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Heparin-induced life-threatening hyperkalemia
Giuseppe Gheno1, Carmelo Savarino, Sandro Vellar
1Departimento di Medicina Interna, Ospedale Civile di Asiago, ASL 3 Regione Veneto di Bassano del Grappa (VI). giuseppe.gheno@tin.it
Hyperkalemia may occur in many clinical settings and lead to serious events. Heparin-induced hyperkalemia is presumably less well recognized than other untoward effects of heparin treatment and more frequent than commonly perceived. To draw attention to this clinically relevant occurrence, we report 2 cases of life-threatening bradyarrhythmia associated with heparin prescription. Heparin-induced hyperkalemia is mediated by an enzymatic block in the synthesis of aldosterone; however, in most cases severe hyperkalemia occurs in the presence of additional factors influencing potassium homeostasis. Patients treated with heparin should be stratified and adequately monitored according to the outlined risk profile.
Hyperkalemia may occur in many clinical settings and lead to serious events. Heparin-induced hyperkalemia is presumably less well recognized than other untoward effects of heparin treatment and more frequent than commonly perceived. To draw attention to this clinically relevant occurrence, we report 2 cases of life-threatening bradyarrhythmia associated with heparin prescription. Heparin-induced hyperkalemia is mediated by an enzymatic block in the synthesis of aldosterone; however, in most cases severe hyperkalemia occurs in the presence of additional factors influencing potassium homeostasis. Patients treated with heparin should be stratified and adequately monitored according to the outlined risk profile.