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

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Alfonso Sforza
Federica De Pisapia
Giuliano De Stefano
Antonio Gaspardini
Maria Immacolata Arnone
Andrea D'Amato
Maria Viviana Carlino
Costantino Mancusi *
(*) Corresponding Author:
Costantino Mancusi | costantino.mancusi@unina.it


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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