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Atropine-resistant bradycardia due to hyperkalaemia

T J Slade1, J Grover, J Benger

  • 1Emergency Department, Bristol Royal Infirmary, Marlborough Street, Bristol, UK. tobyslade@hotmail.com

Emergency Medicine Journal : EMJ
|August 30, 2008
PubMed

Insights

Symptomatic bradycardia can resist standard treatment. Consider hyperkalemia and administer calcium to stabilize the heart and resolve slow heart rates, especially when atropine fails.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Internal Medicine

Background:

  • Symptomatic sinus bradycardia is a common emergency department presentation.
  • Standard treatment involves atropine and cardiac pacing.

Observation:

  • Two cases of atropine-resistant symptomatic bradycardia were observed.
  • Hyperkalemia was identified as a potential underlying cause.

Findings:

  • Hyperkalemia can present as symptomatic bradycardia resistant to atropine.
  • Calcium administration stabilizes the myocardium and resolves bradycardia in hyperkalemic patients.
  • Blood gas analysis offers rapid serum potassium estimation.

Implications:

  • Clinicians should consider hyperkalemia in refractory symptomatic bradycardia.
  • Prompt calcium treatment can be life-saving in such cases.
  • Utilizing blood gas analysis aids in timely diagnosis and management.

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