Document Detail

Syncope caused by hyperkalemia during use of a combined therapy with the angiotensin-converting enzyme inhibitor and spironolactone.
MedLine Citation:
PMID:  20859899     Owner:  NLM     Status:  MEDLINE    
A 76 year-old woman with a history of coronary artery bypass grafting and prior myocardial infarction was transferred to the emergency room with loss of consciousness due to marked bradycardia caused by hyperkalemia. The concentration of serum potassium was high, and normal sinus rhythm was restored after correction of the serum potassium level. The cause of hyperkalemia was considered to be several doses of spiranolactone, an aldosterone antagonist, in addition to the long-term intake of ramipril, an ACE inhibitor. This case is a good example of electrolyte imbalance causing acute life-threatening cardiac events. Clinicians should be alert to the possibility of hyperkalemia, especially in elderly patients using ACE/ARB in combination with potassium sparing agents and who have mild renal disturbance.
Ismail Erden; Subhan Yalcin; Hakan Ozhan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  1043-5; discussion 1046     Citation Subset:  IM    
Department of Cardiology Duzce Medicine Faculty, Duzce University, Duzce, Turkey.
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MeSH Terms
Aldosterone Antagonists / adverse effects
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  adverse effects*
Antihypertensive Agents / adverse effects
Diuretics / adverse effects
Drug Therapy, Combination
Heart Failure / drug therapy
Hyperkalemia / chemically induced*,  diagnosis*,  prevention & control
Hypertension / drug therapy
Spironolactone / administration & dosage,  adverse effects*
Syncope / chemically induced*,  diagnosis*,  prevention & control
Water-Electrolyte Balance
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Diuretics; 52-01-7/Spironolactone

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