Junctional Bradikardia pada Pasien Hiperkalemia
Hyperkalemia is a life-threatening electrolyte abnormality resulting in cardiac arrhythmia. Hyperkalemia may also cause bradycardia with junctional rhythm. However, the prevalence of hyperkalemia accompanying symptomatic bradycardia has only been explored in a few case reports. Thus we present a cas...
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Faculty of Medicine at Universitas Andalas
2021-09-01
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| Series: | Jurnal Kesehatan Andalas |
| Online Access: | http://jurnal.fk.unand.ac.id/index.php/jka/article/view/1772 |
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| author | Cokorda Istri Padmi Suwari Bayu Puradipa Ni Luh Eka Sriayu Wulandari |
| author_facet | Cokorda Istri Padmi Suwari Bayu Puradipa Ni Luh Eka Sriayu Wulandari |
| author_sort | Cokorda Istri Padmi Suwari |
| collection | DOAJ |
| description | Hyperkalemia is a life-threatening electrolyte abnormality resulting in cardiac arrhythmia. Hyperkalemia may also cause bradycardia with junctional rhythm. However, the prevalence of hyperkalemia accompanying symptomatic bradycardia has only been explored in a few case reports. Thus we present a case of hyperkalemia with uncommon ECG findings. It has been reported that a 76 years old woman with type 2 diabetes mellitus, hyperkalemia and suspected coronary artery disease complaining about palpitation. Electrocardiography (ECG) showed junctional bradycardia with tall T wave and laboratory examination showed mild hyperkalemia (5.8 mmol/L). After one day of observation, severe hypotension was detected. Unexpectedly the cardiac rhythm was returned into the sinus after correction of hyperkalemia using calcium gluconate, insulin, dextrose, and salbutamol. As serum potassium level rises, sinoatrial and atrioventricular conduction was blocked, causing escape rhythm (junctional escape rhythm). In hyperkalemia, cardiotoxicity can be caused by an increase in resting membrane potential, decreased depolarization and duration of depolarization. When detected on ECG, hyperkalemia should be treated urgently and important to identify underlying causes or precipitating factors of hyperkalemia. Sinus node dysfunction is not excluded in this case. Hyperkalemia can present a bradycardia junctional rhythm. Although the increasing serum potassium levels were low, hyperkalemia may have affected the conduction system leading to the ECG changes.
Keywords: hyperkalemia, junctional bradycardia, symptomatic bradycardia |
| format | Article |
| id | doaj-art-29190958e0454334aff2950d8b0eddf1 |
| institution | Kabale University |
| issn | 2301-7406 2615-1138 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | Faculty of Medicine at Universitas Andalas |
| record_format | Article |
| series | Jurnal Kesehatan Andalas |
| spelling | doaj-art-29190958e0454334aff2950d8b0eddf12025-02-03T11:08:42ZengFaculty of Medicine at Universitas AndalasJurnal Kesehatan Andalas2301-74062615-11382021-09-0110212513010.25077/jka.v10i2.17721191Junctional Bradikardia pada Pasien HiperkalemiaCokorda Istri Padmi Suwari0Bayu Puradipa1Ni Luh Eka Sriayu Wulandari2Warmadewa UniversityUdayana UniversityUdayana UniversityHyperkalemia is a life-threatening electrolyte abnormality resulting in cardiac arrhythmia. Hyperkalemia may also cause bradycardia with junctional rhythm. However, the prevalence of hyperkalemia accompanying symptomatic bradycardia has only been explored in a few case reports. Thus we present a case of hyperkalemia with uncommon ECG findings. It has been reported that a 76 years old woman with type 2 diabetes mellitus, hyperkalemia and suspected coronary artery disease complaining about palpitation. Electrocardiography (ECG) showed junctional bradycardia with tall T wave and laboratory examination showed mild hyperkalemia (5.8 mmol/L). After one day of observation, severe hypotension was detected. Unexpectedly the cardiac rhythm was returned into the sinus after correction of hyperkalemia using calcium gluconate, insulin, dextrose, and salbutamol. As serum potassium level rises, sinoatrial and atrioventricular conduction was blocked, causing escape rhythm (junctional escape rhythm). In hyperkalemia, cardiotoxicity can be caused by an increase in resting membrane potential, decreased depolarization and duration of depolarization. When detected on ECG, hyperkalemia should be treated urgently and important to identify underlying causes or precipitating factors of hyperkalemia. Sinus node dysfunction is not excluded in this case. Hyperkalemia can present a bradycardia junctional rhythm. Although the increasing serum potassium levels were low, hyperkalemia may have affected the conduction system leading to the ECG changes. Keywords: hyperkalemia, junctional bradycardia, symptomatic bradycardiahttp://jurnal.fk.unand.ac.id/index.php/jka/article/view/1772 |
| spellingShingle | Cokorda Istri Padmi Suwari Bayu Puradipa Ni Luh Eka Sriayu Wulandari Junctional Bradikardia pada Pasien Hiperkalemia Jurnal Kesehatan Andalas |
| title | Junctional Bradikardia pada Pasien Hiperkalemia |
| title_full | Junctional Bradikardia pada Pasien Hiperkalemia |
| title_fullStr | Junctional Bradikardia pada Pasien Hiperkalemia |
| title_full_unstemmed | Junctional Bradikardia pada Pasien Hiperkalemia |
| title_short | Junctional Bradikardia pada Pasien Hiperkalemia |
| title_sort | junctional bradikardia pada pasien hiperkalemia |
| url | http://jurnal.fk.unand.ac.id/index.php/jka/article/view/1772 |
| work_keys_str_mv | AT cokordaistripadmisuwari junctionalbradikardiapadapasienhiperkalemia AT bayupuradipa junctionalbradikardiapadapasienhiperkalemia AT niluhekasriayuwulandari junctionalbradikardiapadapasienhiperkalemia |