Abstract

Case Report

Hyperkalemia: An archenemy in emergency medicine. Description of two case reports

C Naclerio*, A Del Gatto and A Cavallera

Published: 05 November, 2018 | Volume 3 - Issue 3 | Pages: 079-083

Potassium is an important ion capable to maintain intra-extracellular electric gradient. Variations in the intra-extracellular ionic flow may alter cells functions, skeletal and smooth muscle contractility and electric activity of myocardial cells.

In this study we demonstrated that high level of serum potassium may be associated with cardiac and neurological life-threatening diseases.

We describe two case reports in which one patient, chronic hemodialysed, presented with cardiogenic shock in setting of hyperkalemia; the other, with end-stage kidney disease, showed a flaccid paralysis associated to high level of serum potassium during potassium sparing diuretic therapy.

Emergency haemodialysis was performed with a complete remission of the clinical manifestations.

Indeed, the use of simply diagnostic instruments such as serum electrolyte assay and electrocardiographic study (ECG) are helpful in clinical practice solving in timely serious complications due to hyperkalemia.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001029 Cite this Article Read Full Article PDF

Keywords:

Hyperkalemia; Arrythmias; Flaccid paralysis; Spironolactone

References

  1. Clark BA, Brown RS. Potassium homeostasis and hyperkalemic syndromes. Endocrinol Metab Clin N Am J. 1995; 24: 573-591. Ref.: https://goo.gl/Kbb3zm
  2. Freeman SJ, Fale AD. Muscular paralysis and ventilatory failure caused by hyperkalemia. Br J Anesthesia. 1993; 70: 226-227. Ref.: https://goo.gl/SGArQ8
  3. Webster A, Brady W, Morris F. Recognising signs of danger: ECG changes resulting from an abnormal serum potassium concentration. J Emerg Med. 2004; 27: 153-160. Ref.: https://goo.gl/taWceX
  4. Wrenn KD, Slovis CM, Slovis BS. The ability of physicians to predict hyperkalemia from ECG. Ann Emerg Med. 1991; 20: 1229-1232. Ref.: https://goo.gl/StH6DR
  5. Yu AS. Atypical electrocardiographic changes in severe hyperkalemia. Am J Cardiol. 1996; 77: 906-908. Ref.: https://goo.gl/gEJVGq
  6. Cohen HC, Gozo EG Jr, Pick A. The nature and type of arrhytmias in acute experimental hyperkalemia in the intact dog. Am Heart J. 1971; 82: 777. Ref.: https://goo.gl/GNaEPx
  7. O'Neil JP, Chung EK. Unusual electrocardiographic finding--bifascicular block due to hyperkalemia. Am J Med. 1976; 61: 537-540. Ref.: https://goo.gl/RSwZDK
  8. Davidson S, Surawicz B. Ectopic beats and atrioventricular conduction disturbances. Arch Intern Med. 1967; 120: 280-285. Ref.: https://goo.gl/k2bewi
  9. Richardson GO, Sibley JC. Flaccid quadriplegia associated with hyperkalemia. Can Med Assoc J. 1953; 69: 504-506. Ref.: https://goo.gl/oML5so
  10. Udezue WO, Harrold BP. Hyperkalemic paralysis due to spironolactone. Postgrad Med J. 1980; 56: 254-255. Ref.: https://goo.gl/547riQ

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?