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Syncope caused by iatrogenic hyperkalemia
Giuseppe Giancaspro1, Marianna Suppa, Igino Genuini
1Department of Emergency and Urgency, Sapienza University, Azienda Policlinico Umberto I, Rome, Italy. giuseppe.giancaspro@uniroma1.it
Abstract:
Symptomatic bradycardia in the emergency department may have several causes (excessive vagal tone, drug toxicity, acute myocardial ischemia, sick sinus syndrome, heart block, and electrolyte imbalance); among these, hyperkalemia may develop as a complication of chronic medical treatment with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and must be considered in the early approach to the bradyarrhythmic patient with possible electrocardiographic signs of hyperkalemia. We report a case of an 87-year-old woman with a clinical history of chronic angiotensin-receptor blocker consumption that led her to dangerous bradyarrhythmia, cardiogenic syncope, and risk of sudden cardiac death.
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