Hyperkalemia and Cardiac functioning

General
1

We generally associate high potassium concentration only with kidney and its function.

But change in concentration of one ion may lead to effect on many functions of the body.

Hyperkalemia is increased serum concentration of potassium in body. which is associated with cardiac arrhythmias that is irregular heartbeat. Small level of increase may be managed but prolonged and very high concentration of potassium in blood may start to affect functioning of heart.

what causes increase in potassium in body?

  1. Most obvious reason for increased potassium in serum and plasma is kidney disorder. When kidney cannot filter extra potassium out of the system, it leads to hyperkalemia. Hyperkalemia is common in cases of Chronic Kidney Disease(CKD).
  2. Increase in dietary uptake of potassium can also induce hyperkalemia.
  3. Addison’s Disease which is caused by aldosterone deficiency or resistance increases potassium concentration in body.
  4. Medications which impair potassium homeostasis like ACE inhibitors can also alter potassium concentration.

what hyperkalemia does to body?

  • Potassium is required for heart muscle contraction and regulation. It helps in cardiac muscle signaling. Increase in potassium concentration disturbs the resting membrane potential of cardiac myocytes.

Hyperkalemia
Hyperkalemia1312×1199 399 KB

How to diagnose hyperkalemia?

  • It is generally difficult to diagnose because, symptoms start to show only when its concentration becomes very high and causes acute hyperkalemia.
  • It can be diagnosed by an EKG when heart’s rhythm starts becoming irregular. Like, a peaked T wave.

Treatment Includes

  • Use of Diuretics: which will help kidney release extra salts like potassium and sodium.
  • Stopping medicines which cause increase in potassium uptake.
  • IV infusion of calcium gluconate which helps in protecting the heart.
  • Dialysis of kidney if other methods don’t work.

Many times we only look for factors that we are aware of or read much about as reason for particular disease that we tend to overlook other factors involved in its functioning.

What are other possible reasons for arrythmias?

MBH/PS

2

Great post — and the ECG progression is a classic teaching point: peaked T waves first, then QRS widening, then the sine wave. Calcium gluconate is the immediate cardiac stabilizer, but the definitive fix is actually lowering potassium (insulin-glucose, diuretics, or dialysis)

3

True, apart from electrolyte imbalance many factors like any systemic infection, heart valve inflammation, LD cholesterol , any disorder like thyroid, diabetes, obesity, hypertension or on-going medication can be the reason of arrythmias.