Key result
IV calcium gluconate in complete heart block reveals QRS prolongation and peaked T waves indicating hyperkalemia.
Case Report (n=1)
A case report demonstrating electrocardiographic changes associated with hyperkalemia and calcium gluconate administration in a patient with end-stage renal disease.
Alerts clinicians to hyperkalemia unmasking risk after calcium in ESRD heart block; leaves open generalizability and need for prospective data.
Figure 1. A 42-year-old woman with end-stage renal disease from recurrent nephrolithiasis was admitted to the hospital for placement of an arteriovenous fistula for permanent hemodialysis access. While she was undergoing dissection of the brachial artery with local anesthesia, her heart rhythm converted from normal sinus rhythm to complete heart block with a ventricular escape (approximately 25 beats per minute) (Panel A). Two ampules of calcium gluconate (9.2 mEq) were administered intravenously. An electrocardiogram revealed sinus tachycardia with profound prolongation of the QRS interval (left-bundle-branch morphology), first-degree atrioventricular block, and “peaked” T waves (Panel B). The serum potassium concentration was . . .
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Jeffrey T. Kuvin (1998) conducted a case report in End-stage renal disease, hyperkalemia (n=1). Calcium gluconate was evaluated on Electrocardiographic changes. Intravenous calcium gluconate administration in a 42-year-old woman with complete heart block revealed sinus tachycardia with profound QRS prolongation and peaked T waves indicative of hyperkalemia.
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