Electrocardiographic features of hyperkalemia during acute kidney injury in a patient with pacemaker

DOI https://doi.org/10.4081/itjm.2018.986

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Published: Jun 20, 2018
Case Reports

Issue
Vol 12, No 2 (2018)
Pages
145-147
Keywords
Hyperkalemia, implantable medical devices, electrocardiography, calcium chloride therapy, kidney disease.
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How to Cite
Sforza, A., De Pisapia, F., De Stefano, G., Gaspardini, A., Arnone, M. I., D’Amato, A., Carlino, M. V., & Mancusi, C. (2018). Electrocardiographic features of hyperkalemia during acute kidney injury in a patient with pacemaker. Italian Journal of Medicine, 12(2), 145-147. https://doi.org/10.4081/itjm.2018.986
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Main Article Content

Alfonso Sforza
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Federica De Pisapia
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Giuliano De Stefano
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Antonio Gaspardini
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Maria Immacolata Arnone
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Andrea D'Amato
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Maria Viviana Carlino
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
Costantino Mancusi *
Hypertension Research Center, UOC Emergency Medicine, Federico II University Hospital, Naples, Italy.
(*) Corresponding Author:
Costantino Mancusi | costantino.mancusi@unina.it

Abstract

We describe a case of a 79-year-old man with pacemaker who presented to the Emergency Department due to asthenia and acute confusional state. He had a history of atrial fibrillation, anemia and colostomy and he was on treatment with diuretics. The electrocardiogram (ECG) showed pacemaker-induced ventricular activity, QRS complexes excessively wide with sine-wave appearance, tall and peaked T waves, without electrically evident atrial activity. Potassium concentration on arterial blood gas analysis was 8.8 mmol/L. ECG abnormalities disappeared after therapy with calcium chloride and spontaneous cardiac activity reappeared.

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