[Malignant arrhythmias caused by hyperkalemia: a new area of drug-induced electrolyte abnormalities].

INTRODUCTION

High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor.

PATIENTS: Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias.

CONCLUSIONS

The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.