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Anormalidades en los electrolitos subyacentes a las arritmias letales y ventriculares

¹Division of Cardiology, University of North Carolina, Chapel Hill 27599-7075.

|January 1, 1992

Resumen

Los desequilibrios electrolíticos, particularmente los bajos niveles de potasio y magnesio, están relacionados con arritmias ventriculares peligrosas. Estos desequilibrios son comunes en pacientes con insuficiencia cardíaca, hipertensión y después de ataques cardíacos, lo que aumenta el riesgo de muerte cardíaca súbita.

Área de la Ciencia:

Cardiología Cardiología.
Electrofisiología y electrofisiología.
La bioquímica es la bioquímica.

Sus antecedentes:

Se sabe que los cambios en el potasio sérico causan arritmias ventriculares al alterar la electrofisiología de una sola fibra.
La hipocalemia de los diuréticos puede aumentar el riesgo de muerte cardíaca súbita en pacientes con hipertensión y insuficiencia cardíaca.
La hipocalemia es un factor de riesgo independiente para las arritmias ventriculares letales en el infarto agudo de miocardio, el hambre y el alcoholismo.

Objetivo del estudio:

Revisar el papel de los electrolitos y las anomalías metabólicas en las arritmias ventriculares letales.
Hacer hincapié en la importancia de considerar estos factores en el manejo clínico.

Principales métodos:

Revisión de la literatura de los estudios sobre las alteraciones de los electrolitos y las arritmias ventriculares.
Análisis del impacto del potasio, el magnesio y el calcio en la electrofisiología cardíaca.

Principales resultados:

El aumento del potasio extracelular miocárdico después de la oclusión coronaria es una de las principales causas de las arritmias ventriculares.
La hipocalemia está relacionada con arritmias en varios entornos clínicos.
El agotamiento del magnesio puede contribuir a las arritmias, pero falta evidencia causal directa.
Los cambios intracelulares en el calcio están implicados en las arritmias durante la isquemia, la reperfusión, el ejercicio y la toxicidad de la digitalis.

Conclusiones:

Las anomalías electroliticas y metabólicas son las causas subyacentes de las arritmias ventriculares letales.
Estos factores deben considerarse rutinariamente en pacientes con arritmias potencialmente mortales, especialmente aquellos con hipertensión, insuficiencia cardíaca y uso de diuréticos.

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