloremia are usually caused by the underlying cause of this electrolyte imbalance.

Treatment:

Treat the underlying cause, which commonly includes increasing fluid intake

Electrolyte disturbances are involved in many disease processes, and are an important part of patient management in medicine. The causes, severity, treatment, and outcomes of these disturbances can differ greatly depending on the implicated electrolyte.

The kidney is the most important organ in maintaining appropriate fluid and electrolyte balance, but other factors such as hormonal changes and physiological stress play a role.

Low serum chloride levels are associated with adverse prognosis in patients with acute or chronic heart failure (HF) regardless of left ventricular ejection fraction and independently of other prognostic markers such as N-terminal pro-B-type natriuretic peptide levels.