Electrocardiographic findings in an elderly patient before and after resolution of iatrogenic hyperk

• 作 者: Yun-Li XING Hong-Wei LI Chun-Yan JIANG Wei HUANG Feng FENG Ying SUN Fu-Sheng GU
• 机 构: Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China;De
• 出 处: 老年心脏病学杂志（英文版）
• 发表日期: 2020年9期
• 关键词: Electrocardiogram Hyperkalaemia Potassium-sparing diuretic

Hyperkalemia is a life-threatening electrolyte disorder that often occurs in patients with chronic kidney disease (CKD) and in those using potassium-sparing diuretics.Hyperkalemia can destabilize myocardial conduction by reducing the resting membrane potential, leading to increased cardiac depolarization, myocardial excitability, and arrhythmias, which can promote progress to ventricular fibrillation and asystole.[1] These patients often present with non-specific symptoms, such as fatigue and inappetence, or even sudden death.Determining the need for emergency therapy or less aggressive treatment is largely based on the patients electrophysiological presentation.In clinical settings, we need to differentiate hyperkalemia from hyperacute myocardial infarction, early repolarization, and pericarditis because of similarities in T-wave and ST-segment changes in the electrocardiogram (ECG).Here we present a case of hyperkalemia caused by amiloride, and discuss the ECG changes associated with an altered level of serum potassium.This case may help clinicians lea to recognize and manage patients with hyperkalemia.