Sliding with the sines - fatal hyperkalemia: A case report

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• Electrocardiographic (ECG) changes in hyperkalemia, such as peaked T-waves, are known.
• The real-time evolution and speed of these ECG changes are not well-documented.

Observation:

• A case of an elderly male with diabetes, hypertension, acute renal failure, and rhabdomyolysis presented with hyperkalemia and cardiac arrest.
• Despite medical management and hemodialysis, significant cardiac rhythm changes were observed on telemetry less than 10 minutes before the arrest.

Findings:

• Hyperkalemia can lead to instantaneous and significant alterations in cardiac telemetry rhythms.
• Rapidly increasing potassium levels pose a life-threatening risk.

Implications:

• Continuous cardiac monitoring is essential for patients with hyperkalemia, especially those with risk factors.
• Aggressive or advanced interventions beyond standard medical treatment may be necessary for severe hyperkalemia-induced cardiac events.