Hyperkalemia A Silent Threat in Emergency Medicine Insights from Two Case Reports

Understanding Hyperkalemia and Its Implications
Potassium plays a crucial role in maintaining cellular function, particularly in cardiac and neuromuscular activity. Disruptions in potassium balance can lead to severe consequences, including arrhythmias and paralysis.

Case Report Highlights

Case 1: Cardiogenic Shock Due to Hyperkalemia

  • A 70-year-old male with chronic kidney disease presented in shock with pallor, sweating, and hypotension.
  • ECG findings showed wide QRS complexes, consistent with ventricular tachycardia.
  • Laboratory results: K+ level of 9.3 mmol/L.
  • Emergency hemodialysis was performed, leading to a successful recovery with normal cardiac function restored.

Case 2: Flaccid Paralysis and Hyperkalemia

  • An 84-year-old male with chronic atrial fibrillation experienced sudden-onset paralysis.
  • Lab results confirmed severe hyperkalemia (K+ = 9.4 mmol/L).
  • Despite initial medical management with insulin, glucose, and diuretics, urgent dialysis was required.
  • The patient regained full muscle function post-treatment.

Clinical Relevance and Broader Implications

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Key Takeaways:

  • Hyperkalemia can manifest as cardiac arrhythmias or neuromuscular paralysis.
  • Routine serum electrolyte checks and ECG monitoring are essential in emergency settings.
  • Early dialysis intervention can significantly improve patient outcomes.

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