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And she does not know that this is an overdose; she thinks it is a patient with chestpain!! He was admitted to the ICU and was unstable, in shock, overnight. Case Continued: He was stabilized on more calcium, pressors, and high dose insulin. 3 hours later, this was recorded at a K of 2.8 mEq/L and total calcium of 14.7
He did not have chestpain. The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Chestpain in high risk patient. Here is his triage ECG: What do you think? See these other relevant cases: What are these bizarre bigeminal PVCs?? Is it STEMI?
He denied any chestpain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. They recommended repeating his ECG and awaiting troponin since the patient did not have any chestpain. He complained of generalized weakness and left lower extremity numbness. What is it? Activate the Cath Lab?
Upon arrival in the ICU, before getting Continuous Veno-Venous Hemodialysis (CVVHD), his potassium had risen again to 7.8 Hyperkalemia findings include the classic peaked T-waves, as well as the deadly B's of hyperkalemia: Broad (wide QRS), Brady (bradycardia), Blocks (AV blocks), and Bizarre. There is no ECG available from this time.
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