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[Syncope caused by iatrogenic hypercalcemia]
1Zavod za kardiologiju, Klinika za unutrasnje bolesti s poliklinikom, Medicinski fakultet Sveucilista u Zagrebu.
Insights
A patient experienced a syncopal attack due to severe hyperkalemia, a condition exacerbated by heart failure medications and potassium supplements. Treatment successfully normalized potassium levels and compensated heart function.
Area of Science:
- Cardiology
- Nephrology
- Clinical Medicine
Background:
- A 68-year-old female with congestive heart failure presented with a syncopal attack.
- The patient was on digoxin, furosemide, verapamil, spironolactone, and potassium salt.
- She was admitted due to arrhythmia caused by severe hyperkalemia (8.9 nmol/L).
Abstract:
A course of the disease of a 68-year-old female who had been taking medigoxin, furosemide, verapamil and an unknown amount of spironolactone and potassium salt due to congestive heart failure is presented. She was admitted to emergency department of the University Hospital Rebro after an episode of syncopal attack because of arrhythmia due to hyperkalemia (8.9 nmol/L). She has had a fast idioventricular rhythm, followed by atrial tachycardia after that and with fast ventricular rhythm, S-T segment depression and a tall and peaked T-wave. In the following electrocardiograms left anterior hemiblock appeared, a tall R-wave of the anterolateral location, supraventricular and ventricular premature beats and atrioventricular block of the first degree. The patient had signs of non-oliguric form of acute renal failure at the admission which was a partly explanation for the development of hyperkalemia, together with the use of spironolactone and potassium salt. After the treatment she had normal serum creatinine values. She suffered from combined mitral valve disease: stenosis with a predominant regurgitation of the II/III degree. She was discharged from the hospital in a compensated state with normal serum potassium values.