title: Acute coronary syndrome: potassium, magnesium and cardiac arrhythmia.
abstract: BACKGROUND
  Cardiac arrhythmia is often present in patients with acute coronary syndrome (ACS) and may be due to the electrolyte imbalance.
  
  
  OBJECTIVE
  To assess the prevalence and clinical significance of electrolyte imbalance in ACS.
  
  
  METHODS
  Serum potassium and magnesium levels were measured within the first few hours in 204 consecutive patients with ACS admitted to our department over a period of 23 months. Cardiac arrhythmia was documented using continuous ECG monitoring, telemetry or standard ECG.
  
  
  RESULTS
  Hypokalemia was observed in 34% of patients, and was significantly associated with the occurrence of life-threatening ventricular arrhythmias (26% of patients with potassium level <4 mmol/l vs 11.9% of patients with normokalemia, p<0.001). No relationship was found between potassium level and supraventricular arrhythmias or in-hospital mortality. Decreased magnesium serum concentration was found in 22% of patients but was not significantly associated with cardiac arrhythmias or mortality.
  
  
  CONCLUSIONS
  Hypokalemia and hypomagnesemia are often present in patients with ACS. The former is associated with dangerous ventricular arrhythmias. Early assessment of electrolyte serum concentration is needed in order to implement proper supplementation.
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Maciejewski
authors.forename: Bronisław
authors.initials: B
authors.lastname: Bednarz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Chamiec
authors.forename: Aleksander
authors.initials: A
authors.lastname: Górecki
authors.forename: Rafał
authors.initials: R
authors.lastname: Łukaszewicz
authors.forename: Leszek
authors.initials: L
authors.lastname: Ceremuzyński
mesh_terms: D000208:Acute Disease; D000368:Aged; D001281:Atrial Fibrillation / Q000139:chemically induced; D003327:Coronary Disease / Q000150:complications* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008274:Magnesium / Q000009:adverse effects* / Q000097:blood*; D008297:Male; D011188:Potassium / Q000009:adverse effects* / Q000097:blood*; D015995:Prevalence; D013577:Syndrome; D013610:Tachycardia / Q000139:chemically induced* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000139:chemically induced; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D008274:Magnesium; D011188:Potassium