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Case Reports
. 2021 Jul 24;13(7):e16602.
doi: 10.7759/cureus.16602. eCollection 2021 Jul.

Transient Left Bundle Branch Block in the Setting of Hyperkalemia

Abida Naz  1 , Tikal Kansara  1 , Marco Ruiz Santillan  2 , Mohammad Saeed  1
Affiliations
Case Reports

Transient Left Bundle Branch Block in the Setting of Hyperkalemia

Abida Naz et al. Cureus. .

Abstract

Hyperkalemia is a potentially life-threatening condition that can lead to sudden cardiac death. We report a case of transient left bundle branch block (LBBB) pattern on an electrocardiogram (EKG) secondary to hyperkalemia in a patient with a history of end-stage renal disease. A 48-year-old female presented to the emergency department (ED) with chief complaints of weakness and shortness of breath after a missed hemodialysis session. A 12-lead EKG in the ED showed the LBBB pattern with left axis deviation, prolonged PR interval, and peaked T-waves in the precordial leads. The initial serum potassium level was 8.5 mEq/L. EKG changes resolved after correcting the serum potassium level.

Keywords: hemodialysis; hyperkalemia-induced ekg changes; left bundle branch block; myocardial infarction; severe hyperkalemia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial EKG.
First-degree atrioventricular block (PR: 222 ms), LBBB (QRS: 174 ms), and tall tented T-waves. EKG: electrocardiogram; LBBB: left bundle branch block
Figure 2
Figure 2. EKG after intravenous calcium gluconate.
EKG after calcium gluconate showed shortening of the PR interval (202 ms from 222 ms) and mild narrowing of the QRS complex (158 ms from 174 ms). EKG: electrocardiogram
Figure 3
Figure 3. EKG after hemodialysis showing normal sinus rhythm.
EKG: electrocardiogram
See this image and copyright information in PMC

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