[Malignant arrhythmias caused by hyperkalemia: a new area of drug-induced electrolyte abnormalities].
BACKGROUND
High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor.


METHODS
Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias.


CONCLUSIONS
The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.
Tomcsányi
János
J
Budai Irgalmasrendi Kórház, Kardiológia.
Somlói
Miklós
M
Arabadzisz
Hrisula
H
Horváth
Lajos
L
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D004562:Electrocardiography; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced / Q000150:complications* / Q000209:etiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced* / Q000503:physiopathology
D000806:Angiotensin-Converting Enzyme Inhibitors