HYPOKALEMIA – INDUCED OUT-OF-HOSPITAL CARDIAC ARREST – CASE STUDY

Abstract

Life-threatening electrolyte abnormalities, such as sudden changes in serum potassium, cause or contribute to fatal cardiac consequences, including cardiac arrest. Here we present a case of a 57-year-old man with unrecognized hypokalaemia who experienced exercise-related out-of-hospital cardiac arrest (OHCA). Successful CPR was initiated immediately; however, he remained in a coma for four days. The patient had no other comorbidities except a history of mild hypertension treated with low doses of angiotensin receptor blocker (ARB) combined with thiazide. On admission: sinus heart rhythm 80 bpm, potassium level 2.8 mmol/l, Glasgow Coma Scale 3, blood pressure normal. Coronary angiography did not show any coronary occlusion. Other additional tests were nonspecific. Upon awakening, he had major confusion with severe memory deficits. A week later, he was able to walk and was discharged from the hospital. Seventeen months later, the patient still struggles with severe cognitive impairment, lack of motivation, muscle weakness, and fatigue. He requires special care, including supervision and help with activities of daily living. Although the exact cause of hypokalaemia remained unrecognized, several probable mechanisms were taken into consideration.