Recognising signs of danger: ECG changes resulting from an abnormal serum potassium concentration

Webster, A. J. F.

doi:10.1136/emj.19.1.74

Cited by 76 publications

(70 citation statements)

References 13 publications

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“…1). Although the electrocardiographic changes have been reported in 80% of patients with potassium level of [3,4]. Hypomagnesemia and hypocalcemia both result in abnormal, prolonged cardiac repolarization but with the isolated hypocalcemia, all of the QT interval prolongation Fig.…”

mentioning

confidence: 95%

Electrocardiographic changes in combined electrolyte depletion

Khan¹,

Patel²,

Wilbur³

et al. 2007

International Journal of Cardiology

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mentioning

confidence: 95%

Electrocardiographic changes in combined electrolyte depletion

Khan¹,

Patel²,

Wilbur³

et al. 2007

International Journal of Cardiology

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“…373,375,376 Finally, a sine wave pattern, VF, and asystole or pulse less electrical activity may be seen at potassium lev els exceeding 10 mmol/L. 372,374 It is important to note, however, that electrocardiographic manifestations for hyperkalemia vary among individuals and may not be predictable. 345,373,377 Magnesium.…”

Section: Electrolyte Abnormalitiesmentioning

confidence: 99%

“…373 Various sources have classified hyperkalemia with slight differences but typically as mild (5.5-6.4 mmol/L), moderate (6.5-8.0 mmol/L), or severe (>8.0 mmol/L). 374 This classification helps illustrate the pro gressive effect on the ECG. As hyperkalemia progress es, the T wave often (but not always) becomes peaked (5.5-6.5 mmol/L), the PR interval lengthens (6.5-7.5 mmol/L), and the QRS widens (7.0-8.0 mmol/L).…”

Section: Electrolyte Abnormalitiesmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

207

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…Moreover, as the serum potassium levels decline, the transmembrane potassium gradient decreases. The effect on the cell membrane is an elevation in the resting membrane potential and a prolongation of the action potential (particularly in phase 3 repolarization) and the refractory periods (8). As a result of the increased duration of the activation potential and the refractory period, patients with hy-pokalemia are at increased risk for arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Primary Aldosteronism with Concurrent Primary Hyperparathyroidism in a Patient with Arrhythmic Disorders

et al. 2013

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A 25-year-old Caucasian woman was admitted to our department with severe hypokalemia that was associated with hypercalcemia. An endocrinological investigation showed the coexistence of primary hyperparathyroidism (PHPT) and primary aldosteronism (PA), arising from an adenoma of the left cortical adrenal gland. The patient underwent left laparoscopic adrenalectomy, but refused the surgical neck exploration that would be required for parathyroidectomy. The post-operative course was uneventful, and the patient realized a normalization of her potassium serum level and a reduction of her blood pressure values. We herein report the important issues regarding the management of a severe electrolyte imbalance, in view of the reciprocal interaction between aldosterone and parathyroid hormone, and their combined potential for causing cardiovascular damage.

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Recognising signs of danger: ECG changes resulting from an abnormal serum potassium concentration

Cited by 76 publications

References 13 publications

Electrocardiographic changes in combined electrolyte depletion

Electrocardiographic changes in combined electrolyte depletion

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Primary Aldosteronism with Concurrent Primary Hyperparathyroidism in a Patient with Arrhythmic Disorders

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