Life threatening severe hyperkalemia presenting typical electrocardiographic changes - Rapid recovery following medical, temporary pacing, and hemodialysis treatments

摘要

A 74 year-old male patient presented to the emergency room with chest discomfort and general weakness since several hours ago. He had a history of diabetes mellitus and hypertension for 20 years and had undergone percutaneous coronary intervention for acute myocar-dial infarction 9 years ago. Atrial fibrillation and mild renal impairment (serum creatinine, 1.5 mg/dL) were identified in the past medical record. He was regularly followed up and has taken such medications for uncontrolled hypertension and ischemic heart disease for one and half years: carvedilol 12.5 mg, diltiazem 90 mg, barnidipine 15 mg, valsartan 160 mg and imidapril 5 mg twice a day, but his blood pressure was about 150/95 mm Hg. Follow-up serum potassium level taken 8 months ago was 6.0 mmol/L