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Emergency Cardiac Pacing in Hyperkalemia

Emergency Cardiac Pacing in Hyperkalemia Abstract Hyperkalemia can be readily diagnosed when the history is available or characteristic tall peaked T waves are seen on the electrocardiogram. However, emergency treatment may be required in hyperkalemic patients, particularly in the absence of a history or typical electrocardiographic patterns. In the following case report the patient presented in severe congestive heart-failure with a ventricular rate of 20 per minute. Emergency cardiac pacing markedly improved the cardiac failure until more specific therapy was instituted. We believe this to be the first published report of cardiac pacing in hyperkalemia. Patient Summary A 77-year-old diabetic woman was admitted to Montefiore Hospital and Medical Center, Bronx, NY, with a six-hour history of marked congestive heart-failure, and severe epigastric pain. The patient had been hospitalized three months previously in moderate congestive failure and discharged on a regimen of daily digoxin (0.25 mg alternating with 0.50 mg), hydrochlorothiazide (50 mg), and potassium chloride (45 References 1. Surawicz B: Arrhythmias and electrolyte disturbances. Bull NY Acad Med 43:1160-1180, 1967. 2. Pick A: Arrhythmias and potassium in man. Amer Heart J 72:295-306, 1966.Crossref 3. Sjoberg WE, Kreisle JE: Hyperkalemia and sudden death during spironolactone (aldactone) therapy. Texas Med 58:1022-1024,1962. 4. Chamberlain MJ: Emergency treatment of hyperkalemia. Lancet 1:464-467, 1964.Crossref 5. Levinsky NG: Management of emergencies VI Hyperkalemia. New Eng J Med 274:1076-1077, 1966.Crossref 6. Clark NE: The action of calcium on the human electrocardiogram. Amer Heart J 22:367-373,1941.Crossref 7. Bellet S: Clinical Disorders of the Heart Beat . Philadelphia, Lea & Febiger, 1963, pp 801-808. 8. Rosenberg AS, Grossman JI, Escher DJW, et al: Bedside transvenous cardiac pacing. Amer Heart J 77:697-703, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1970.00310100104013
Publisher site
See Article on Publisher Site

Abstract

Abstract Hyperkalemia can be readily diagnosed when the history is available or characteristic tall peaked T waves are seen on the electrocardiogram. However, emergency treatment may be required in hyperkalemic patients, particularly in the absence of a history or typical electrocardiographic patterns. In the following case report the patient presented in severe congestive heart-failure with a ventricular rate of 20 per minute. Emergency cardiac pacing markedly improved the cardiac failure until more specific therapy was instituted. We believe this to be the first published report of cardiac pacing in hyperkalemia. Patient Summary A 77-year-old diabetic woman was admitted to Montefiore Hospital and Medical Center, Bronx, NY, with a six-hour history of marked congestive heart-failure, and severe epigastric pain. The patient had been hospitalized three months previously in moderate congestive failure and discharged on a regimen of daily digoxin (0.25 mg alternating with 0.50 mg), hydrochlorothiazide (50 mg), and potassium chloride (45 References 1. Surawicz B: Arrhythmias and electrolyte disturbances. Bull NY Acad Med 43:1160-1180, 1967. 2. Pick A: Arrhythmias and potassium in man. Amer Heart J 72:295-306, 1966.Crossref 3. Sjoberg WE, Kreisle JE: Hyperkalemia and sudden death during spironolactone (aldactone) therapy. Texas Med 58:1022-1024,1962. 4. Chamberlain MJ: Emergency treatment of hyperkalemia. Lancet 1:464-467, 1964.Crossref 5. Levinsky NG: Management of emergencies VI Hyperkalemia. New Eng J Med 274:1076-1077, 1966.Crossref 6. Clark NE: The action of calcium on the human electrocardiogram. Amer Heart J 22:367-373,1941.Crossref 7. Bellet S: Clinical Disorders of the Heart Beat . Philadelphia, Lea & Febiger, 1963, pp 801-808. 8. Rosenberg AS, Grossman JI, Escher DJW, et al: Bedside transvenous cardiac pacing. Amer Heart J 77:697-703, 1969.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1970

References