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ARTICLE |

Thiazide-lnduced Hypokalemia: Title and subTitle BreakAssociation With Acute Myocardial Infarction and Ventricular Fibrillation FREE

Martin Duke, MD
[+] Author Affiliations

Reprint requests to the Departments of Medicine and Cardiology, Manchester Memorial Hospital, 71 Haynes St, Manchester, CN 06040 (Dr Duke).


JAMA. 1978;239(1):43-45. doi:10.1001/jama.1978.03280280043024
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Ten of 59 patients (17%) were receiving a thiazide preparation at the time of an acute myocardial infarction and ventricular fibrillation. Hypokalemia was present in seven of eight patients (87%) receiving thiazides, whereas it was observed in only one of 38 patients (2.6%) not receiving these medications. If hypokalemia is present in patients receiving thiazides who have had an acute myocardial infarction, it should be corrected so as to remove this predisposing cause of ventricular fibrillation.

(JAMA 239:43-45,d 1978)

REFERENCES

MacConaill M:  Critical potassium concentration for the persistence of ventricular fibrillation . Rev Can Biol 27:361-363, 1968;.
Redleaf PD, Lerner IJ:  Thiazide-induced hypokalemia with associated major ventricular arrhythmias: Report of a case and comment on therapeutic use of bretylium . JAMA 206:1302-1304, 1968;.
Surawicz B:  Ventricular fibrillation . Am J Cardiol 28:268-287, 1971;.
Fisch C:  Relation of electrolyte disturbances to cardiac arrhythmias . Circulation 47:408-419, 1973;.
Curry P, Stubbs W, Fitchett D, et al:  Ventricular arrhythmias and hypokalemia . Lancet 2:231-233, 1976;.
 Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC), American Heart Association Committee on Cardiopulmonary Resuscitation and Emergency Cardiac Care . JAMA 227( (suppl) ):833-868, 1974;.
Leemhuis MP, Struyvenberg A:  Significance of hypokalemia due to diuretics . Neth J Med 16:18-28, 1973;.
Han J:  Mechanism of ventricular arrhythmias associated with myocardial infarction . Am J Cardiol 24:800-813, 1969;.
Daniell HW:  Arrhythmia in hypokalemia . N Engl J Med 284:1385, 1971;.
Logan RW, Murdoch WR:  Blood-levels of hydrocortisone, transaminases, and cholesterol after myocardial infarction . Lancet 2:521-524, 1966;.
Spurr GB, Liu CT:  Intra- and extracellular K+ concentrations of cardiac and skeletal muscle during acute respiratory acid-base alterations . Am J Med Sci 252:413-418, 1966;.
Kunin AS, Surawicz B, Sims EAH:  Decrease in serum potassium concentrations and appearance of cardiac arrhythmias during infusion of potassium with glucose in potassiumdepleted patients . N Engl J Med 266:228-233, 1962;.

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MacConaill M:  Critical potassium concentration for the persistence of ventricular fibrillation . Rev Can Biol 27:361-363, 1968;.
Redleaf PD, Lerner IJ:  Thiazide-induced hypokalemia with associated major ventricular arrhythmias: Report of a case and comment on therapeutic use of bretylium . JAMA 206:1302-1304, 1968;.
Surawicz B:  Ventricular fibrillation . Am J Cardiol 28:268-287, 1971;.
Fisch C:  Relation of electrolyte disturbances to cardiac arrhythmias . Circulation 47:408-419, 1973;.
Curry P, Stubbs W, Fitchett D, et al:  Ventricular arrhythmias and hypokalemia . Lancet 2:231-233, 1976;.
 Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC), American Heart Association Committee on Cardiopulmonary Resuscitation and Emergency Cardiac Care . JAMA 227( (suppl) ):833-868, 1974;.
Leemhuis MP, Struyvenberg A:  Significance of hypokalemia due to diuretics . Neth J Med 16:18-28, 1973;.
Han J:  Mechanism of ventricular arrhythmias associated with myocardial infarction . Am J Cardiol 24:800-813, 1969;.
Daniell HW:  Arrhythmia in hypokalemia . N Engl J Med 284:1385, 1971;.
Logan RW, Murdoch WR:  Blood-levels of hydrocortisone, transaminases, and cholesterol after myocardial infarction . Lancet 2:521-524, 1966;.
Spurr GB, Liu CT:  Intra- and extracellular K+ concentrations of cardiac and skeletal muscle during acute respiratory acid-base alterations . Am J Med Sci 252:413-418, 1966;.
Kunin AS, Surawicz B, Sims EAH:  Decrease in serum potassium concentrations and appearance of cardiac arrhythmias during infusion of potassium with glucose in potassiumdepleted patients . N Engl J Med 266:228-233, 1962;.
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