Soe KK, Seto AH. Sliding with the sines − fatal hyperkalemia: A case report. World J Cardiol 2021; 13(7): 230-236 [PMID: 34367507 DOI: 10.4330/wjc.v13.i7.230]
Corresponding Author of This Article
Kyaw Khaing Soe, MBBS, MD, Attending Doctor, Internal Medicine, Methodist Hospital of Southern California, 300 W Huntington Dr. TCU #52, Arcadia, CA 91007, United States. kyawkhaings@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jul 26, 2021; 13(7): 230-236 Published online Jul 26, 2021. doi: 10.4330/wjc.v13.i7.230
Sliding with the sines − fatal hyperkalemia: A case report
Kyaw Khaing Soe, Arnold Hoo Seto
Kyaw Khaing Soe, Internal Medicine, Methodist Hospital of Southern California, Arcadia, CA 91007, United States
Kyaw Khaing Soe, Graduate Medical Education, St. Mary Medical Center, Long Beach, CA 90813, United States
Arnold Hoo Seto, Department of Medicine, University of California Irvine, Orange, CA 92868, United States
Arnold Hoo Seto, Interventional Cardiology, Long Beach VA Medical Center, Long Beach, CA 90822, United States
Author contributions: Soe KK prepared the manuscript; Seto AH edited the manuscript into the final version; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kyaw Khaing Soe, MBBS, MD, Attending Doctor, Internal Medicine, Methodist Hospital of Southern California, 300 W Huntington Dr. TCU #52, Arcadia, CA 91007, United States. kyawkhaings@gmail.com
Received: May 29, 2021 Peer-review started: May 29, 2021 First decision: June 17, 2021 Revised: June 19, 2021 Accepted: July 6, 2021 Article in press: July 6, 2021 Published online: July 26, 2021
Abstract
BACKGROUND
Classic electrocardiographic manifestations of hyperkalemia starting with peaked symmetrical T-waves are widely recognized in daily clinical practice but little evidence is documented how quickly it can evolve in real-time.
CASE SUMMARY
An elderly diabetic and hypertensive male presented with acute renal failure and rhabdomyolysis. He experienced cardiac arrest with moderate hyperkalemia despite medical treatment and hemodialysis. Telemetry changes were retrospectively studied and found to have significant rhythm changes that occurred just less than 10 minutes prior to the cardiac arrest.
CONCLUSION
In hyperkalemia, telemetry rhythm can change instantaneously in a significant way. Rapidly rising potassium could be life threatening and may require more than medical treatment.
Core Tip: We present a case of acute rhabdomyolysis and renal failure where the patient experienced cardiac arrest with moderate hyperkalemia despite medical treatment and hemodialysis. This case illustrates how quickly the telemetry rhythm can change in a short period of time (9 min).
