Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest
Shareez Peerbhai1, Luke Masha2, Adrian DaSilva-DeAbreu1
1Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 1.150, Houston, 77030, TX, USA.
International Journal of Emergency Medicine
|January 27, 2017
Summary
Severe hyperkalemia can mimic acute myocardial infarction on ECG, leading to delayed diagnosis. This case highlights a rare pseudo-STEMI presentation of hyperkalemia, even with cardiac arrest.
Area of Science:
- Cardiology
- Electrophysiology
- Nephrology
Background:
- Hyperkalemia is a common electrolyte imbalance.
- ECG findings include PR prolongation and T wave peaking.
- Severe cases can cause arrhythmias and blocks.
Purpose of the Study:
- To present a rare case of hyperkalemia mimicking acute myocardial infarction.
- To discuss the diagnostic challenges and implications of this pseudo-STEMI pattern.
Main Methods:
- Case report of a patient with acute renal failure and hyperkalemia.
- ECG interpretation initially suggested ST-segment elevation myocardial infarction (STEMI).
- Coronary angiography was performed to rule out coronary artery disease.
Main Results:
- The patient experienced ventricular fibrillation cardiac arrest due to malignant hyperkalemia.
- ECG findings mimicked STEMI, delaying the diagnosis of hyperkalemia.
- Coronary angiography revealed no obstructive coronary artery disease.
Conclusions:
- Hyperkalemia can rarely present as a pseudo-STEMI on ECG.
- This is the first reported case of pseudo-STEMI from hyperkalemia presenting with cardiac arrest.
- Prompt recognition of hyperkalemia is crucial to avoid life-threatening complications.
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