A female patient with hypokalaemia- induced J wave syndrome An unusual case report

作者:Wang, Aqian; Li, Xiang; Dookhun, Muhammad Nabeel; Zhang, Tiancheng; Xie, Ping*; Cao, Yunshan*
来源:Medicine, 2017, 96(38): e8098.
DOI:10.1097/MD.0000000000008098

摘要

Rationale: Prominent J waves can be seen in life-threatening cardiac arrhythmias such as Brugada syndrome, early repolarization syndrome, and ventricular fibrillation. We herein present an unusual case report of hypokalemia-induced J wave syndrome and ST (a part of ECG) segment elevation. @@@ Patients concerns: A 52-year-old woman with chief complaints of chest pain for 2hours and diarrhea showed a marked hypokalemia (2.8 mmol/L) and slightly elevated creatine kinase-MB (CK-MB) (57.5 U/L). The electrocardiographic (ECG) recording was normal upon admission and computed tomography (CT) aorta angiography excluded an aorta dissection. ECG done 17hours after admission showed ST segment elevation and elevated J wave in leads II, III and aVF, and fusion of T and U wave in all leads. @@@ Diagnosis: We first thought that the diagnosis of this patient was acute myocardial syndrome. @@@ Intervention: Potassium chloride and oflocaxin treatment was given to the patient. @@@ Outcomes: Laboratory test showed the level of serum potassium ion increased to 3.4mmol/L and CK-MB did not have any significant change. The infusion of potassium chloride-induced disappearance of the elevated J wave, although QT (a part of ECG) intervals were still longer than that upon admission. @@@ Lessons: This case tells us that hypokalaemia might induce J wave and elevated ST segments which should be distinguished from acute myocardial syndrome.