Hyperkalemia: Causes, Effects on the Heart, Pathophysiology, Treatment, Animation.
How serum potassium levels affect resting membrane potential and cardiac action potential; ECG (EKG) changes in hyperkalemia. How hyperkalemia causes bradycardia. Electrolytes disorders
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Hyperkalemia refers to abnormally high levels of potassium in the blood. The ratio of INTRAcellular to EXTRAcellular potassium is important for generation of action potentials and is essential for normal functions of neurons, skeletal muscles and cardiac muscles. This is why potassium levels in the blood are strictly regulated within a narrow range between 3.5 and 5mmol/L. As the normal daily dietary intake of potassium varies widely and can be as much as 100mmol a day, the body must keep blood potassium levels within the normal limits. This is achieved by 2 mechanisms:
- Excretion of potassium through the kidneys and intestines
- Shifting of potassium from the extracellular fluid into the cells by the sodium/potassium pump. The pump is mainly regulated by hormones such as insulin and catecholamines.
Hyperkalemia is defined as a serum potassium concentration HIGHER than 5mmol/L. Hyperkalemia may result from decreased excretion, excessive intake, or shift of potassium from INSIDE the cells to EXTRA-cellular space. The most common scenario is a RENAL INsufficiency combined with excessive potassium supplements OR administration of certain drugs. Impaired kidney function is most prominent
Mild hyperkalemia is often without symptoms, some patients may develop muscle weakness. Slow or chronic increase in potassium levels is less dangerous, as the kidneys eventually adapt by excreting more potassium. Sudden onset and rapid progression of hyperkalemia can be fatal. Primary cause of mortality is the effect of potassium on cardiac functions. As potassium levels INcrease in the EXTRAcellular space, the MAGNITUDE of potassium gradient across the cell membrane is REDUCED, and so is the ABSOLUTE value of the resting membrane potential. Membrane voltage becomes less negative, moving closer to the threshold potential, making it EASIER to initiate an action potential. The effect this has on excitability of myocytes, however, is complex. While initial changes seem to increase myocyte excitability; further rise of potassium has the OPPOSITE effect. This is because the value of membrane potential at the onset of an action potential DETERMINES the number of voltage-gated sodium channels activated during depolarization. As this value becomes less negative in hyperkalemia, the number of available sodium channels DEcreases, resulting in a SLOWER influx of sodium and subsequently SLOWER impulse conduction.
ECG changes produced by hyperkalemia follow a typical pattern that correlates with serum potassium levels: peaked T-wave, P wave widens and flattens, PR interval lengthens, QRS complex widens and eventually blends with T-wave. Diagnosis on the basis of ECG alone very difficult. Acute hyperkalemia must be suspected in any patient having new bradycardia or conduction block, especially in those with renal problems.
Severe hyperkalemia is treated in 3 steps:
- Calcium infusion is given to rapidly REVERSE conduction abnormalities.
- Insulin to stimulate the sodium/potassium pump, promoting INTRA-cellular shift
- Hemodialysis to remove potassium
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The first part of this video is the same as the "hypokalemia" video. If you have watched our hypokalemia video, you may want to skip to 1:19.
The best explanation I've found on youtube! Thank you ❤
Finally after so many days I got the explaination of ECG PATHOPHYSIOLOGY IN HYPERKALEMIA.TY GUYS
@rakeshsamal2884
5 жыл бұрын
Aniket Nerlekar m
the best explanation of effects of Hyperkalemia ever
finally got a discernible explanation it's happy ;earning when we understand things tysm for providing that :))
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Good explanation ! Thanks !
thanks for clearing the concept
this was actually incredibly informative
This is fantastic expkaibation I never heard before, Keep it up
i think i understand this more! tysm as always☺️
thank you so muc,perfect explanation,perfect sound,100/100 marks
Thank you.. Finally I got the explanation im looking for
Thank you for the nice and clear explanation
Amazing wow totally makes sense and I cant believe that many people in the medical field doesn't even cross their mind orr had any idea that i could actually have this.. Thank you so much for the knowledge, keep up the great work and God bless you and yours.
amazing as always good job
Simple. Fantastic!
Best ever explanation for hyperkalemia
In using insulin for the treatment of hyperkalemia, glucose must be added to prevent iatrogenic hypoglycemia.
Beautiful explanation, couldn’t have been better.
well explained ! Thank You
Excellent video!
your videos are awesome . good job
excellent presentatoin show ECG LEADS
Amazing explanation
Yes. The best channel I have found in explaining EP . BEST WORK !
@Alilamedicalmedia
Жыл бұрын
Great to hear!
Great video for learnig. Thankyou
Very claire vidio and well explained.
Love the visuals!
It took me SEVERAL attempts and i still don't nearly get the ekg graph but this is incredibly interesting and well explained
Excellent thank you.
The best explanation. thank
may i know more deeply about how calcium infusion can reverse conduction abnormalities? thank you very much
This video gave me such an epiphany bless the heck out of you
Yes....it was....amazing video ma'am
good, thank you
excelllent presentation
Wowww superb ,very short but very sweet lecture.it will help all medical professionals.thank you.if possible do a vedios of pottasium Vs sodium in body how it's co related. Also hyperkalemia Vs hypokalemia
Thx alot , finally undrrstood hyperkalemia effect on heart
Thank you so much!!!!
Excellent!!!!
Great educational video
Thank you.
Great explanation. Great effort. All the best!!!!!
Thank you for this wonder animation explaining hyperkalemia. I was diagnosed with hyponatremia and seek to understand via an animation how low serum sodium (hypernatremia) impacts the body's electrolyte balance. An animation of the body's electrolyte balance including the sodium-potassium pump of the cell would be very helpful. It makes sense that too much water without salt can be very detrimental to the optimal function of the sodium-potassium cell. I would LOVE a series of animations to offer a comprehensive understanding of both hypernatremia and hyponatremia. PLUS, cause-effect symptoms and both clinical and alternative treatments.
@Alilamedicalmedia
5 жыл бұрын
Those subjects are on our list of videos to make, likely soon. Take good care of yourself!
Please make videos on test and clinical examination for central nervous system disorders
Great video but no mention in the use of salbutamol as a treatment for hyperkalaemia?
Hypokalemia video is here now: kzread.info/dash/bejne/Y6Rlxa9_o8asaNY.html. Enjoy learning!
@RealQueenBowsette
7 жыл бұрын
+Alila Medical Media thanks for the videos i am learning and getting smarter and i find the human body the most interesting thing ever
@Alilamedicalmedia
7 жыл бұрын
Great! Thanks for watching!
videos on hyper and hypo sodium, magnesium and phosphorous would be good
good thanks
The EKG explanation was great thanks!!
great job thanks so halpful and very clear explanation .more similar video please
thank you!!!!
Thanks ☺️
Thanks
Thankyou
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amazing
Thank you! the info was most helpful. please explain further more about the repolarization and why does the T wave raises respectively. thanks!
@Basharkhan23
2 жыл бұрын
Have you meet any answer of Your question I have the same qz?
@mioszstarczynski8413
2 жыл бұрын
"There appears to be a direct effect of elevated potassium on some of the potassium channels that increases their activity and speeds membrane repolarisation." You're welcome :))
Thanks so much very well explained video. Please make a new video explaining boost of insulin in pancreas medically & or by diet & excercise. Thanks
❤❤❤❤ thank you
Very good. Thank you very much, from Brazil!
Excellent video that talks about the RMP being raised due to the inhibition of efflux of potassium out of the cell. One addition, the Ca++ is giving to stabilize the cardiac membrane potential; however, Ca*+ stabilizes the membrane potential by raising the threshold potential. The raise in threshold potential counteracts the raised RMP, enabling activation of sodium channels to maintain influx of sodium intracellularly . Furthermore, treatment of insulin, usually 10 units, helps drive glucose and potassium intracellularly. This can cause iatrogenic hypoglycemia. The provider should administer glucose to supplement the effect of possible hypoglycemia.
Thanks it’s was really informative And tell me why T wave rise please?
I just had this it almost killed me when I went to the emergency room they gave me insulin a nebulizer and two IVs of fluid it worked in an hour I was out of there I thought they were going to have to keep me in the hospital but it was a quick treatment I quit taking potassium powder and just get what I need out of vegetables
can you guys PLEASE make more videos
Very nicely explained ☺️.
how absolute value of resting membrane potential rises with decrease in potassium gradient around myocardial cell
great explanation. can u pls do a video on acid base balance and renal system?
@Alilamedicalmedia
7 жыл бұрын
It's on our list!
@iftikharkhan5659
6 жыл бұрын
Thnx for great knowledge
this video saved my life. 4 years of nursing school and I still never understood it full till this day.
@gustavoo3886
3 жыл бұрын
are you 11 years old?
@burntcaramel164
3 жыл бұрын
@@gustavoo3886 why is it relevant?
@suvrajyotipatra7834
2 жыл бұрын
@@gustavoo3886 😂😂😂
I have been getting changes in feeling like muscle tightening one moment and there is a looseness in muscles
The Juice U came for 2:28
welcome back
How can ca+2 infusion helps in the treatment..?????
Do effect of hypercalcemia and hypercalcemia on heart
thank you so much for 3:10, nobody could explain it to me properly >.
I am brand new to understanding what hyperkalemia is. This was so confusing.
Why do you get peaked T wave in hyperkalemia? Even if the potassium efflux is slower
So counter intuitive
Mam which is the first mineral and vitamin to be depleted in hair cells during stress causing sudden graying of hairs is it sodium chloride iron or copper.or calcium
I've had irregular heart beat show up when put under in surgery for a unrelated procedure & after some investigation on potassium intake im a huge consumer of coconut water , bananas etc.high im potassium,is there a possibility this could be he cure.?
Thankyou, if I mistake and take a 400mg. mg. How do i do control Why do i get the change s in feeling
Tq
why is there less sodium channels available if the membrane potential Is too high?
mechanism of action potential
ABOUT PROTEIN DISORDER
I have been so freaking confused between Hyperkalemia and Hypokalemia and how they relate to Cardiac Arrest; correct me if I'm wrong, but I think it simplifies down to this: Hyperkalemia - the cell has difficulty contracting, Hypokalemia - the cell has difficulty relaxing
if the potassium was high at the ECF; and since potassium is a positive ion, should the ICF would be more negative thus increasing threshold?
@blkavalonnahc7536
6 жыл бұрын
Threshold Potential does not move, but the RMP moves up closer to Threshold Potential if there is decrease in electric gradient: less K+ leaks from ICF to ECF, more K+ in ICF leads to decrease value (-90mV to -65mV) of RMP.
@bhartibajaj8730
4 жыл бұрын
No it’s not about absolute values it’s about potential DIFFERENCE . RMP is the concentration gradient across the membrane. Suppose initially there were 100 k+ions inside and zero outside . The difference would be 100 making the rmp -100 mV . Now if 25 k+ ions move outside, only 75 remain inside making the difference 50 so rmp is now -50 mV which is closer to threshold potential. Hope this helps
@Reemm-124
2 жыл бұрын
@@bhartibajaj8730 but why do sodium channels decrease when threshold increases ?
But why do sodium channels decrease when threshold increases ?
How membrane potential becomes less negative when there is still the same amount of Kalium inside the cell and also same amaunt of negative charge. Should Hypercalemia outsuide of the cell contribute to positivity outside and thus increase potential difference from -90mv to maybe -120 mv and lead to hyperpolarization ?
@blkavalonnahc7536
6 жыл бұрын
Focus on the natural K+ leak channels. Less K+ leaks when hyperK in ECF (electric gradient is lessen). More K+ is retained in ICF that will move the RMP up closer to the AP threshold. Conversely, if hypoK+ occurs in ECF.
Thanks for the video! But WHY does HyperK cause peaked T waves?
@nachiketpargaonkar8646
5 жыл бұрын
I have same query!
@capnyoshi5679
5 жыл бұрын
The T waves show you the electrical signal when the cardiac myocytes are repolarizing. I know that you need the sodium/potassium pump to work to restore concentration gradients... maybe that's an easier job when you're not fighting as high a concentration gradient so it goes up more quickly? That's probably wrong, but that's how I remember it...
Please what do you mean by magnitude of potassium gradient is increased across the cell membrane? Thanks in anticipation
@Alilamedicalmedia
5 жыл бұрын
Gradient = difference in potassium concentration between the inside and outside of the cell. Increased gradient = the difference is larger.
I have a hypotetical question, if I persons has CKF and also COPD, would that further increase the levels of K+??? I mean, the kidneys can't remove K+, the lungs keep building up CO2 in the blood which would leade to imbalance in PH since the cells would start exchanging K+ outside the cell and taking H+ in as a compensatory mechanism to reach back the normal levels of PH and correct the acidosis. In short, respiratory acidosis could worsen the increase of extracelular K+??? And also suppose that the patient takes Inhibitors of ACE, wouldn't that further spike K+ and maybe become a life threatening critical point to the patient's heart??
How ACEI n ARB cause hyperkalemia. Help plis
@ibrahimlawan8056
5 жыл бұрын
Normally aldosterone leads to secretion of K+ in principal cells of DCT and Na+ reabsorption. So in adrenal insufficiency when we’ve less aldosterone secreted there’ll be buildup of K+ in the blood and therefore hyperkalemia. So any drug that decreases efficiency of aldosterone like ARBs, ACEIs, Renin inhibitors, K+-sparing diuretics, and selective aldosterone blockers will definitely leads to hyperkalemia.
Too difficult for me. Damn.
can anyone make understand ?
Why does increasing the extracellular K+ concentration make the membrane potential having a more positive value? Thanks
@benstevens13
5 жыл бұрын
The intracellular voltage becomes less negative in comparison to the more positive extracellular environment.
@poljakovaandrea2223
4 жыл бұрын
@@benstevens13 how? when the + ions are increased extracellulary, the intracellular space becomes even more negative! can somebody explain, please?
@travelfreak6901
4 жыл бұрын
@@poljakovaandrea2223 you know when the gradient of an ion increases across membrane its tendency to move to side with lower conc. increases, so when overall potassium increases in serum more than normal of it would percolate in the cell making inside of membrane less negative. I hope it helps :)
@poljakovaandrea2223
3 жыл бұрын
@@travelfreak6901 Thanks! :)
why hyperkalemia causes inactivation of sodium channels?
I understand that RMP is higher but I don’t understand why Its make T wave taller? Thank you.
@alio1057
5 жыл бұрын
Pang keekee that’s hyperpolarization