P180 EXTREMELY WIDE QRS TACHYCARDIA IN SEVERE HYPERKALEMIA: THE IMPORTANCE OF MONITORING MRA THERAPY
نویسندگان
چکیده
Abstract Although uncommon in the general population, hyperkalemia can affect up to 50% of patients with heart failure who are receiving MRA and/or affected by CKD . Since potassium is most abundant intracellular cation, hyperkaliemia causes a profound change action potential, which manifests as expected electrocardiographic changes (lower voltage P wave, AV block, wide QRS, high T wave) and arrhythmias. Clinic case. A 77–year–old woman was admitted ED for dyspnea. She had medical history stage 3 HFrEF recent admission department worsening congestion, from dimitted supratherapeutic dose (canrenone 300 mg/die). Physical examination at excluded signs central or peripheral congestion An EKG performed revealed an rate 95 beats per minute extremely QRS (280 ms). Contextually, blood gas analysis showed level (K 9 mmol/l) metabolic acidosis. Due inability demonstrate presence wave regular A–V conduction, differential diagnosis between VT SVT required. The fusion beat, negative concordance precordials derivation, extreme right axis deviation led slow VT. Cuncurrently onset therapy, ECV sinus rhythm restoration done. following EKGs electrical based on measured level. After K 8 mmol/l: remained (180ms) 65 possible junctional sino–ventricular rhythm, sometimes described expression atrial inectability exception conduction fibers. 1 hour 6.3 normal duration HR 60 bpm but low concomitant block I grade that gradually restored normalization levels after canrenone suspension. Because numerous side effects careful monitoring therapy plays critical role prevention arrhythmias HFrEF.
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ژورنال
عنوان ژورنال: European Heart Journal Supplements
سال: 2023
ISSN: ['1520-765X', '1554-2815']
DOI: https://doi.org/10.1093/eurheartjsupp/suad111.259