Vol 68, No 9 (2010)
Chorzy trudni typowi
Published online: 2010-09-21
Syncope caused by hyperkalemia during use of a combined therapy with the angiotensin-converting enzyme inhibitor and spironolactone
DOI: 10.33963/v.kp.79610
Kardiol Pol 2010;68(9):1043-1045.
Abstract
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.
Kardiol Pol 2010; 68, 9: 1043-1045
Kardiol Pol 2010; 68, 9: 1043-1045
Keywords: angiotensin-converting enzyme inhibitorshyperkalemiaaldosteroneantagonistsyncope