A 23-year-old Central American man who presented to a community ED under federal custody with several days of nausea and vomiting was found to have a serum potassium level of 1.5 mEq/L. [ncbi.nlm.nih.gov]

We present a rare case of a patient with AN who presented with life-threatening ventricular tachycardia. Case Report A 20-year-old Chinese woman was brought to the ED due to generalized weakness for the entire day. [heraldopenaccess.us]

Severe hypokalemia can present similarly to hyperkalemia; therefore, a thorough history is paramount. [emra.org]

• Weakness

  A middle-aged woman presented with episodic weakness of the bilateral thumbs lasting for 2 years. Hypokalemia and a left adrenal mass were subsequently found. [ncbi.nlm.nih.gov]

  A 65-year-old female presented to the ED for evaluation of generalized weakness and hyperglycemia following a syncopal episode. [emra.org]

  Myopathic weakness develops in these patients after an increased intake of potassium or resting after vigorous exercise. [acls.com]

  Even though severe hypokalemia related muscle weakness reported rarely, it is a potentially treatable and correctable cause of neuromuscular weakness. [ajns.paans.org]

• Fatigue

  Weakness and fatigue are often the first signs of potassium deficiency. There are several ways that this mineral deficiency can cause weakness and fatigue. First, potassium helps regulate muscle contractions. [healthline.com]

  Mental fatigue can manifest as somnolence, lethargy, or directed attention fatigue.[4] Fatigue and 'feelings of fatigue' are sometimes confused.[5] Unlike weakness, fatigue usually can be alleviated by periods of rest. [en.wikipedia.org]

  A 32-year-old woman who had been diagnosed with PBC at our hospital was found to have hypokalemia due to repeated fatigue for 2 years, and the etiology was unknown. [ncbi.nlm.nih.gov]

  Mild hypokalemia tends to be asymptomatic, with fatigue, muscle cramps, and ECG changes occurring rarely. Therapy This section has been translated automatically. [altmeyers.org]

  Symptomatic patients can present with weakness, fatigue, and palpitations. In severe cases, muscle cramps, pain, and respiratory arrest can occur. [clinchem.aaccjnls.org]

• Nocturnal Leg Cramp

  Nocturnal leg cramps[edit] Nocturnal leg cramps are involuntary muscle contractions that occur in the calves, soles of the feet, or other muscles in the body during the night or (less commonly) while resting. [en.wikipedia.org]

• Respiratory Distress

  Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. [dovepress.com]

  distress Respiratory failure Lethargy Edema (Cushingoid appearance) [4] Associated Co-morbidities Hypokalemia may present as a result of: Chronic Kidney Failure Diabetic Ketoacidosis Diarrhea/Vomiting Excessive Sweating Excessive use of laxatives Prescription [physio-pedia.com]

  distress Respiratory failure Lethargy or other mental status changes Decreased muscle strength, fasciculations, or tetany Decreased or absent tendon reflexes Cushingoid appearance (eg, edema) Workup in hypokalemia Laboratory studies in the workup of [emedicine.medscape.com]

  Clinical features  Signs of ileus  Hypotension  Ventricular arrhythmias  Cardiac arrest  Bradycardia or tachycardia  Premature atrial or ventricular beats • Hypoventilation, respiratory distress • Respiratory failure • Lethargy or other mental status [slideshare.net]

  On physical examination the patient was fully conscious, but in acute respiratory distress wearing a face mask with high oxygen flow supplementation. [ajns.paans.org]

• Constipation

  Clinical features include transient periods of muscle weakness and tetany, dizziness, abdominal pains and constipation. Patients can also present with convulsions due to severe metabolic alkalosis or hypomagnesemia. [ncbi.nlm.nih.gov]

  Now, she has a terrible case of constipation. What are the side effects of too much potassium? Thank you. Your kidneys regulate potassium and depending on the levels in her blood and inside her cells, she is probably excreting the... [dietitian.com]

  Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K+ falls below 2.5 mEq/L. [dovepress.com]

  When symptoms do occur, they may include: Fatigue Muscle weakness Constipation Difficulty breathing Tingling or numbness Irregular heartbeat Fainting Diagnosis You will be asked about your symptoms and medical history. A physical exam will be done. [winchesterhospital.org]

  According to the Linus Pauling Institute, intestinal paralysis is manifested as abdominal pain and other symptoms such as constipation and bloating. Tests To determine if a person has hypokalemia, several blood tests are run. [livestrong.com]

• Nausea

  A 54-year-old woman presented with a history of nausea, vomiting, diarrhea, and recurrent episodes of severe hypokalemia requiring hospitalization. [ncbi.nlm.nih.gov]

  Vomiting Associations: Abdominal pain + nausea Pathophysiology: The parietal cells within the gastric mucosa utilize the K+/H+ ATPase pump to regulate the gastric contents of K+ and H+ ions. When vomiting occurs, there is a loss of both. [ebmconsult.com]

  Treat nausea and vomiting and provide fluid resuscitation for dehydration and hypovolemia. [amboss.com]

• Bulimia Nervosa

  Although Gitelman syndrome (n = 33), Bartter syndrome (n = 10), and distal renal tubular acidosis (n = 12) were the predominant renal tubular disorders, 44 patients (44%) were diagnosed with anorexia/bulimia nervosa (n = 21), surreptitious use of laxatives [ncbi.nlm.nih.gov]

  Differentials Common Vomiting Severe diarrhea Laxative and bowel cleansing agent use Bulimia nervosa Anorexia nervosa Drug-induced Alcoholism Diabetic ketoacidosis Hyperosmolar hyperglycemic state Primary aldosteronism Exercising in a hot climate Stress [bestpractice.bmj.com]

  Standard management of severe hypokalaemia in patients with anorexia or bulimia nervosa and persistent self-induced vomiting includes intravenous replacement of potassium and correction of hypovolaemia. [cjgim.ca]

  Diarrhea or vomiting Medicines, such as diuretics, blood pressure medicines, or antibiotics Excessive use of laxatives Anorexia or bulimia nervosa Medical conditions, such as Cushing syndrome or kidney disease Not eating enough foods that contain potassium [drugs.com]

  Hypokalemia: A Marker of Covert Bulimia Nervosa. Am J Med. 2015 Sep. 128 (9):e37. [Medline]. Mohee K, Kucharska-Pietura K, Karthigeyan A, Naqvi A. [emedicine.com]

• Abdominal Distension

  Failures to thrive, chronic diarrhea, vomiting abdominal distension are usual symptoms. [ncbi.nlm.nih.gov]

  Involvement of GI muscles can cause an ileus with associated symptoms of nausea, vomiting, and abdominal distension. Severe hypokalemia can also lead to muscle cramps, rhabdomyolysis, and resultant myoglobinuria. [statpearls.com]

  Patients presented with symptoms typical of bowel obstruction including abdominal distension, nausea and vomiting. The majority had diarrhea, but constipation was described in a subset of patients. [karger.com]

  Moderate hypokalemia (serum K 2.5-3 mEq/L) can cause mild symptoms such as nausea, vomiting, abdominal distension, ileus 6. [recapem.com]

• Decreased Bowel Sounds

  […] paralysis Decrease deep tendon reflexes Decreased bowel sounds Easy way to Remember 7 L’s Lethargy (confusion) Low, shallow respirations (due to decreased ability to use accessory muscles for breathing) Lethal cardiac dysrhythmias Lots of urine Leg cramps [registerednursern.com]

• Tachycardia

  Cardiac telemetry monitoring showed ventricular tachycardia. The patient’s implanted cardiac defibrillator delivered a shock, leading to resolution of the ventricular tachycardia, and the patient immediately became alert and oriented. [emra.org]

  An electrocardiogram revealed ventricular tachycardia, which progressed to asystole (Figure 1a). [heraldopenaccess.us]

  The ECG demonstrated sinus tachycardia (Figure 1). Table 1. [atsjournals.org]

  Background Clinical Features Central nervous system Weakness Cramps Hyporeflexia Gastrointestinal Ileus Renal Metabolic alkalosis Cardiovascular PACs/PVCs Bradycardia or atrial/junctional tachycardia AV block Ventricular tachycardia, Ventricular fibrillation [wikem.org]

  Published on Mar 15, 2017 How hypokalemia causes tachycardia; how it affects resting membrane potential. Electrolytes disorders. [youtube.com]

• Palpitations

  This feeling is known as a heart palpitation and is commonly linked to stress or anxiety. However, heart palpitations can also be a sign of potassium deficiency (13). [healthline.com]

  In Brief Section: A 22-year-old man presented to the emergency room with palpitations after intravenous injection of heroin. Physical examination was notable for tachycardia and hypotension. [atsjournals.org]

  Decreased excretion Renal failure Addison’s disease Medications Potassium sparing diuretics ACE inhibitors NSAIDs Trimethoprim, cyclosporin, tacrolimus Signs and symptoms Non-specific Generalised muscle weakness Respiratory depression Ascending paralysis Palpitations [armandoh.org]

  […] non-renal losses (vomiting, diarrhea, sweating) Decreased intake (malnutrition) Intracellular shift (metabolic alkalosis) Endocrine (Cushing’s disease, Insulin therapy) Clinical Manifestations Mild hypokalemia often asymptomatic Non-specific Symptoms Palpitations [emdocs.net]

  Of Hypokalemia If there is a slight depreciation in the level of potassium, then it may not lead to any significant symptom but if there are symptoms then they include the following: Dysrhythmias, especially in people with heart problems Constipation Palpitations [epainassist.com]

• Hypotension

  We conclude that rapid correction of respiratory acidosis, especially in the setting of hypotension, can lead to life-threatening hypokalemia. [ncbi.nlm.nih.gov]

  What is the most likely cause of the patient’s hypotension and tachycardia? The cause of the patient’s hypotension and tachycardia was β2-agonist toxicity related to injection of clenbuterol-contaminated heroin. 2. [atsjournals.org]

  Arrhythmias associated with hypotension are premature ventricular contractions and ventricular tachycardia and fibrillation. [journals.lww.com]

  […] failure to administer in intravenous solutions, or to gastrointestinal loss; severe potassium deficiency may produce muscular weakness and lead to paralysis and respiratory failure; muscular malfunction may result in hypoventilation, paralytic ileus, hypotension [icd9data.com]

  […] individual with Hypokalemia may exhibit signs of the following: Abnormal heart rhythyms Constipation Fatigue Muscle Damage Muscle Weakness or spasms Paralysis [2] Nausea and vomiting Polyuria, nocturia or polydipsia Altered mental status Signs of Ileus Hypotension [physio-pedia.com]

• Irregular Heart Rhythm

  This is most common in people who take digitalis medications (digoxin) or have irregular heart rhythm conditions such as: fibrillation, atrial or ventricular tachycardia (heartbeat too fast) bradycardia (heartbeat too slow) premature heartbeats Other [healthline.com]

  ECG or a heart tracing is done to detect electrical changes in the heart and certain types of irregular heart rhythms that may be caused by low potassium. [emedicinehealth.com]

• Ventricular Bigeminy

  Citing Literature Number of times cited according to CrossRef: 3 Konrad Miszczuk, Joanna Mroczek-Wacinska, Robert Piekarski, Beata Wysocka- Lukasik, Renata Jawniak and Iwona Ben-Skowronek, Ventricular bigeminy and trigeminy caused by hypophosphataemia [doi.org]

• Sweating

  People who participate in vigorous sports or exercise in warm weather should be sure to replace potassium that is lost through excessive sweating. [rarediseases.org]

  Rarely, in excessive sweating, loss of K+ through the integument can provoke hypokalemia. Renal K+ loss accounts for most cases of chronic hypokalemia. [unboundmedicine.com]

  […] mEq/L Epidemiology Common electrolyte disorder – 20% of hospitalized patients 10-40% of patients on thiazide diuretics (Rosen 2014) Causes Renal Losses (diuretics, steroid use, DKA, hyperaldosteronism) Increased non-renal losses (vomiting, diarrhea, sweating [coreem.net]

  Sweat chloride test (for cystic fibrosis). Management [ 9 ] The management of hypokalaemia is almost always by potassium replacement. The amount of supplementation required depends on the severity of the hypokalaemia. [patient.info]

• Muscle Weakness

  Careful monitoring of electrocardiogram changes and muscle weakness in hyperkalemia is important to determine its functional consequences. If these are observed to be severe, immediate correction of hyperkalemia is essential. [acls.com]

  Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. [dovepress.com]

  Muscle weakness may accompany serum potassium of less than 2.5 mEq/L due to any etiology, but significant muscle weakness is uncommon and suggests the possibility of one of the periodic paralysis syndromes. [clinicaladvisor.com]

  A 25-year-old female patient presenting after a fall with muscle weakness in both legs was followed clinically and radiographically. [ncbi.nlm.nih.gov]

• Muscle Twitch

  twitches, tetany, and rhabomyolysis; nephropathy from potassium deficit impairs the concentrating mechanism Hypokalemia; lower than normal levels of potassium in the circulating blood Lower than normal levels of potassium in the circulating blood Applies [icd9data.com]

  Muscular malfunction may result in paralysis of the bowel, low blood pressure, muscle twitches and mineral deficiencies (tetany). Severe hypokalemia may also lead to disruption of skeletal muscle cells, particularly during exercise. [rarediseases.org]

  However, when they do, they may experience: muscle weakness that can result in paralysis respiratory failure low blood pressure muscle twitching cramping during exercise excessive thirst excessive urination loss of appetite nausea and vomiting constipation [medicalnewstoday.com]

  Muscle weakness and spasms. Tingling and numbness. More severe cases of low potassium may cause signs and symptoms such as: Muscle twitches. Muscle cramps. Severe muscle weakness, leading to paralysis. Low blood pressure (hypotension). [my.clevelandclinic.org]

• Chvostek Sign

  sign ipsilateral facial muscle contraction caused by tapping the facial nerve Trousseau sign carpopedal spasms by inflating the sphygmomanometer above systolic blood pressure Studies QTc prolongation Treatment address underlying cause asymptomatic or [step2.medbullets.com]

• Restless Legs Syndrome

  […] observed that leg cramps and restless legs syndrome can result from excess insulin, sometimes called hyperinsulinemia.[4] Skeletal muscle cramps[edit] Under normal circumstances, skeletal muscles can be voluntarily controlled. [en.wikipedia.org]

• Anxiety Disorder

  Her history included hypertension, anxiety disorder and heroin abuse. She never reported any muscle weakness, vomiting or diarrhoea. Her dietary pattern was very deficient, with a high consumption of Red Bull energy drinks. [njmonline.nl]

• Polyuria

  Therefore, potassium deficiency may lead to concentrating defects via this pathway, leading to polyuria. There is also some evidence that hypokalaemia leads to impaired responsiveness to ADH. [renalfellow.org]

  Predisposing factors General Polyuria increases urinary loss of potassium. Anorexia reduces dietary intake. Pathophysiology Vast majority (95%) of body potassium is present intracellularly. [vetstream.com]

  Genitourinary Polyuria or sexual dysfunction. [2] Medical Management (current best evidence) Severe hypokalmeia levels that cause ECG changes such as T-wave flattening or prominent U waves require hospital admission. [physio-pedia.com]

  Persistent hypokalemia can impair renal concentrating ability, causing polyuria with secondary polydipsia. [merckmanuals.com]

• Nocturia

  […] between gender and race. [3] Characteristics/Clinical An individual with Hypokalemia may exhibit signs of the following: Abnormal heart rhythyms Constipation Fatigue Muscle Damage Muscle Weakness or spasms Paralysis [2] Nausea and vomiting Polyuria, nocturia [physio-pedia.com]

  GS most commonly manifests with muscle weakness, salt craving, thirst, nocturia, paresthesia (especially in the face), tetany, and abdominal pain ( 3 ). Blood pressure is typically lower than that in the general population. [clinchem.aaccjnls.org]

  Clinical signs include salt craving, cramps, muscle weakness and aches, fatigue, generalised weakness and dizziness, nocturia and polydipsia. Incidental finding. [patient.info]

  In contrast, Gitelman patients often complain of nocturia and polyuria. Persistent hypokalemia may give rise to interstitial nephritis, signaled by urinary anomalies. Urinary calcium excretion is important because it distinguishes the two syndromes. [ec.bioscientifica.com]

• Confusion

  Weak pulses (irregular and thread) Orthostatic Hypotension Depression ST, flat or inverted T wave and prominent u-wave Shallow respirations with diminished breath sounds….due to weakness of accessory muscle movement to breath) Confusion, weak Flaccid [registerednursern.com]

  This may help explain the still confusing and unresolved relationship between lysozymuria and potassium wasting in leukemia. ( Arch Intern Med 1981;141:786-787) [jamanetwork.com]

  Symptoms Mild hypokalemia usually results in no symptoms, while moderate hypokalemia results in confusion, disorientation, weakness, and discomfort of muscles. On occasion, moderate hypokalemia causes cramps during exercise. [medical-dictionary.thefreedictionary.com]

  […] shift (metabolic alkalosis) Endocrine (Cushing’s disease, Insulin therapy) Clinical Manifestations Mild hypokalemia often asymptomatic Non-specific Symptoms Palpitations Nausea Muscle Weakness Myalgias Fatigue Neurological Effects Paresthesias Weakness Confusion [emdocs.net]

• Lethargy

  Patients with hypertension who frequently complain of unrefreshed sleep, daytime sleepiness, impaired concentration, fatigue, and lethargy commonly suffer from hypokalemia. [empr.com]

  Causes Symptoms Usually asymptomatic, but… Weakness, lethargy, paralysis, tetany Cardiac dysrhythmias if severe: VT, VF, heart block, asystole Investigations Bloods EUC ideally via Venous Blood Gas. [aci.health.nsw.gov.au]

  Hypokalemia may mimic neurovegetative symptoms, such as weakness, lethargy, apathy, fatigue, and depressed mood (2). [ajp.psychiatryonline.org]

  T wave and prominent u-wave Shallow respirations with diminished breath sounds….due to weakness of accessory muscle movement to breath) Confusion, weak Flaccid paralysis Decrease deep tendon reflexes Decreased bowel sounds Easy way to Remember 7 L’s Lethargy [registerednursern.com]

• Flaccid Paralysis

  Abstract Hypokalaemic periodic paralysis is a rare skeletal muscle channelopathy causing flaccid paralysis, which predominantly presents in adolescents and young adults. [journals.sagepub.com]

  Severe hypokalemia (plasma potassium <2.5 mmol/L) is usually associated with acute flaccid paralysis that can range from mild muscle weakness to severe paralysis. [acutecaretesting.org]

  Weak pulses (irregular and thread) Orthostatic Hypotension Depression ST, flat or inverted T wave and prominent u-wave Shallow respirations with diminished breath sounds….due to weakness of accessory muscle movement to breath) Confusion, weak Flaccid [registerednursern.com]

  Severe hypokalemia results in extreme weakness of the body and, on occasion, in paralysis. The paralysis that occurs is "flaccid paralysis," or limpness. Paralysis of the muscles of the lungs results in death. [medical-dictionary.thefreedictionary.com]

• Paresthesia

  […] malnutrition) Intracellular shift (metabolic alkalosis) Endocrine (Cushing’s disease, Insulin therapy) Clinical Manifestations Mild hypokalemia often asymptomatic Non-specific Symptoms Palpitations Nausea Muscle Weakness Myalgias Fatigue Neurological Effects Paresthesias [emdocs.net]

  As weakness progresses, the patient develops paresthesia and leg cramps. Deep tendon reflexes may be decreased or absent and respiratory muscles can become paralyzed. Because potassium affects cell function, hypokalemia can lead to rhabdomyolysis. [journals.lww.com]

  If you experience persistent paresthesia, it’s best to see your doctor. Summary Persistent tingles and numbness may be a sign of impaired nerve function due to potassium deficiency. [healthline.com]

  Additionally, hypokalemia can mimic anxiety reactions, such as headache, irritability, nervousness, paresthesias, visual disturbances, and muscle discomfort (3). [ajp.psychiatryonline.org]

  Paresthesias, especially in the face, frequently occur. Remarkably, some patients are completely asymptomatic except for the appearance at adult age of chondrocalcinosis that causes swelling, local heat, and tenderness over the affected joints. [orpha.net]

• Dizziness

  Clinical features include transient periods of muscle weakness and tetany, dizziness, abdominal pains and constipation. Patients can also present with convulsions due to severe metabolic alkalosis or hypomagnesemia. [ncbi.nlm.nih.gov]

  Others, such as iron-deficiency anemia, may result from heavy menstrual periods, ulcers, colon pol ... yps and even an iron-poor diet, making you dizzy, cold, weak and irritable. [sharecare.com]

  The "Cardinal Presentations Section" provides quick and easy reference to differential diagnosis and directed testing for fever in the adult patient; dizziness and vertigo; chest pain; and over 20 other frequently seen presentations in the emergency department [books.google.ca]

  You are dizzy or light-headed, or you feel like you may faint. You feel depressed, or you lose touch with reality. Watch closely for changes in your health, and be sure to contact your doctor if: You do not get better as expected. [myhealth.alberta.ca]

  Early symptoms may include: increased thirst extreme sweating dizziness muscle cramps fatigue and weakness nausea light-headedness As the high temperature persists or gets worse, the severity of the symptoms can increase. [medicalnewstoday.com]

We present a 22-year-old woman with a history of hypertension and repeated hypokalemia, who was finally diagnosed with a small renin-secreting tumor after extensive paraclinical workup and imaging studies. [ncbi.nlm.nih.gov]

Thus, it should be included in the workup of secondary hypertension. [endocrine-abstracts.org]

Published on Jan 2, 2018 This video shows you an easy workup to hypokalemia. It focusses on the possible causes and provides an overview that's easy to remember. I live for feedback! Let me know what you think! Watch my video on hyperkalemia! [youtube.com]

[…] in hypokalemia Laboratory studies in the workup of hypokalemia include the following: Serum potassium level [5] Blood urea nitrogen (BUN) and creatinine level Glucose, calcium, and/or phosphorus level if coexistent electrolyte disturbances are suspected [emedicine.medscape.com]

Other investigations that may be important in the workup of hypokalaemia are as follows. [app.pulsenotes.com]

• Hypocapnia

  […] hyperviscosity syndrome 過粘稠血症候群 hypervitaminosis A ビタミンA過剰症 hypervitaminosis D ビタミンD過剰症 hypoalbuminemia 低アルブミン血症 hypoaldosteronism 低アルドステロン症/低アルドステロン hypoallergenic product 低アレルギー製品 hypocalcemia 低カルシウム血症/低カルシウム血 hypocalciuric hypercalcemia 低カルシウム尿性高カルシウム血症 hypocapnia [jpeds.or.jp]

  […] and toxins (acetazolamide, outdated tetracycline, aminoglycosides, sodium valproate, 6-mercaptopurine, streptozotocin, iphosphamide, lead, cadmium, mercury) Associated with other clinical entities (vitamin D deficiency, hyperparathyroidism, chronic hypocapnia [mja.com.au]

• Bicarbonate Increased

  Administration of sodium bicarbonate to treat metabolic acidosis can cause this condition.  Increased hematopoiesis: GM-CSF used to treat neutropenia and B-12 and folic acid to treat megaloblastic anemia may cause sharp rise in cell production and increased [slideshare.net]

• Wide QRS Complex

  Serial ECGs (Figures 1-3) showed inverted T-waves, wide QRS complexes, and prominent U-waves with frequent premature ventricular contractions. Point of care laboratory testing revealed: K 1.9 mmol/L, Mg 2.4 mg/dL, glucose 440 mg/dL. [emra.org]

• Prolonged PR Interval

  SEE ALSO Chest Pain Assessment Cover image depicts an ECG from a person with a potassium level of 1.1 showing the classical ECG changes of ST segment depression, inverted T waves, large U waves, and a slightly prolonged PR interval. [ausmed.com]

  ECG findings in hypokalemia [2][13] Mild to moderate hypokalemia T-wave flattening or inversion ST depression Prolonged PR interval Moderate to severe hypokalemia Presence of U waves: small waveform following the T wave that is often absent but becomes [amboss.com]

  The following signs and symptoms should raise the concern for hyperkalemia: Cardiac manifestations: -Peaked T waves -Shortened QT interval -Prolonged PR interval -Flattening of P wave -Widened QRS interval -Bundle branch and atrioventricular conduction [clinicaladvisor.com]

• Prolonged QT Interval

  When the U wave exceeds the T-wave amplitude, the serum potassium level is < 3 mEq/L. 2 In severe hypokalemia, T- and U-wave fusion with giant U waves masking the smaller preceding T waves becomes apparent on the ECG. 1,2 A pseudo-prolonged QT interval [doi.org]

  Replete cautiously Take Home Points Severe hypokalemia can lead to lethal dysrhythmias typically by prolongation of the QT interval. [emdocs.net]

  U-wave prominence May fuse with the T-wave to produce a prolonged QT interval (technically a Q-T-U interval). ST segments may appear depressed. QT prolongation, which may predict risk of arrhythmia. [emcrit.org]

  Changes include: U waves (most important; represents delayed ventricular repolarization) flattened or inverted T waves depressed ST segment prolonged QT interval Prolonged QT interval, prolonging action potential duration, and increasing spontaneous firing [sharinginhealth.ca]

  VT, VF and Torsades de Pointes Hypokalaemia: T wave inversion and prominent U waves QU interval: The apparent pseudo-prolonged QT interval is actually the QU interval with an absent T wave The push-pull effect Hypokalaemia creates the illusion that the [litfl.com]

• Torsades De Pointes

  de pointes, ventricular fibrillation. [escardio.org]

  Arrhythmias Torsades de pointes may be the most classic. [emcrit.org]

  Example 3 Hypokalaemia causing Torsades de Pointes Another ECG from the same patient. Note the atrial ectopic causing ‘R on T’ (or is it ‘R on U’?) [lifeinthefastlane.com]

  In addition, it reiterates the importance of repeated history taking in a patient with undiagnosed hypokalemia and torsade de pointes which avoided a device therapy. [ncbi.nlm.nih.gov]

  A QT interval >500 ms increases the risk of torsades de pointes by 2 to 3 times 4. Hypokalemia can cause rhabdomyolysis secondary to muscular ischemia mediated through a poor vasodilatory response 5. [recapem.com]

• Ventricular Bigeminy

  Citing Literature Number of times cited according to CrossRef: 3 Konrad Miszczuk, Joanna Mroczek-Wacinska, Robert Piekarski, Beata Wysocka- Lukasik, Renata Jawniak and Iwona Ben-Skowronek, Ventricular bigeminy and trigeminy caused by hypophosphataemia [doi.org]

• Prominent U Wave

  T wave inversion. Prominent U waves. Long QU interval. This patient had a serum K+ of 1.7 Example 2 Hypokalaemia ST depression. T wave inversion. Prominent U waves. Long QU interval. The serum K+ was 1.9 mmol/L. [lifeinthefastlane.com]

  […] inversion Prominent U waves Long QU interval This patient had a serum K+ of 1.7 Example 2 Hypokalaemia ST depression and T wave inversion best noted in inferior leads Prominent U waves Long QU interval The serum K+ was 1.9 mmol/L. [litfl.com]

  Early EKG changes may include increased amplitude and width of P-waves, PR segment prolongation, T-wave flattening and inversion, ST-segment depression, prominent U waves in the lateral precordial leads. [emra.org]

  Genitourinary Polyuria or sexual dysfunction. [2] Medical Management (current best evidence) Severe hypokalmeia levels that cause ECG changes such as T-wave flattening or prominent U waves require hospital admission. [physio-pedia.com]

  These include flattening or inversion of T wave, increasingly prominent U wave, ST-segment depression, and prolonged QU interval. Hypokalemia-induced arrhythmias require immediate potassium replacement. [youtube.com]

• Flattened T Wave

  T waves U waves Prolonged QT Interval Non-specific ST segment changes Note: Hypokalemia is a common predisposing condition for Torsades de Pointes Urine potassium level (spot): Elevation of urine potassium indicates renal losses as cause of hypokalemia [emdocs.net]

  ECG done early on suspicion of electrolyte abnormalities: Normal, flattened T waves, peaked P waves U wave. Management Cardiac monitoring and treatment of cause are the underlying principles. [aci.health.nsw.gov.au]

  Electrocardiograms may show a flattened T wave, a depressed ST segment, and a characteristic U wave. Arrhythmias associated with hypotension are premature ventricular contractions and ventricular tachycardia and fibrillation. [journals.lww.com]

  T-wave inversion U-wave elevation Clinical arrhythmias Heart block Atrial flutter Paroxysmal atrial tachycardia Ventricular fibrillation Digitalis-induced arrhythmias Musculoskeletal Cramping and impaired muscle contraction Means of Confirmation and [accesspharmacy.mhmedical.com]

  […] de pointes PEA/asystole To remember that low potassium may result in a flattened T wave, think of: "No pot, no tea (T)!" [amboss.com]

• Electrocardiogram Change

  Oral replacement is preferred except when there is no functioning bowel or in the setting of electrocardiogram changes, neurologic symptoms, cardiac ischemia, or digitalis therapy. [ncbi.nlm.nih.gov]

  Treatments involve inducing potassium loss. 6-8 Electrocardiogram changes in hyperkalemia include a tall peaked T wave. [acls.com]

  Treatments involve inducing potassium loss.6-8 Electrocardiogram changes in hyperkalemia include a tall peaked T wave. [resources.acls.com]

Treatment of acute hyperkalaemia in adults. March 1, 2014. http://www.renal.org/guidelines/joint-guidelines/treatment-of-acute-hyperkalaemia-in-adults#sthash.o9MgdJbw.dpbs. Accessed September 1, 2014. 31. Smellie WS. Spurious hyperkalaemia. [aafp.org]

A serum potassium concentration Oral potassium administration is the treatment of choice for hypokalemia. [merckvetmanual.com]

Patients with both hypokalemia and hypomagnesemia have an increased risk of developing polymorphic ventricular tachycardia.2 Severe Hypokalemia Treatment The treatment of hypokalemia consists of several strategies that may be utilized depending on the [emra.org]

Thus, no patients in our study sample required potassium supplementation before the initiation of insulin treatment. [ncbi.nlm.nih.gov]

PURPOSE: Stroke is independently associated with the common conditions of hypokalemia and supraventricular ectopy, and we hypothesize that the combination of excessive supraventricular ectopic activity and hypokalemia has a synergistic impact on the prognosis [ncbi.nlm.nih.gov]

Resident Survival Guide Hypokalemia Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Causes Differentiating Hypokalemia from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis [wikidoc.org]

Compared to plasma levels, serum levels are usually slightly higher due to delays in processing and/or the effect of clotting.[1][2][3][4] Etiology A variety of etiologies can result in hypokalemia. [ncbi.nlm.nih.gov]

Non aldosterone increase in mineralcorticoids Possible etiologies are: Vomiting Nasogastric tube Possible etiologies are: Diuretics Bartter's Gitelman's References Template:WikiDoc Sources [wikidoc.org]

There are over 20 clinical etiologies of hypokalemia. It is useful to think about etiologies in three general categories: cellular shifts, extra-renal losses and renal losses ( Table I ). Table I. Etiologies of hypokalemia. [clinicaladvisor.com]

<figure-inline><figure-inline></figure-inline></figure-inline> Resident Survival Guide Hypokalemia Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Causes Differentiating Hypokalemia from other Diseases Epidemiology [wikidoc.org]

Severe hypokalemia 2.5 mEq/L Epidemiology Common electrolyte disorder – 20% of hospitalized patients 10-40% of patients on thiazide diuretics (Rosen 2014) Causes Renal Losses (diuretics, steroid use, DKA, hyperaldosteronism) Increased non-renal losses [coreem.net]

Control, Region 1 Chiang Mai Tanasit Wijitraphan Sanpatong hospital DOI: https://doi.org/10.14456/dcj.2021.35 Keywords: investigation, hypokalemia, prison, Chiang Mai Abstract The aims of this study were to confirm the diagnosis and outbreak, describe epidemiology [he01.tci-thaijo.org]

Mild hypokalemia (serum potassium 3.0 to 3.5 mEq/L) Moderate hypokalemia (serum potassium 2.5 to 3.0 mEq/L) Severe hypokalemia (serum potassium <2.5 mEq/L) Epidemiology Predominant sex: male = female Incidence Electrolyte abnormality is commonly encountered [unboundmedicine.com]

The Council, a multidisciplinary group comprising specialists in cardiology, hypertension, epidemiology, pharmacy, and compliance, was formed to examine the critical role of potassium in clinical practice. [ncbi.nlm.nih.gov]

Pathophysiology: Renal salt wasting due to a defect in thiazide Na+/Cl- co-transporter in the distal convoluted tubule. [ebmconsult.com]

Ingestion of massive amounts of cola can lead to severe hypokalemia through several pathophysiologic mechanisms. [ncbi.nlm.nih.gov]

<figure-inline><figure-inline></figure-inline></figure-inline> Resident Survival Guide Hypokalemia Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Causes Differentiating Hypokalemia from other Diseases Epidemiology [wikidoc.org]

Intracellular shift Alkalosis (See also the “Pathophysiology” section.) [amboss.com]

| Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies Case Studies Case #1 Related Chapters Hypomagnesemia Hyperkalemia [wikidoc.org]

[…] patients is to prevent cardiac rhythm disorders and neuromuscular symptoms. [advancedrenaleducation.com]

How you intervene Careful monitoring and skilled interventions can help prevent hypokalemia and spare your patient from its associated complications. [journals.lww.com]

Early detection and treatment allow clinician to prevent morbidity and mortality from cardiac arrhythmias and respiratory failure. [ncbi.nlm.nih.gov]

Hyperthyroidism should be treated when present, and the administration of a nonselective beta-adrenergic blocker (e.g., propranolol) may prevent episodes in patients with the familial form of the disorder. 2006 [enotes.tripod.com]