The resident and attending returned and talked to Cara and her mother. \"Cara, y
ID: 169387 • Letter: T
Question
The resident and attending returned and talked to Cara and her mother. "Cara, you are suffering from hyperkalemia, which means you have more potassium in your blood than normal. Two things happened to you today to create the perfect storm. First you ate a meal high in potassium and second you took a high dose of spironolactone. The drug blocks the action of a hormone in your body called aldosterone, which works to rid your body of excess potassium, exchanging it for sodium. Decreased aldosterone activity means the level of potassium in your blood increased while the level of sodium decreased. Also, the loss of sodium in your urine causes you to also lose water " "So I guess that's why it's a diuretic," interrupted Cara. "Exactly. The elevated potassium levels in the fluid around your cells is responsible for your heart arrhythmia, high heart rate and muscle cramps. I recommend staying away from potassium-rich foods like bananas and tomatoes." Usually I do; I only eat apples and oranges." "I also suggest taking acetaminophen instead of NSAIDs, like naproxen, as it is thought that there may be some drug interaction that further increases hyperkalemia. You have to be careful what you eat; your body is losing a lot of water and sodium so hydration is key when you are on spironolactone. I recommend that your diet consists of low potassium and high sodium meals as well as a lot of water or Gatorade, especially while you are training. This could have been a lot worse if you hadn't come in for treatment. Are there any concerns you would like to address?" asked the resident. "No. Thank you so much! I'll try to be more careful in the future," said Cara.Explanation / Answer
The pace marker for the heart located at the top of the heart's upper-right chamber (the right atrium).
Hyperkalemia may cause cardiac pacemaker malfunctioning due to a reduction of the electronegativity of the resting myocardial potential. Both sensing and capture mechanisms could be temporarily affected, with possible life-threatening effects. Calcium chloride may counteract almost immediately such a dangerous effect of hyperkalemia, restoring the normal pacemaker function.it causes abnormal rhythm of the heart beat.