Exchangeable potassium, sodium and chloride were measured in 41 patients with severe valvular heart disease subjected to optimal medical treatment during preparation for intracardiac surgery. The results obtained were evaluated with the aid of two references for normal body composition: (1) ideal body weight, based upon body height, and (2) population weight taking into account body height and body weight increasing with age. According to both references, total exchangeable potassium was below normal, while exchangeable sodium and chloride were slightly elevated or normal. The decrement of exchangeable potassium, which was most pronounced in patients receiving diuretics, was interpreted as being due to a decrease of body cell mass in response to chronic wasting illness. No correlation was found between the incidence of postoperative ventricular arrhythmias and the decrease of exchangeable potassium or previous use of diuretics.
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