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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Voice by: Sue Stern.
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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

Пікірлер: 161

  • @Alilamedicalmedia
    @Alilamedicalmedia Жыл бұрын

    Love this video? Check out our ECG/EKG course made entirely with videos like this: Students, click here: www.alilaacademy.com/courses/ecg-ekg-for-students Teachers, click here: www.alilaacademy.com/courses/ecg-ekg-for-teachers

  • @Alilamedicalmedia
    @Alilamedicalmedia7 жыл бұрын

    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.

  • @marythecool
    @marythecool6 жыл бұрын

    The best explanation I've found on youtube! Thank you ❤

  • @Ani.DR.07
    @Ani.DR.077 жыл бұрын

    Finally after so many days I got the explaination of ECG PATHOPHYSIOLOGY IN HYPERKALEMIA.TY GUYS

  • @rakeshsamal2884

    @rakeshsamal2884

    5 жыл бұрын

    Aniket Nerlekar m

  • @mosalashupingjohnmolefe1627
    @mosalashupingjohnmolefe16275 жыл бұрын

    the best explanation of effects of Hyperkalemia ever

  • @travelfreak6901
    @travelfreak69014 жыл бұрын

    finally got a discernible explanation it's happy ;earning when we understand things tysm for providing that :))

  • @Alilamedicalmedia
    @Alilamedicalmedia7 жыл бұрын

    Follow us on Twitter twitter.com/AlilaMedical for instant notification of our new videos!

  • @swaruphange9770
    @swaruphange97707 жыл бұрын

    Good explanation ! Thanks !

  • @mercedesbenzjones6633
    @mercedesbenzjones66335 жыл бұрын

    thanks for clearing the concept

  • @stevencarrillo9285
    @stevencarrillo92853 жыл бұрын

    this was actually incredibly informative

  • @chikumbutsokaferapanjira8332
    @chikumbutsokaferapanjira83322 жыл бұрын

    This is fantastic expkaibation I never heard before, Keep it up

  • @susudiwa7101
    @susudiwa71012 жыл бұрын

    i think i understand this more! tysm as always☺️

  • @barkibhai7657
    @barkibhai76573 жыл бұрын

    thank you so muc,perfect explanation,perfect sound,100/100 marks

  • @manusharamanayake8142
    @manusharamanayake81422 жыл бұрын

    Thank you.. Finally I got the explanation im looking for

  • @leenababiker2078
    @leenababiker20784 жыл бұрын

    Thank you for the nice and clear explanation

  • @solomonromeci
    @solomonromeci Жыл бұрын

    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.

  • @MP3inoY
    @MP3inoY7 жыл бұрын

    amazing as always good job

  • @mbstewart
    @mbstewart2 жыл бұрын

    Simple. Fantastic!

  • @haseebali2164
    @haseebali21642 жыл бұрын

    Best ever explanation for hyperkalemia

  • @christophercasanova3664
    @christophercasanova36643 жыл бұрын

    In using insulin for the treatment of hyperkalemia, glucose must be added to prevent iatrogenic hypoglycemia.

  • @rashmisinghkuntia6657
    @rashmisinghkuntia66574 жыл бұрын

    Beautiful explanation, couldn’t have been better.

  • @ak27170
    @ak271704 жыл бұрын

    well explained ! Thank You

  • @raphaelwedd6204
    @raphaelwedd62043 жыл бұрын

    Excellent video!

  • @alaaali7534
    @alaaali75347 жыл бұрын

    your videos are awesome . good job

  • @jackoleenkashif9440
    @jackoleenkashif94406 жыл бұрын

    excellent presentatoin show ECG LEADS

  • @arslanijaz9629
    @arslanijaz96295 жыл бұрын

    Amazing explanation

  • @Tzushky1
    @Tzushky1 Жыл бұрын

    Yes. The best channel I have found in explaining EP . BEST WORK !

  • @Alilamedicalmedia

    @Alilamedicalmedia

    Жыл бұрын

    Great to hear!

  • @leonarda6529able
    @leonarda6529able5 жыл бұрын

    Great video for learnig. Thankyou

  • @safiyakamila7488
    @safiyakamila74885 жыл бұрын

    Very claire vidio and well explained.

  • @biomedsessions
    @biomedsessions2 жыл бұрын

    Love the visuals!

  • @emmath5226
    @emmath52262 жыл бұрын

    It took me SEVERAL attempts and i still don't nearly get the ekg graph but this is incredibly interesting and well explained

  • @dciresearch8281
    @dciresearch82815 жыл бұрын

    Excellent thank you.

  • @reginadias7134
    @reginadias71344 жыл бұрын

    The best explanation. thank

  • @nili224
    @nili2245 жыл бұрын

    may i know more deeply about how calcium infusion can reverse conduction abnormalities? thank you very much

  • @leighfountain1800
    @leighfountain18004 жыл бұрын

    This video gave me such an epiphany bless the heck out of you

  • @RahulGupta-sh7oj
    @RahulGupta-sh7oj5 жыл бұрын

    Yes....it was....amazing video ma'am

  • @amanuelmekibib
    @amanuelmekibib6 жыл бұрын

    good, thank you

  • @jackoleenkashif9440
    @jackoleenkashif94406 жыл бұрын

    excelllent presentation

  • @arjunsr1338
    @arjunsr13383 жыл бұрын

    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

  • @amrali2108
    @amrali21084 жыл бұрын

    Thx alot , finally undrrstood hyperkalemia effect on heart

  • @SuperYaniv12
    @SuperYaniv123 жыл бұрын

    Thank you so much!!!!

  • @sha1041
    @sha10412 жыл бұрын

    Excellent!!!!

  • @Mansmatters
    @Mansmatters7 ай бұрын

    Great educational video

  • @carlos01268
    @carlos012686 жыл бұрын

    Thank you.

  • @universalknowledge6478
    @universalknowledge64785 жыл бұрын

    Great explanation. Great effort. All the best!!!!!

  • @IncariStudio
    @IncariStudio5 жыл бұрын

    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

    @Alilamedicalmedia

    5 жыл бұрын

    Those subjects are on our list of videos to make, likely soon. Take good care of yourself!

  • @sunilp.2597
    @sunilp.25975 жыл бұрын

    Please make videos on test and clinical examination for central nervous system disorders

  • @Jayhughes2000
    @Jayhughes20004 жыл бұрын

    Great video but no mention in the use of salbutamol as a treatment for hyperkalaemia?

  • @Alilamedicalmedia
    @Alilamedicalmedia7 жыл бұрын

    Hypokalemia video is here now: kzread.info/dash/bejne/Y6Rlxa9_o8asaNY.html. Enjoy learning!

  • @RealQueenBowsette

    @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

    @Alilamedicalmedia

    7 жыл бұрын

    Great! Thanks for watching!

  • @JITJIMBO
    @JITJIMBO6 жыл бұрын

    videos on hyper and hypo sodium, magnesium and phosphorous would be good

  • @Ben-oi4gs
    @Ben-oi4gs5 жыл бұрын

    good thanks

  • @MeganMichelleTimeLapses
    @MeganMichelleTimeLapses5 жыл бұрын

    The EKG explanation was great thanks!!

  • @neciromar2484
    @neciromar24846 жыл бұрын

    great job thanks so halpful and very clear explanation .more similar video please

  • @x8slayerx8
    @x8slayerx84 жыл бұрын

    thank you!!!!

  • @PaedsSalim
    @PaedsSalim2 жыл бұрын

    Thanks ☺️

  • @shorifdsa
    @shorifdsa5 жыл бұрын

    Thanks

  • @savitadevi-to6hn
    @savitadevi-to6hn5 жыл бұрын

    Thankyou

  • @Alilamedicalmedia
    @Alilamedicalmedia Жыл бұрын

    Love this video? Check out our course “Anatomy and Physiology” made entirely with videos like this (without watermark): www.alilaacademy.com/courses/anatomy-and-physiology-for-teachers

  • @islamibrahim9901
    @islamibrahim99017 жыл бұрын

    amazing

  • @yaelamrani
    @yaelamrani6 жыл бұрын

    Thank you! the info was most helpful. please explain further more about the repolarization and why does the T wave raises respectively. thanks!

  • @Basharkhan23

    @Basharkhan23

    2 жыл бұрын

    Have you meet any answer of Your question I have the same qz?

  • @mioszstarczynski8413

    @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 :))

  • @SmartSam1
    @SmartSam12 жыл бұрын

    Thanks so much very well explained video. Please make a new video explaining boost of insulin in pancreas medically & or by diet & excercise. Thanks

  • @mayahfawaz5307
    @mayahfawaz53073 жыл бұрын

    ❤❤❤❤ thank you

  • @mateusfernandes7347
    @mateusfernandes73476 жыл бұрын

    Very good. Thank you very much, from Brazil!

  • @CalciumChloride4
    @CalciumChloride49 ай бұрын

    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.

  • @Basharkhan23
    @Basharkhan232 жыл бұрын

    Thanks it’s was really informative And tell me why T wave rise please?

  • @ShepherdsChapelonYT
    @ShepherdsChapelonYT3 жыл бұрын

    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

  • @ellios5734
    @ellios573410 ай бұрын

    can you guys PLEASE make more videos

  • @047-aparnadeepgupta6
    @047-aparnadeepgupta63 жыл бұрын

    Very nicely explained ☺️.

  • @simarwaraich8626
    @simarwaraich86266 жыл бұрын

    how absolute value of resting membrane potential rises with decrease in potassium gradient around myocardial cell

  • @aim2327
    @aim23277 жыл бұрын

    great explanation. can u pls do a video on acid base balance and renal system?

  • @Alilamedicalmedia

    @Alilamedicalmedia

    7 жыл бұрын

    It's on our list!

  • @iftikharkhan5659

    @iftikharkhan5659

    6 жыл бұрын

    Thnx for great knowledge

  • @burntcaramel164
    @burntcaramel1644 жыл бұрын

    this video saved my life. 4 years of nursing school and I still never understood it full till this day.

  • @gustavoo3886

    @gustavoo3886

    3 жыл бұрын

    are you 11 years old?

  • @burntcaramel164

    @burntcaramel164

    3 жыл бұрын

    @@gustavoo3886 why is it relevant?

  • @suvrajyotipatra7834

    @suvrajyotipatra7834

    2 жыл бұрын

    @@gustavoo3886 😂😂😂

  • @robertlyon6968
    @robertlyon69684 жыл бұрын

    I have been getting changes in feeling like muscle tightening one moment and there is a looseness in muscles

  • @Dr_Cardiologist_99
    @Dr_Cardiologist_995 жыл бұрын

    The Juice U came for 2:28

  • @hmohmo3209
    @hmohmo32097 жыл бұрын

    welcome back

  • @hinalpatel4377
    @hinalpatel43773 жыл бұрын

    How can ca+2 infusion helps in the treatment..?????

  • @atharvasamel5905
    @atharvasamel59055 жыл бұрын

    Do effect of hypercalcemia and hypercalcemia on heart

  • @C4LLI4
    @C4LLI42 жыл бұрын

    thank you so much for 3:10, nobody could explain it to me properly >.

  • @donnieraveling188
    @donnieraveling1882 жыл бұрын

    I am brand new to understanding what hyperkalemia is. This was so confusing.

  • @bhuvaneshwariravichandran8202
    @bhuvaneshwariravichandran82022 жыл бұрын

    Why do you get peaked T wave in hyperkalemia? Even if the potassium efflux is slower

  • @dstyles8913
    @dstyles89134 жыл бұрын

    So counter intuitive

  • @tigerkills3038
    @tigerkills30385 жыл бұрын

    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

  • @davidnasari6909
    @davidnasari69096 жыл бұрын

    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.?

  • @robertlyon6968
    @robertlyon69684 жыл бұрын

    Thankyou, if I mistake and take a 400mg. mg. How do i do control Why do i get the change s in feeling

  • @venkybly
    @venkybly Жыл бұрын

    Tq

  • @TorchFilms_
    @TorchFilms_3 жыл бұрын

    why is there less sodium channels available if the membrane potential Is too high?

  • @tabs_spaces
    @tabs_spaces6 жыл бұрын

    mechanism of action potential

  • @nilkanthasharmapoudel5700
    @nilkanthasharmapoudel57007 жыл бұрын

    ABOUT PROTEIN DISORDER

  • @harry2696
    @harry26968 ай бұрын

    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

  • @achmadsamjunanto6410
    @achmadsamjunanto64106 жыл бұрын

    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

    @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

    @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

    @Reemm-124

    2 жыл бұрын

    @@bhartibajaj8730 but why do sodium channels decrease when threshold increases ?

  • @Reemm-124
    @Reemm-1242 жыл бұрын

    But why do sodium channels decrease when threshold increases ?

  • @Mentalist7if
    @Mentalist7if6 жыл бұрын

    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

    @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.

  • @dianacardenas5401
    @dianacardenas54015 жыл бұрын

    Thanks for the video! But WHY does HyperK cause peaked T waves?

  • @nachiketpargaonkar8646

    @nachiketpargaonkar8646

    5 жыл бұрын

    I have same query!

  • @capnyoshi5679

    @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...

  • @inyeneakpan3612
    @inyeneakpan36125 жыл бұрын

    Please what do you mean by magnitude of potassium gradient is increased across the cell membrane? Thanks in anticipation

  • @Alilamedicalmedia

    @Alilamedicalmedia

    5 жыл бұрын

    Gradient = difference in potassium concentration between the inside and outside of the cell. Increased gradient = the difference is larger.

  • @TheHalcyonView
    @TheHalcyonView4 жыл бұрын

    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??

  • @hadierahnur8775
    @hadierahnur87755 жыл бұрын

    How ACEI n ARB cause hyperkalemia. Help plis

  • @ibrahimlawan8056

    @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.

  • @AndyJ658
    @AndyJ6586 жыл бұрын

    Too difficult for me. Damn.

  • @sayedkhan8162
    @sayedkhan81624 жыл бұрын

    can anyone make understand ?

  • @fasdglkads
    @fasdglkads5 жыл бұрын

    Why does increasing the extracellular K+ concentration make the membrane potential having a more positive value? Thanks

  • @benstevens13

    @benstevens13

    5 жыл бұрын

    The intracellular voltage becomes less negative in comparison to the more positive extracellular environment.

  • @poljakovaandrea2223

    @poljakovaandrea2223

    4 жыл бұрын

    @@benstevens13 how? when the + ions are increased extracellulary, the intracellular space becomes even more negative! can somebody explain, please?

  • @travelfreak6901

    @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

    @poljakovaandrea2223

    3 жыл бұрын

    @@travelfreak6901 Thanks! :)

  • @no8aelanee8a33
    @no8aelanee8a333 жыл бұрын

    why hyperkalemia causes inactivation of sodium channels?

  • @hikarichichioya
    @hikarichichioya5 жыл бұрын

    I understand that RMP is higher but I don’t understand why Its make T wave taller? Thank you.

  • @alio1057

    @alio1057

    5 жыл бұрын

    Pang keekee that’s hyperpolarization