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Electrocardiographic changes in thyrotoxic periodic paralysis.

B Ee, J S Cheah

    Journal of Electrocardiology
    |July 1, 1979
    PubMed
    Summary
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    Electrocardiograms (ECGs) in hypokalaemic thyrotoxic periodic paralysis can show hypokalaemia signs, but serum potassium levels are hard to predict. Sinus arrest and heart block were noted, unlike common extrasystoles.

    Area of Science:

    • Endocrinology
    • Cardiology
    • Internal Medicine

    Background:

    • Thyrotoxic periodic paralysis is a condition characterized by episodes of muscle weakness due to low serum potassium.
    • Electrocardiogram (ECG) changes are often associated with electrolyte imbalances, including hypokalaemia.

    Purpose of the Study:

    • To investigate the electrocardiographic (ECG) findings in patients with hypokalaemic thyrotoxic periodic paralysis.
    • To determine the correlation between ECG features and serum potassium levels during paralytic episodes.
    • To identify any novel ECG findings in this patient cohort.

    Main Methods:

    • Retrospective analysis of ECGs from 30 patients with hypokalaemic thyrotoxic periodic paralysis.
    • ECGs were recorded during and after paralytic episodes.

    Related Experiment Videos

  • Serum potassium levels were measured concurrently with ECG recordings.

    • Main Results:

    • Typical hypokalaemia features on ECG were observed in patients with serum potassium ≤ 2.8 mmol/l.
    • Above 2.8 mmol/l, ECG findings varied from non-diagnostic to showing hypokalaemia.
    • Serum potassium levels were not accurately predictable from ECGs, except in cases of sinus arrest or heart block.
    • Extrasystoles, previously reported as common, were absent in all patients.
    • Sinus arrest occurred in 2 patients, and second-degree atrio-ventricular block in 3 patients.

    Conclusions:

    • ECG findings in hypokalaemic thyrotoxic periodic paralysis correlate with serum potassium levels, but prediction is limited.
    • Sinus arrest and atrio-ventricular block are potential ECG manifestations of hypokalaemia in this condition, and have not been previously reported.
    • The absence of extrasystoles in this cohort warrants further investigation.