<strong>Background:</strong> Hypokalemia is seen on regular basis in medical emergency. The definition of hypokalemia is serum potassium level below 3.5 mmol/L, meanwhile severe hypokalemia is serum potass...<strong>Background:</strong> Hypokalemia is seen on regular basis in medical emergency. The definition of hypokalemia is serum potassium level below 3.5 mmol/L, meanwhile severe hypokalemia is serum potassium level below 2.5 mmol/L [1]. Patient with hypokalemia can present with wide range of presentation including musculoskeletal complaints from numbness to acute paralysis. Severe hypokalemia has tendency to progress to intestinal paralysis and respiratory failure. In some cases of hypokalemia, cardiovascular system can also be affected causing cardiac arrhythmias and heart failure [2]. <strong>Aim:</strong> This case report is to highlight that severe hypokalaemia can present with ECG changes mimicking acute coronary syndrome (ACS) which was fully resolved with correction of potassium level. <strong>Methods:</strong> We report a case of 84 years old Chinese man with underlying triple vessel disease presented with generalised body weakness for 2 days. ECG on arrival noted changes suggestive of ACS with ST segment depression in lead V4-V6 with first degree heart block, however patient had no ischemic symptoms and the potassium level was severe low at 1.6 mmol/L (3.5 - 5.1 mmol/L). He was correctly not treated for ACS. <strong>Outcomes:</strong> Repeated ECG post fast intravenous potassium correction noted complete resolution of the ST segment depression and first degree heart block. Patient discharged well from hospital four days later with potassium level of 3.8 mmol/L. <strong>Conclusions:</strong> Severe hypokalemia with asymptomatic ECG of ACS changes can safely be treated as a single entity clinical emergency with good resolution and no complication after normalizing potassium level.展开更多
目的探讨阿托伐他汀预处理对经皮冠状动脉介入治疗(PCI)患者血清脂质及心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平的影响。方法选取河北医科大学第一医院2016年6月-2018年6月收治的符合纳入标准的90例急性冠脉综合征患者,采用随...目的探讨阿托伐他汀预处理对经皮冠状动脉介入治疗(PCI)患者血清脂质及心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平的影响。方法选取河北医科大学第一医院2016年6月-2018年6月收治的符合纳入标准的90例急性冠脉综合征患者,采用随机数字表法分为观察组(n=45)及对照组(n=45)。两组患者术前均常规给予口服阿司匹林100 mg、氯吡格雷300 mg及静脉输注普通肝素(80 IU/kg)等药物治疗。观察组术前给予阿托伐他汀40 mg(立普妥20 mg/片,辉瑞)口服,对照组术前给予安慰剂100 mg(维生素C片剂)口服。两组术后口服阿托伐他汀(20 mg/d),疗程3个月。患者出院后随访1年。结果两组术前血清总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平差异无统计学意义(P<0.05)。两组患者术后7 d血脂水平较术前及术后第1天明显下降(P<0.05),且观察组显著低于对照组(P<0.05)。两组患者术前超敏C反应蛋白(hs-CRP)水平差异无统计学意义(P=0.898),两组患者术后1 d hs-CRP水平较术前均显著增高,但组间差异无统计学意义(P=0.135),术后7 d hs-CRP水平明显低于术后1 d(P=0.000),观察组明显低于对照组(P=0.000)。两组术前cTnI和CK-MB水平差异无统计学意义(P<0.05),术后1 d cTnI和CK-MB水平明显高于术前(P=0.000),但两组间差异无统计学意义(P<0.05),术后7 d cTnI和CK-MB水平较术后1 d显著下降(P=0.000),且观察组显著低于对照组(P=0.000)。观察组总不良心血管事件发生率低于对照组,差异有统计学意义(P=0.01)。结论阿托伐他汀预处理可有效降低患者的血脂和cTnI、CK-MB水平,降低不良心血管事件发生率。展开更多
文摘<strong>Background:</strong> Hypokalemia is seen on regular basis in medical emergency. The definition of hypokalemia is serum potassium level below 3.5 mmol/L, meanwhile severe hypokalemia is serum potassium level below 2.5 mmol/L [1]. Patient with hypokalemia can present with wide range of presentation including musculoskeletal complaints from numbness to acute paralysis. Severe hypokalemia has tendency to progress to intestinal paralysis and respiratory failure. In some cases of hypokalemia, cardiovascular system can also be affected causing cardiac arrhythmias and heart failure [2]. <strong>Aim:</strong> This case report is to highlight that severe hypokalaemia can present with ECG changes mimicking acute coronary syndrome (ACS) which was fully resolved with correction of potassium level. <strong>Methods:</strong> We report a case of 84 years old Chinese man with underlying triple vessel disease presented with generalised body weakness for 2 days. ECG on arrival noted changes suggestive of ACS with ST segment depression in lead V4-V6 with first degree heart block, however patient had no ischemic symptoms and the potassium level was severe low at 1.6 mmol/L (3.5 - 5.1 mmol/L). He was correctly not treated for ACS. <strong>Outcomes:</strong> Repeated ECG post fast intravenous potassium correction noted complete resolution of the ST segment depression and first degree heart block. Patient discharged well from hospital four days later with potassium level of 3.8 mmol/L. <strong>Conclusions:</strong> Severe hypokalemia with asymptomatic ECG of ACS changes can safely be treated as a single entity clinical emergency with good resolution and no complication after normalizing potassium level.
文摘目的探讨阿托伐他汀预处理对经皮冠状动脉介入治疗(PCI)患者血清脂质及心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平的影响。方法选取河北医科大学第一医院2016年6月-2018年6月收治的符合纳入标准的90例急性冠脉综合征患者,采用随机数字表法分为观察组(n=45)及对照组(n=45)。两组患者术前均常规给予口服阿司匹林100 mg、氯吡格雷300 mg及静脉输注普通肝素(80 IU/kg)等药物治疗。观察组术前给予阿托伐他汀40 mg(立普妥20 mg/片,辉瑞)口服,对照组术前给予安慰剂100 mg(维生素C片剂)口服。两组术后口服阿托伐他汀(20 mg/d),疗程3个月。患者出院后随访1年。结果两组术前血清总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平差异无统计学意义(P<0.05)。两组患者术后7 d血脂水平较术前及术后第1天明显下降(P<0.05),且观察组显著低于对照组(P<0.05)。两组患者术前超敏C反应蛋白(hs-CRP)水平差异无统计学意义(P=0.898),两组患者术后1 d hs-CRP水平较术前均显著增高,但组间差异无统计学意义(P=0.135),术后7 d hs-CRP水平明显低于术后1 d(P=0.000),观察组明显低于对照组(P=0.000)。两组术前cTnI和CK-MB水平差异无统计学意义(P<0.05),术后1 d cTnI和CK-MB水平明显高于术前(P=0.000),但两组间差异无统计学意义(P<0.05),术后7 d cTnI和CK-MB水平较术后1 d显著下降(P=0.000),且观察组显著低于对照组(P=0.000)。观察组总不良心血管事件发生率低于对照组,差异有统计学意义(P=0.01)。结论阿托伐他汀预处理可有效降低患者的血脂和cTnI、CK-MB水平,降低不良心血管事件发生率。
