Hypokalemia-induced pseudoischemic electrocardiographic changes and quadriplegia

Mirijello, Antonio; Rinninella, Emanuele; Leva, Francesca De; Tosoni, Alberto; Vassallo, Gabriele; Antonelli, Massimo; Addolorato, Giovanni; Landolfi, Raffaele

doi:10.1016/j.ajem.2013.09.033

Cited by 6 publications

(12 citation statements)

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“…30 Early detection and treatment allow clinicians to prevent morbidity and mortality from cardiac arrhythmia. 31 Gastrointestinal reactions, which comprised nausea, vomiting, and diarrhoea, were the most common adverse events, accounting for 41.2% (7/17) of the total events. The incidence of adverse events was not significantly different between the two groups over the 5-day study period.…”

Section: Discussionmentioning

confidence: 98%

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Effect of dynamic stratified potassium supplementation in elderly patients with chronic heart failure and moderate to severe hypokalaemia—a randomised, controlled trial

et al. 2021

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Objective To compare the effectiveness of dynamic stratified potassium supplementation at high concentrations with enteral potassium supplementation in older patients with chronic heart failure and moderate to severe hypokalaemia. Methods We performed a single-centre, short-term, randomised, controlled, open-labelled, clinical trial, and patients were randomly allocated to the control or intervention group. The intervention group received intermittent infusions of 30 mmol/100 mL potassium chloride. In the control group, 10% potassium chloride was administered orally in a bolus dose. Short-term efficacy and adverse events were compared. Results The intervention group received less potassium than that in the control group. T-wave normalisation and U-wave disappearance occurred sooner in the intervention group than in the control group after potassium supplementation. The rate of increase in potassium concentrations gradually became similar in both groups. The initial blood potassium concentration, method of potassium supplementation, potassium supplement dose, and 24-hour urinary potassium excretion significantly affected the rate of increase in blood potassium concentrations after supplementation. Conclusions The efficacy of enteral potassium supplementation is equivalent to that of supplementation with high intravenous potassium concentrations in elderly patients with chronic heart failure and moderate to severe hypokalaemia. High intravenous potassium concentrations may lead to a superior potassium recovery rate.

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Section: Discussionmentioning

confidence: 98%

“…30 Early detection and treatment allow clinicians to prevent morbidity and mortality from cardiac arrhythmia. 31 …”

Section: Discussionmentioning

confidence: 99%

Effect of dynamic stratified potassium supplementation in elderly patients with chronic heart failure and moderate to severe hypokalaemia—a randomised, controlled trial

et al. 2021

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“…3 Hypokalemia directly produces the resting membrane hyperpolarization and action potential duration prolongation, which are associated with specific ECG patterns including STsegment depression, T-U wave fusion, and a prolonged QTU interval. 4,5 Incertaincases,hypokalemiacanresultinwidespreadST-segment depression in more than 6 surface leads and ST-segment elevation in lead aVR, which may often be confused with NSTEMI due to multives-CME at jamacmelookup.com sel ischemia or left main coronary artery obstruction, especially in a patient associated with cardiac biomarker elevation. 1,5 In these patients, urgent echocardiography evaluating regional and global left ventricular function may be helpful for differential diagnosis and risk stratification.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Incertaincases,hypokalemiacanresultinwidespreadST-segment depression in more than 6 surface leads and ST-segment elevation in lead aVR, which may often be confused with NSTEMI due to multives-CME at jamacmelookup.com sel ischemia or left main coronary artery obstruction, especially in a patient associated with cardiac biomarker elevation. 1,5 In these patients, urgent echocardiography evaluating regional and global left ventricular function may be helpful for differential diagnosis and risk stratification. 1 In the present case, a mild cTnT elevation was likely associated with an excess of thyroid hormones, which can enhance the myocardial response to catecholamines.…”

Section: Discussionmentioning

confidence: 99%

Ominous Electrocardiogram Changes in a Man With Distal Extremity Weakness

Zhang,

Han,

Huang

2023

JAMA Intern Med

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“…Typical ECG changes in hypokalemia are T-wave inversion, prolonged PR, and U wave [8]. Hypokalemia presenting as a pseudoischemic change pattern is rare.…”

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confidence: 99%