Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu, Abhijeet Dhoble

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. Case presentation: We present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest. Recognition of this disorder was delayed secondary to an initial ECG pattern suggesting an acute ST segment elevation myocardial infarction (STEMI). Emergent coronary angiography performed showed no evidence of coronary artery disease. Conclusions: Pseudo-STEMI patterns are rarely seen in association with acute hyperkalemia and are most commonly described with patient without acute cardiac symptomatology. This is the first such case presenting concurrently with cardiac arrest. A brief review of this rare pseudo-infarct pattern is also given.

Original languageEnglish (US)
Article number3
JournalInternational Journal of Emergency Medicine
Volume10
Issue number1
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Keywords

  • Cardiac arrest
  • ECG
  • Hyperkalemia
  • Myocardial infarction
  • STEMI

ASJC Scopus subject areas

  • Emergency Medicine

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