RESUMO
La hiperkalemia es una de las principales complicaciones potenciales del uso de drogas del tipo IECA, bloqueadores ARAII y antagonistas del receptor de aldosterona, en relación a su dosis, su eventual uso combinado y la función renal del paciente. A continuación se reporta el caso de un paciente de 71 años de edad, hipertenso y diabético que se encontraba en tratamiento con Enalapril 10 mg c/12 h y Furosemida 40 mg a/ 12 h, que sufre una bloqueo aurículo ventricular de 3º grado, secundario a una hiperkalemia de 8.53 mEq/l.
Assuntos
Humanos , Masculino , Idoso , Bloqueio Atrioventricular/etiologia , Enalapril/efeitos adversos , Espironolactona/efeitos adversos , Hiperpotassemia/complicações , Hiperpotassemia/induzido quimicamente , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Antagonistas de Receptores de Mineralocorticoides/efeitos adversos , Fatores de Risco , Furosemida/efeitos adversos , Hiperpotassemia/fisiopatologiaRESUMO
Calcium plays a central role in ventricular function. We report a 37 year-old woman with chronic hypoparathyroidism and hypocalcemia secondary to a thyroidectomy performed when she was 18 years old, as treatment for a Graves Basedow's disease. She did not have previous cardiac symptoms and rapid progressive congestive heart failure developed after the beginning of levothyroxin supplementation for post operative hypothyroidism. Echocardiography revealed severe systolic and diastolic left ventricular dysfunction, mitral and tricuspid valve insufficiency, systolic pulmonary hypertension, left atrial enlargement and pericardial effusion. Calcium supplementation in addition to diuretics, captopril and digoxin were followed by rapid clinical improvement. Follow up until 18 months showed persistent left ventricular dilatation and systolic dysfunction, with improvement of all the other ecocardiographic findings.