Introduction
Hyperkalemia is among the most common electrolyte
imbalances encountered in clinical practice, affecting up to
8% of hospitalized patients in the United States.1 The most
common causes are renal disease (encountered in 75% of
patients with severe hyperkalemia) and administration of
medications that elevate serum potassium levels (found in
67% of patients), including drugs often employed in
cardiovascular disease such as angiotensin-converting
enzyme inhibitors, angiotensin-receptor blockers and aldosterone
blocking agents. Often the origin of hyperkalemia is
multifactorial and the specific cause is never defined. Hyperkalemia
is known to have significant effects on electrical
impulse generation and propagation in the heart, with
conduction disturbances that may occur at various locations
in the specialized conduction system.