A 6-month-old patient with cleft lip palate, atrial septal defect, and presenting hyperkalemia: a case report

Introduction: Cleft Lip Palate (CLP) is a prevalent congenital anomaly in Indonesia. Gradual surgery is the gold standard treatment for the condition. However, screening for other comorbidities must be conducted before the surgery. Congenital heart Defects (CHDs) are one of the prevalent concurrent conditions of CLP patients. One of the CHD that can be found is Atrial Septal Defect (ASD). Moreover, electrolyte levels must also be assessed and treated if abnormal before surgery. Hyperkalemia is a type of electrolyte imbalance that can be found, possibly caused by increased potassium load or decreased excretion. Case description: A 6-month-old girl was admitted to our hospital with a fever and dehydration. She complained of persistent vomiting. She had a history of CLP and CHD since birth. The echocardiogram revealed Small Secundum ASD. Laboratory results showed an elevated potassium (5.52 mEq/l). The patient was planned to get primary cleft lip repair and tip rhinoplasty. The surgery was postponed due to the patient’s condition and laboratory findings. During hospitalization, she received electrolyte imbalance correction and symptomatic treatment. A 1-week follow-up assessment showed stable condition, and the patient continued to prepare for the surgery. Conclusion: ASD is frequently observed as one of the most prevalent comorbidities of a CLP patient. Dehydration can increase the potassium level of the blood, and it must be treated before the surgical procedure for CLP patients with ASD condition.