Abstract

BackgroundHyperkalaemia in oleander (Nerium oleander) poisoning has been associated with a poor prognosis. Different electrocardiographic (ECG) presentations are possible because of vagotonia and hyperkalaemia.Methods/ResultsWe report a series of three cases of oleander poisoning in which ECG showed unusual hyperkalaemia features, such as bradyarrhythmia, sinoatrial block, atrioventricular block and junctional rhythm.ConclusionsIf arterial blood gas analysis or laboratory values indicate hyperkalaemia in oleander poisoning, the hyperkalaemia should be treated immediately, even if the ECG does not show typical hyperkalaemia features.LEARNING POINTSHyperkalaemia in oleander poisoning is associated with a poor prognosis.Hyperkalaemia should be treated aggressively in oleander poisoning even if the ECG does not show typical features, as mimics other conditions on ECG.

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