Electrolyte and electrocardiographic changes in the course of hemodialysis
Identifieur interne : 005615 ( Main/Exploration ); précédent : 005614; suivant : 005616Electrolyte and electrocardiographic changes in the course of hemodialysis
Auteurs : Francesco Del Greco [États-Unis] ; Howard Grumer [États-Unis]Source :
- The American Journal of Cardiology [ 0002-9149 ] ; 1962.
Abstract
The electrocardiographic patterns associated with forty-six consecutive hemodialyses performed on twenty-one uremic patients were correlated with changes in plasma electrolytes. Electrocardiographic patterns resulting from organic heart disease frequently made interpretation of electolyte imbalance hazardous. Conversely, distortion of electrocardiographic patterns produced by electrolyte imbalance obscured patterns caused by underlying organic heart disease. Changes in the configuration of the T wave and RS-T segment constituted the majority of electrocardiographic abnormalities. The distortion of the RS-T segment in the predialysis tracings obscured established patterns of left ventricular hypertrophy and strain and of remote myocardial infarction.Arrhythmias were observed in six instances in five patients. In three, arrhythmias subsided spontaneously, while in three others, normal sinus mechanism was restored only after potassium was added to the dialysis rinsing fluid. The occurrence of arrhythmias in the course of hemodialysis emphasizes their probable chemical origin and indicates that the procedure may harm cardiac function.Although the electrocardiogram is of little value for assessing specific electrolyte disturbances in the uremic patient, it contributes greatly to the safe conduct of hemodialysis.
Url:
DOI: 10.1016/0002-9149(62)90096-6
Affiliations:
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<front><div type="abstract" xml:lang="en">The electrocardiographic patterns associated with forty-six consecutive hemodialyses performed on twenty-one uremic patients were correlated with changes in plasma electrolytes. Electrocardiographic patterns resulting from organic heart disease frequently made interpretation of electolyte imbalance hazardous. Conversely, distortion of electrocardiographic patterns produced by electrolyte imbalance obscured patterns caused by underlying organic heart disease. Changes in the configuration of the T wave and RS-T segment constituted the majority of electrocardiographic abnormalities. The distortion of the RS-T segment in the predialysis tracings obscured established patterns of left ventricular hypertrophy and strain and of remote myocardial infarction.Arrhythmias were observed in six instances in five patients. In three, arrhythmias subsided spontaneously, while in three others, normal sinus mechanism was restored only after potassium was added to the dialysis rinsing fluid. The occurrence of arrhythmias in the course of hemodialysis emphasizes their probable chemical origin and indicates that the procedure may harm cardiac function.Although the electrocardiogram is of little value for assessing specific electrolyte disturbances in the uremic patient, it contributes greatly to the safe conduct of hemodialysis.</div>
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