Tag: hyperk

STEMI and Hyperkalaemia

Hyperkalaemia can mimic STEMI, but true coronary occlusion and hyperkalaemia may coexist. The challenge is to recognise the ECG abnormalities, confirm potassium rapidly, treat life-threatening hyperkalaemia and avoid delaying reperfusion.

The key principle is parallel management: investigate and treat hyperkalaemia while activating the primary PCI pathway when acute coronary occlusion remains a credible diagnosis.

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Hyperkalaemia

Remember: is it a haemolysed blood sample? (you can do an iSTAT)

Severity

  • Mild: 5.5-5.9mmol/l – No urgent action required (Dietary & Medication modification & GP F/U)
  • Moderate: 6.0-6.4mmol/l – Follow treatment guide (maybe suitable for discharge)
  • Severe: ≥6.5mmol/l OR ECG changes – Follow treatment guide, must admit

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