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This case highlights the importance of monitoring for hyperkalemia-induced muscle weakness in elderly heart failure patients taking potassium-sparing diuretics and ACE inhibitors.
Purpose: To describe the hyperkalemia (excessive potassium) caused muscle weakness that was apparent in a nursing home patient.Case Description: An 86-year-old woman with diagnosis of congestive heart failure was referred to physical therapy because of generalized muscle weakness. The patient's physical status indicated increased proximal (trunk) weakness during the first three weeks of physical therapy treatment.Intervention and Outcome: Hyperkalemia-caused weakness due to Spironolactone (AldactoneR) and Ramipril (AltaceR) was suspected and confirmed by laboratory tests. Spironolactone was removed from the medication list, and Ramipril dosage was reduced. After nine more weeks of intervention, mainly focusing on muscle strengthening around the shoulder and pelvic girdles, the patient met her goals and returned to her prior functional independence.
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Liu et al. (2005) studied this question.
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