RE: hyperkalemia electrocardiogram NEJM

[Guest guest]

Did someone have hyperkalemia and an odd ecg that I missed in the posts? That particular example shows likely a dying patient (they say that patient didn't die though and appeared to be at least faiirly stable, but they don't give the other data) Anyway, that was not just your run of the mill hyperkalemia ecg.. That's a bad heart ryhthm that has to be fixed now. From experience I would think that this patient is in and out of consciousness or close to it with that example ecg or was at one point unconscious in the dialysis chair. Almost certainly though that was a renal failure patient.

From: Valarie <val@...>Subject: hyperkalemia electrocardiogram NEJMhyperaldosteronism Date: Wednesday, May 2, 2012, 8:15 PM

Electrocardiogram shows hyperkalemia

http://www.nejm.org/image-challenge?query=TOC

Val

[Guest guest]

That reminds me there was a fellow - not the guy with the resistant HTN - at the clinic here who had a 9 K, but he was fine, kidneys fine, etc. The 2 NP's were kind of ganging up on him, and I suggested it was just drawn wrong - not knowing THEY drew it the day before in the clinic(most go over to LabCorp). Oops...they didn't like that because they do nothing wrong........really, they said they drew it right and that can't be it. The guy was 100% perfectly fine. ECG on him ? I don't recall one. Funny, you just made me think of that. My kids see the NP's over there so I love them, they're doggone it just not as smart as me. But then again who is right?

.........at least in MY head

From: Valarie <val@...>Subject: hyperkalemia electrocardiogram NEJMhyperaldosteronism Date: Wednesday, May 2, 2012, 8:15 PM

Electrocardiogram shows hyperkalemia

http://www.nejm.org/image-challenge?query=TOC

Val

[Guest guest]

The diagnosis is hyperkalemia.  I thought it would be interesting for people to see that. " The electrocardiogram shows a regular rhythm, with a widened QRS complex in a sine-wave configuration, and there no discernible P waves. The T waves were fused with the widened QRS complexes to form the sine-wave pattern (sinoventricular rhythm). The patient's serum potassium level was 9.1 mmol per liter. His condition stabilized after the administration of calcium chloride, bicarbonate, glucose, and insulin therapy, which was followed by hemodialysis. " Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham Did someone have hyperkalemia and an odd ecg that I missed in the posts? That particular example shows likely a dying patient (they say that patient didn't die though and appeared to be at least faiirly stable, but they don't give the other data) Anyway, that was not just your run of the mill hyperkalemia ecg.. That's a bad heart ryhthm that has to be fixed now. From experience I would think that this patient is in and out of consciousness or close to it with that example ecg or was at one point unconscious in the dialysis chair. Almost certainly though that was a renal failure patient. From: Valarie <val@...>Electrocardiogram shows hyperkalemiahttp://www.nejm.org/image-challenge?query=TOC .

[Guest guest]

Gotchya. Didn't know if I missed one as sometimes I will delete a bunch and wanted to put a person to the scenario.

- On Wed, 5/2/12, Valarie <val@...> wrote:

From: Valarie <val@...>Subject: RE: hyperkalemia electrocardiogram NEJMhyperaldosteronism Date: Wednesday, May 2, 2012, 10:35 PM

The diagnosis is hyperkalemia. I thought it would be interesting for people to see that.

"The electrocardiogram shows a regular rhythm, with a widened QRS complex in a sine-wave configuration, and there no discernible P waves. The T waves were fused with the widened QRS complexes to form the sine-wave pattern (sinoventricular rhythm). The patient's serum potassium level was 9.1 mmol per liter. His condition stabilized after the administration of calcium chloride, bicarbonate, glucose, and insulin therapy, which was followed by hemodialysis."

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham

Did someone have hyperkalemia and an odd ecg that I missed in the posts? That particular example shows likely a dying patient (they say that patient didn't die though and appeared to be at least faiirly stable, but they don't give the other data) Anyway, that was not just your run of the mill hyperkalemia ecg.. That's a bad heart ryhthm that has to be fixed now. From experience I would think that this patient is in and out of consciousness or close to it with that example ecg or was at one point unconscious in the dialysis chair. Almost certainly though that was a renal failure patient.

From: Valarie <val@...>

Electrocardiogram shows hyperkalemia

http://www.nejm.org/image-challenge?query=TOC

..

[Guest guest]

Ekg can show either low or high K. But usually must be at extremes to see an effect. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 22:35, Valarie <val@...> wrote:

The diagnosis is hyperkalemia. I thought it would be interesting for people to see that. "The electrocardiogram shows a regular rhythm, with a widened QRS complex in a sine-wave configuration, and there no discernible P waves. The T waves were fused with the widened QRS complexes to form the sine-wave pattern (sinoventricular rhythm). The patient's serum potassium level was 9.1 mmol per liter. His condition stabilized after the administration of calcium chloride, bicarbonate, glucose, and insulin therapy, which was followed by hemodialysis." Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham Did someone have hyperkalemia and an odd ecg that I missed in the posts? That particular example shows likely a dying patient (they say that patient didn't die though and appeared to be at least faiirly stable, but they don't give the other data) Anyway, that was not just your run of the mill hyperkalemia ecg.. That's a bad heart ryhthm that has to be fixed now. From experience I would think that this patient is in and out of consciousness or close to it with that example ecg or was at one point unconscious in the dialysis chair. Almost certainly though that was a renal failure patient. From: Valarie <val@...>Electrocardiogram shows hyperkalemiahttp://www.nejm.org/image-challenge?query=TOC .

[Guest guest]

Likely error or the guy would be dead.CE Grim MDOn May 2, 2012, at 9:14 PM, Bingham wrote: That reminds me there was a fellow - not the guy with the resistant HTN - at the clinic here who had a 9 K, but he was fine, kidneys fine, etc. The 2 NP's were kind of ganging up on him, and I suggested it was just drawn wrong - not knowing THEY drew it the day before in the clinic(most go over to LabCorp). Oops...they didn't like that because they do nothing wrong........really, they said they drew it right and that can't be it. The guy was 100% perfectly fine. ECG on him ? I don't recall one. Funny, you just made me think of that. My kids see the NP's over there so I love them, they're doggone it just not as smart as me. But then again who is right? ........at least in MY head From: Valarie <val@...>Subject: hyperkalemia electrocardiogram NEJMhyperaldosteronism Date: Wednesday, May 2, 2012, 8:15 PM Electrocardiogram shows hyperkalemia http://www.nejm.org/image-challenge?query=TOC Val