An overview of electrolyte disorders stratified for serum potassium is presented in Table 1. The distribution of serum potassium is presented in Fig. 1. [journals.lww.com]

[…] may indicate an aggressive tumour genesis process even at presentation and require urgent treatment. [ncbi.nlm.nih.gov]

Practical algorithms for the optimal diagnostic, treatment and follow-up strategy are presented, while an individualized approach is emphasized. Introduction Hypokalemia is present when serum levels of potassium are lower than normal. [ec.bioscientifica.com]

• Weakness

  The effects of low potassium include may cause heart palpitations, muscle cramps, muscle aches, and muscle weakness. [medicinenet.com]

  […] 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 Nausea Muscle Weakness [emdocs.net]

  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 low potassium level can make muscles feel weak, cramp, twitch, or even become paralyzed, and abnormal heart rhythms may develop. The diagnosis is based on blood tests to measure the potassium level. [msdmanuals.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]

• Fatigue

  Hypokalemia (low potassium) often causes weakness, fatigue, muscle cramps and arrhythmia, while hyperkalemia (high potassium) may cause nausea, fatigue, weakness and tingling in certain areas of the body. [kidneyandhypertensioncare.com]

  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]

  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]

  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]

  Decreased intake (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 [emdocs.net]

• 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]

  Antiemetics, vomiting, constipation Constipation Constipation is common and may be due to a variety of causes. Constipation is generally defined as bowel movement frequency < 3 times per week. [lecturio.com]

  You feel bloated or constipated. You have to urinate a lot. You feel very thirsty most of the time. You are dizzy or light-headed, or you feel like you may faint. You feel depressed, or you lose touch with reality. [myhealth.alberta.ca]

  […] which can cause diarrhea Chronic kidney disease Low magnesium level Sweating Genetic disorders, such as hypokalemic periodic paralysis, Bartter syndrome A small drop in potassium level often does not cause symptoms, which may be mild, and may include: Constipation [medlineplus.gov]

  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]

  […] 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 Nausea [emdocs.net]

• 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]

  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]

  Other causes of hypokalemia include: Eating disorders, such as bulimia nervosa. Excessive sweating (hyperhidrosis). Alcohol use disorder. Water pills (diuretics). Diuretics can cause too much potassium to be expelled through your pee (urine). [my.clevelandclinic.org]

  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]

  She was admitted to the hospital for headache and tachycardia during the last two days after she did some sports and coinciding with an increase in the consumption of a beverages containing taurine. She denied chest pain or dyspnoea. [revistanefrologia.com]

  A 38-year-old obese woman presented with recurrent polymorphic ventricular tachycardia secondary to persistent hypokalemia necessitating more than 40 DC shocks. [ncbi.nlm.nih.gov]

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

  […] smaller preceding T waves becomes apparent on the ECG. 1,2 A pseudo-prolonged QT interval may be seen, which is actually the QU interval with an absent T wave. 1 Severe hypokalemia can also cause a variety of tachyarrhythmias, including ventricular tachycardia [doi.org]

• 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]

  The effects of low potassium include may cause heart palpitations, muscle cramps, muscle aches, and muscle weakness. [medicinenet.com]

  […] 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]

  Low magnesium level Sweating Genetic disorders, such as hypokalemic periodic paralysis, Bartter syndrome A small drop in potassium level often does not cause symptoms, which may be mild, and may include: Constipation Feeling of skipped heart beats or palpitations [medlineplus.gov]

  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]

• 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]

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

  […] 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]

  Symptoms may include muscle weakness, cramping, tremor, intestinal obstruction, hypotension, respiratory depression and abnormal heart rhythms. [youtube.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

  When the kidneys are functioning normally, the amount of potassium in the diet is sufficient for use by the body and the excess is usually excreted through urine and sweat. [rarediseases.org]

  Your kidneys control your body’s potassium levels, allowing for excess potassium to leave the body through urine or sweat. [healthline.com]

  Causes of potassium loss include: Alcohol use (excessive) Chronic kidney disease Diabetic ketoacidosis Diarrhea Diuretics (water retention relievers) Excessive laxative use Excessive sweating Folic acid deficiency Primary aldosteronism Some antibiotic [mayoclinic.org]

  […] 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 [emdocs.net]

• Muscle Weakness

  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]

  Eleven patients had a history of recurring muscle weakness. All patients had quadraparesis (muscle weakness in all four limbs); in 10 patients the weakness was severe. [acutecaretesting.org]

  The effects of low potassium include may cause heart palpitations, muscle cramps, muscle aches, and muscle weakness. [medicinenet.com]

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

  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]

  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]

• 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]

  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]

  Polyuria: While the kidneys are generally able to reduce potassium concentrations to 5 to 10 mEq/L, high urine output may still lead to excessive potassium losses. [cancertherapyadvisor.com]

  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]

  Excessive urination (polyuria). Excessive thirst (polydipsia). Diagnosis and Tests How is hypokalemia diagnosed? Your healthcare provider will check your potassium level through a blood test. [my.clevelandclinic.org]

• 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]

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

  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]

  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]

  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]

  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]

  Snapshot A 56-year-old man is brought to the emergency department by his son due to mild confusion and shortness of breath. Prior to symptom develop he needed to sleep on a recliner due to feeling short of breath while supine. [step2.medbullets.com]

• 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]

  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]

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

  […] cause unclear, consider checking serum and urine electrolytes, renal function, and acid base balance Refer patients with no obvious explanation for their hypokalaemia for endocrine or renal assessment A 22 year old woman had a blood test to investigate lethargy [bmj.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]

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

  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]

  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]

• Flaccid Paralysis

  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]

  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]

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

  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]

• 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]

  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]

  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]

  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]

[…] 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]

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

Clinical Presentation A 23-year-old G2P1A0 woman was admitted to an obstetrics unit at 32 weeks of gestation after a routine outpatient laboratory workup revealed severe hypokalemia that failed to resolve despite potassium replacement. [ajkd.org]

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 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]

  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]

  […] of the T wave with the presence of the U wave may appear as a prolonged QT interval, however the true QT is actually unchanged Investigation Patients with hypokalaemia should be investigated and managed appropriately due to the associated risks, especially [teachmesurgery.com]

• 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]

  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 [cancertherapyadvisor.com]

  Hypokalemia Other names Hypokalaemia, hypopotassaemia, hypopotassemia An ECG in a person with a potassium level of 1.1 meq/l showing the classical changes of ST segment depression, inverted T waves, large U waves, and a slightly prolonged PR interval. [en.wikipedia.org]

• Torsades De Pointes

  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]

  Kalium cca < 2,3 mmol/l: torsades de pointes, ventricular fibrillation. Therapy of hypokalemia The treatment of hypokalemia depends on its severity and etiology. [escardio.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’?) [litfl.com]

  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

  […] 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]

  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]

  Prominent U waves after T waves in hypokalemia. [emedicine.medscape.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]

• 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]

  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]

  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]

  Typical ECG findings when potassium is <3.0 mmol/L[11] Flat T waves. ST depression. Prominent U waves. NB: the QT interval may appear prolonged but this is usually a pseudo-prolongation as the flattened T waves merge into the U waves. [patient.info]

• 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]

Treatment for hypokalemia and hyperkalemia aims to restore normal potassium levels, which may include dietary changes, supplements or treatment of an underlying condition. [kidneyandhypertensioncare.com]

Figure 3 is an algorithm for the management of hyperkalemia, and Table 322,30,36 summarizes medications used in the treatment of the condition. URGENT TREATMENT Intravenous Calcium. [aafp.org]

Etiology1 Low dietary potassium intake Malnutrition Chronic diarrhea Drugs: Increment of colonic potassium excretions Mineralocorticoids3 Imprudent use of potassium-exchange resins4 Prevention and Treatment The treatment goal for hypokalemia in hemodialysis [advancedrenaleducation.com]

Treatment included magnesium and potassium salts and potassium saving diuretics. In general, the long-term prognosis of Gitelman's syndrome is good if the patient adhere with the 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]

(Hyponatremia secondary to congestive heart failure) Potassium Electrolyte Disturbances Hyponatremia Hypernatremia Definition serum sodium of < 135 mmol/L Etiology pseudohyponatremia hyperglycemia hyperlipidemia hypervolemic hyponatremia congestive heart [step2.medbullets.com]

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]

In 22 patients (42%), no definite etiology of severe hypokalemia could be identified by use of the emergency department chart. [journals.lww.com]

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 [emdocs.net]

<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]

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 = femaleIncidence Electrolyte abnormality is commonly encountered [unboundmedicine.com]

Epidemiologic studies suggest an inverse relation between potassium intake and the prevalence of hypertension. [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]

Disorders of potassium homeostasis: pathophysiology and management. J Assoc Physicians India. 2008;56:685-693. Kim G-H, Han JS. Therapeutic approach to hypokalemia. Nephron. 2002;92 Suppl 1:28-32. Morrison G, Michelson EL, Brown S, Morganroth J. [advancedrenaleducation.com]

Pathophysiology of intense physical conditioning in a hot climate. I. Mechanisms of potassium depletion. The Journal of clinical investigation. 1972;51(2):242-55. [revistas.rcaap.pt]

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

To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes. [aafp.org]

Preventing prolonged bouts of illness and loss of fluids is important to keeping hypokalemia from occurring. Potassium-rich diet Eating a diet that is rich in potassium can help prevent and treat low blood potassium. [healthline.com]