Korean J Crit Care Med.  1999 Jun;14(1):42-46.

Severe Hyperkalemia without Typical Electrocardiographic Manifestations: A case report

Affiliations
  • 1Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.

Abstract

Severe hyperkalemia can induce life threatening cardiac rhythm disturbances, and usually produce classic electrocardiographic (EKG) manifestations. We report a case of severe hyperkalemia in which the EKG did not reveal the expected alterations. The patient was a 57-year-old man with adenocarcinoma of stomach. There were no significant abnormal findings in laboratory analysis, chest X-ray and EKG. His preoperative medications for hypertension consisted of furosemide, amiloride and enalapril. The tests for serum potassium concentration ([K ]) were performed on 20 and 7 days before the operation and the results were 4.5 and 4.9 mEq/l, respectively. Just after induction of anesthesia, we tried the blood gas and electrolyte analysis and the result revealed high [K ] of 8.5 mEq/l, but EKG did not show typical phenotype of hyperkalemia at that time. His intraoperative and postoperative courses were not eventful.

Keyword

Ions; potassium; hyperkalemia

MeSH Terms

Adenocarcinoma
Amiloride
Anesthesia
Electrocardiography*
Enalapril
Furosemide
Humans
Hyperkalemia*
Hypertension
Ions
Middle Aged
Phenotype
Potassium
Stomach
Thorax
Amiloride
Enalapril
Furosemide
Ions
Potassium
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