Acute Management of Patients with Arrhythmias and Non-cardiac Diseases: Metabolite Disorders and Ion Disturbances

• Published in: The Arrhythmic Patient in the Emergency Department pp. 129 - 150
• Main Authors: Bardari, Stefano, D’Agata, Biancamaria, Sinagra, Gianfranco
• Format: Book Chapter
• Language: English
• Published: Switzerland Springer International Publishing AG 2016; Springer; Springer International Publishing
• Subjects: Accident & emergency medicine; Cardiothoracic surgery; Cardiovascular medicine; Electrolyte Abnormality; Intraventricular Conduction Delay; Ionise Calcium Level; Serum Potassium; Serum Potassium Level
• ISBN: 3319243268; 9783319243269
• DOI: 10.1007/978-3-319-24328-3_9

Acute metabolic disorders are relatively common amongst medical and surgical patients, especially in the critically ill. Whilst increasing the complexity of management plans, these circumstances also increase the risk of cardiac complications, such as arrhythmias, and furthermore are associated with increased mortality. Arrhythmic risk is promoted by electrolyte, acid-base and fluid balance disturbance, increased sympathetic drive and cardiac ischaemia. Particularly, electrolyte abnormalities may generate or facilitate clinical arrhythmias, even in the setting of normal cardiac tissue, by modulating ion conduction across (specific) cardiac cell membrane channels [1], and management of the underlying pathology may be all that is required to allow rapid normalisation of the metabolic profile. Moreover, complex pharmacological regimes may exacerbate the situation [2].