Use of Tolvaptan in a Patient With Palliated Congenital Heart Disease.

Heart failureis a common problem in the ever growing population of patients with palliated congenital heart disease. It is frequently complicated by hyponatremiathat has been associated with increased morbidity and mortality. Tolvaptanis a vasopressin receptorantagonist that has been effective in improving hyponatremiaand congestive symptoms in adults with chronic heart failure. We describe the short-term use of tolvaptanto treat hyponatremic hypervolemiain an adolescent patient with chronic heart failurein the setting of palliated congenital heart disease prior to definitive surgical intervention. In this case, the patient had improvement in hyponatremiaand a decrease in body weight, without any adverse effects.