This is the continuation of 73 years old male presented with bradycardia ( Click here ). HR 31/min, BP 160/90, ECG is typical of Hyperkalemia. This man presented with Tiredness Giddiness Altered sensorium. On evaluation he had serum potassium levels 6.6, serum calcium 7.9, ABG revealed pH 7.21, serum creatinine 3.6 mg, urea 167 mg. We concluded that he has acute kidney injury on preexisted CKD, metabolic acidosis, Hyperkalemia, Hypocalcemia leading on to these ECG changes.
Typically, Hyperkalemia is associated with hypocalcemia, acidosis. ECG changes are sinus bradycardia, sluggish P waves, first or second degree or complete Heart block. Tall narrow peaked T waves mimicking Myocardial injury, prolonged QTc interval. Nephrologist opinion is taken. We treated with temporary pacing, Glucose Insulin infusion, IV Calcium gluconate, Asthalin inhalation, correction of Acidosis, oral K binders,…
