Severe Hyperkalemia, a Case Report.

Area of Science:

• Cardiology
• Nephrology
• Emergency Medicine

Background:

• Electrolyte abnormalities, particularly hyperkalemia, pose significant risks in patients with end-stage renal disease.
• Electrocardiography (ECG) is a crucial tool for the rapid, non-invasive assessment of cardiac function and electrolyte disturbances.

Purpose of the Study:

• To highlight the classic ECG findings associated with severe hyperkalemia.
• To emphasize the role of ECG in the prompt diagnosis and management of electrolyte abnormalities.
• To underscore the importance of initiating therapy based on ECG findings prior to laboratory confirmation.

Main Methods:

• Case presentation of a 78-year-old male with end-stage renal disease presenting with chest pain.
• Initial ECG interpretation revealing a severely widened QRS complex with a sinusoidal pattern.
• Administration of emergency treatment including calcium, insulin, and beta-agonists for hyperkalemia.

Main Results:

• ECG findings were classic for severe hyperkalemia, prompting immediate treatment.
• Serum potassium levels were confirmed to be severely elevated at 8 mmol/L.
• Despite aggressive management, the patient experienced pulseless electrical activity cardiac arrest.

Conclusions:

• ECG is vital for the rapid screening and diagnosis of electrolyte derangements like hyperkalemia.
• Prompt initiation of treatment based on ECG findings can be life-saving.
• Severe hyperkalemia carries a high risk of fatal arrhythmias and rapid clinical deterioration.