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老年患者高钾血症早期心电图识别及及时处理的重要性。

Importance of early electrocardiographic recognition and timely management of hyperkalemia in geriatric patients.

作者信息

McIntyre William F, Femenía Francisco, Arce Mauricio, Pérez-Riera Andrés Ricardo, Baranchuk Adrian

机构信息

Cardiology Division, Kingston General Hospital, Kingston, Ontario;

出版信息

Exp Clin Cardiol. 2011 Summer;16(2):47-50.

Abstract

Hyperkalemia is a potentially life-threatening electrolyte imbalance that can be difficult to diagnose due to the paucity of specific signs and symptoms. Because hyperkalemia can lead to sudden death from cardiac arrhythmias and asystole, any patient whose history, physical examination or laboratory studies raise clinical suspicion of hyperkalemia requires an immediate 12-lead electrocardiogram to ascertain whether electrocardiographic manifestations of electrolyte imbalance are present. The current report describes a case involving an elderly man who developed hyperkalemia secondary to acute-on-chronic kidney injury. Factors affecting the vulnerability of geriatric patients to hyperkalemia, the electrocardiographic manifestations of elevated serum potassium levels, and the importance of timely recognition and management are discussed. Understanding the factors that contribute to hyperkalemia, timely recognition of electrocardiogram changes and timely initiation of appropriate therapy are all critical in the approach to hyperkalemia in the geriatric patient.

摘要

高钾血症是一种可能危及生命的电解质失衡,由于缺乏特异性体征和症状,可能难以诊断。由于高钾血症可导致心律失常和心搏骤停引起的猝死,任何通过病史、体格检查或实验室检查引起高钾血症临床怀疑的患者都需要立即进行12导联心电图检查,以确定是否存在电解质失衡的心电图表现。本报告描述了一例涉及一名老年男性的病例,该患者因急性慢性肾损伤继发高钾血症。讨论了影响老年患者高钾血症易感性的因素、血清钾水平升高的心电图表现以及及时识别和处理的重要性。了解导致高钾血症的因素、及时识别心电图变化以及及时开始适当治疗,对于老年患者高钾血症的处理至关重要。

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