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

Alfonso Sforza, Federica De Pisapia, Giuliano De Stefano, Antonio Gaspardini, Maria Immacolata Arnone, Andrea D'Amato, Maria Viviana Carlino, Costantino Mancusi
  • 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 | 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.

Keywords

Hyperkalemia; implantable medical devices; electrocardiography; calcium chloride therapy; kidney disease.

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Submitted: 2018-01-19 19:24:35
Published: 2018-06-20 12:31:21
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Copyright (c) 2018 Alfonso Sforza, Federica De Pisapia, Giuliano De Stefano, Antonio Gaspardini, Maria Immacolata Arnone, Andrea D'Amato, Maria Viviana Carlino, Costantino Mancusi

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