Traditionally, sodium and potassium disorders have been considered the most relevant ionic disturbances in heart failure (HF)., [1] However, in recent years, hypochloremia has emerged as a critical electrolyte imbalance in HF., [2–5] The prevalence of hypochloremia among patients with HF varies between 10 % and 30 %, depending on the clinical context and the population studied., [6–13] Importantly, hypochloremia has also been recognized as a prognostic indicator in both acute and chronic scenarios[6–13] Growing evidence indicates that chloride may also play a pathogenic role in the progression of HF, rather than merely serving as a marker of disease severity.
