Introduction: Loop diuretics are currently the first-choice treatment for acutely decompensated HF therapy and for maintaining euvolemia, but the addition of other diuretic agents, such as the carbonic anhydrase inhibitor acetazolamide might be effective for patients with refractory heart failure. Case: A 35-year-old woman referred from a private hospital came to the emergency unit at Sanjiwani Regional Hospital with complaints of shortness of breath and palpitations, and both legs were swollen. The patient has risk factors for hyperthyroidism and a family history of coronary heart disease. On physical examination, he was conscious of compost mentis with blood pressure 85/50 mmHg, heart rate 79 times/minute, respiratory rate 45 times/minute with saturation 93%, rales (+), oedema in both legs, cold acral; laboratory examination showed TsHs 0.22 uIU/ml, FT4 26.29 pmol/L. Discussion: Acetazolamide is a carbonic anhydrase inhibitor that reduces proximal tubular sodium reabsorption and may improve diuretic efficiency when added to loop diuretics, thereby potentially facilitating decongestion, was not associated with an increased incidence of adverse events, and associated with a shorter duration of hospital stay. Conclusion: Acetazolamide is a carbonic anhydrase inhibitor that may improve diuretic efficiency when added to loop diuretics.
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