A Case of Thiazide-induced Hypokalemic Paralysis

We describe the case of a patient presenting with odd neurologic symptoms initially thought to represent somatization who was found to have critical hypokalemia manifesting as hypokalemic non-periodic paralysis. It was determined that the patient had baseline hypokalemia as a function of alcohol abuse, exacerbated by self overmedication with hydrochlorothiazide for elevated blood pressure readings at home. The diagnosis was suspected when an electrocardiogram was obtained demonstrating a pseudo-prolonged QT interval with ST depression, consistent with T-U wave fusion and a QU interval with an absent T wave.1 The patient received oral and intravenous potassium and magnesium supplementation with resolution of symptoms.

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Carvedilol and Pycnogenol® improve the function of diabetic hearts in rats

Acta Facultatis Pharmaceuticae Universitatis Comenianae ◽

10.2478/afpuc-2013-0019 ◽

2013 ◽

Vol 60 (2) ◽

pp. 15-21

Author(s):

Kráľová E. ◽

Jankyová S. ◽

Pekárik A. ◽

Čuboň J. ◽

Stankovičová T.

Keyword(s):

Blood Pressure ◽

Electrical Activity ◽

Qt Interval ◽

Heart Function ◽

Left Ventricular ◽

Biometric Parameters ◽

Haemodynamic Parameters ◽

Arterial Blood ◽

Prolonged Qt Interval ◽

Prolonged Qt

Abstract We observed the changes in electrical activity, biometric and haemodynamic parameters of hearts in animals with experimental diabetes mellitus (DM). As well the effect of carvedilol, PycnogenolR and its combination with carvedilol on DM heart function was tested. DM was induced by streptozotocin over three sequential days at a dose of 25 mg/kg body weight i.p. We started therapy by suspension of carvedilol, PycnogenolR and their combination for six weeks. Blood pressure was measured using tail cuff plethysmography. ECG, haemodynamic and biometric parameters were measured in isolated hearts perfused according to the Langendorff. DM rats had increased systolic arterial blood pressure, thicker free wall of left ventricle but weakened myocardial contractility compared with controls. In contrast to controls, electrophysiological parameters showed prolonged QT interval and increased incidence of dysrhythmias in DM rats. The PycnogenolR administration induced regression of left ventricular hypertrophy, improved left ventriculi contraction and increased coronary flow; however, it did not improve the electrical activity of the myocardium compared with DM ones. Carvedilol also reversed the myocardial remodelling, shortened the duration of QT interval and suppressed the incidence of dysrhythmias. The common combination of drugs improved biometric and haemodynamic parameters compared with DM animals, however, not so significantly as monotherapy. On the other hand, the combination of carvedilol and PycnogenolR significantly reduced the duration of the QT interval and shortened the incidence of dysrhythmias. We can conclude that the administration of PycnogenolR effectively improved haemodynamic parameters, and carvedilol affected biometric parameters and also electrical parameters in DM animals. We observed the marked synergic effect of the combination of both drugs on the electrical activity of myocardium. This combination shortened the most pathologically prolonged QT interval and reduced the number of dysrhythmias.

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Heart rate variability, t wave alteration and prolonged qt interval as markers of arrhythmogenesis in patients with sleep apnea syndrome and arterial hypertension

Sleep Medicine ◽

10.1016/j.sleep.2013.11.445 ◽

2013 ◽

Vol 14 ◽

pp. e188

Author(s):

S. Lypovetska

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Arterial Hypertension ◽

Qt Interval ◽

Sleep Apnea Syndrome ◽

T Wave ◽

Prolonged Qt Interval ◽

Prolonged Qt ◽

Apnea Syndrome

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Reduced baroreflex sensitivity and pulmonary dysfunction in alcoholic cirrhosis: effect of hyperoxia

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00078.2010 ◽

2010 ◽

Vol 299 (3) ◽

pp. G784-G790 ◽

Cited By ~ 7

Author(s):

Søren Møller ◽

Jens S. Iversen ◽

Aleksander Krag ◽

Peter Bie ◽

Andreas Kjær ◽

...

Keyword(s):

Blood Pressure ◽

Qt Interval ◽

Baroreflex Sensitivity ◽

Arterial Oxygen ◽

Pulmonary Dysfunction ◽

Oxygen Inhalation ◽

Arterial Blood ◽

Cirrhotic Patients ◽

Prolonged Qt Interval ◽

Prolonged Qt

Patients with cirrhosis exhibit impaired regulation of the arterial blood pressure, reduced baroreflex sensitivity (BRS), and prolonged QT interval. In addition, a considerable number of patients have a pulmonary dysfunction with hypoxemia, impaired lung diffusing capacity (DlCO), and presence of hepatopulmonary syndrome (HPS). BRS is reduced at exposure to chronic hypoxia such as during sojourn in high altitudes. In this study, we assessed the relation of BRS to pulmonary dysfunction and cardiovascular characteristics and the effects of hyperoxia. Forty-three patients with cirrhosis and 12 healthy matched controls underwent hemodynamic and pulmonary investigations. BRS was assessed by cross-spectral analysis of variabilities between blood pressure and heart rate time series. A 100% oxygen test was performed with the assessment of arterial oxygen tensions (PaO2) and alveolar-arterial oxygen gradient. Baseline BRS was significantly reduced in the cirrhotic patients compared with the controls (4.7 ± 0.8 vs. 10.3 ± 2.0 ms/mmHg; P < 0.001). The frequency-corrected QT interval was significantly prolonged in the cirrhotic patients ( P < 0.05). There was no significant difference in BRS according to presence of HPS, PaO2, DlCO, or Child-Turcotte score, but BRS correlated with metabolic and hemodynamic characteristics. After 100% oxygen inhalation, BRS and the QT interval remained unchanged in the cirrhotic patients. In conclusion, BRS is significantly reduced in patients with cirrhosis compared with controls, but it is unrelated to the degree of pulmonary dysfunction and portal hypertension. Acute hyperoxia does not significantly revert the low BRS or the prolonged QT interval in cirrhosis.

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