Highlights the importance of recognizing ECG features of severe hyperkalemia, which can cause life-threatening bradycardia and hemodynamic instability, especially in the context of polypharmacy, AKI, and DKA.
Supports vigilance for hyperkalemia in bradycardic instability with polypharmacy/AKI; leaves open systematic study of ECG-guided approaches.
We report a case of hemodynamic instability due to bradycardia on the basis of severe hyperkalemia. Diabetic ketoacidosis and acute kidney injury together with polypharmacy triggered the acute onset. Potentially life-threatening hyperkalemia is often induced by drug interactions. ECG features may be crucial for diagnosis, and treatment depends on setting and resources.
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Schnaubelt et al. (2020) studied this question.
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