[Acute myocardial infarct in the setting of a hyperpotassemia: electrocardiographic findings].
Graded hyperkalemia and acute myocardial ischemia are remarkably reflected (and can even be predicted) in the surface ECG when they occur alone. If, however, acute ischemia supervenes in the setting of previous hyperkalemia, the ECG changes are less known. We describe a patient who suffered an acute septal myocardial infarction while his extracellular potassium was high. Changes in the ECG waveform brought about by both acute ischemia and hyperkalemia are emphasized. The origin of a sine-wave ventricular activation pattern, the supraventricular origin and likely sinoventricular conduction, versus ventricular tachycardia is, as well, discussed. Correction of hyperkalemia and other metabolic disturbances, as the first and most important therapeutic target, is critical when the origin and nature of the rhythm are controversial.
Raviña
T
T
Sección de Cardiología, Hospital de Cabueñes, Gijón, Asturias.
Lapuerta
J A
JA
D000368:Aged; D004562:Electrocardiography; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*