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Hyperkalaemia mimics pseudostemi infarct pattern.

Nasra Idilbi^1,2, Mohamad Zbidat²

¹The Max Stern Yezreel Valley College, D.N. Emek Yezreel, 1930600, Emek Yezreel, Israel nasra612@hotmail.com.

BMJ Case Reports

|February 3, 2022

Summary

Severe hyperkalaemia can mimic acute myocardial infarction on an electrocardiogram (ECG), presenting with ST-segment elevation. Prompt diagnosis and treatment of this electrolyte abnormality are crucial to prevent misdiagnosis and dangerous cardiac arrhythmias.

Keywords:

acute renal failure ischaemic heart disease pacing and electrophysiology

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Area of Science:

Cardiology
Nephrology
Electrophysiology

Background:

Hyperkalaemia, a common electrolyte disturbance, typically presents with peaked T waves on electrocardiograms (ECGs).
ST-segment elevation mimicking acute myocardial infarction is an exceptionally rare ECG manifestation of hyperkalaemia.

Observation:

A case of acute kidney injury complicated by severe hyperkalaemia is presented.
The hyperkalaemia induced ST-segment elevation on the ECG, closely resembling acute myocardial infarction.

Findings:

Rapid assessment of serum potassium levels via arterial blood gases guided immediate treatment.
Aggressive management of hyperkalaemia led to normalization of ECG changes and averted unnecessary cardiac catheterization.

Implications:

Awareness of hyperkalaemia-induced ECG changes is vital for clinicians to avoid misdiagnosis of acute myocardial infarction.
Timely and accurate diagnosis prevents invasive procedures and potential complications associated with delayed or incorrect treatment.
This case highlights the importance of considering electrolyte abnormalities in the differential diagnosis of ST-segment elevation myocardial infarction (STEMI).