Severe Hyperkalemia Masquerading as Acute Ischemic Stroke: A Case Report

Autor: Zahra Bahrami, Marzieh Salimi, Vahid Reza Ostovan
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Iranian Journal of Medical Sciences, Vol 47, Iss 6, Pp 608-611 (2022)
Druh dokumentu: article
ISSN: 0253-0716
1735-3688
DOI: 10.30476/ijms.2021.91382.2253
Popis: Severe hyperkalemia usually presents as cardiac or neurologic manifestations. We report a case of a 63-year-old Caucasian woman, who was admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) in August 2019. The patient suffered from left-sided weakness and slurred speech for one hour prior to admission. Initially, the patient was treated for acute ischemic stroke, and an intravenous recombinant tissue plasminogen activator (IV-rTPA) was prescribed. However, further investigations showed severe hyperkalemia. Hemiparesis and slurred speech improved significantly with appropriate management of hyperkalemia. To the best of our knowledge, this is the first case of hyperkalemia masquerading as acute ischemic stroke without evidence of concomitant central nervous system malignancies, large vessel atherosclerosis, or recreational drug abuse. Stroke mimics due to hyperkalemia should be considered in any patient with simultaneous sudden onset of focal neurologic deficits and tall peaked T waves, particularly in the context of renal failure and a history of potassium-sparing drug use.
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