16-coronary artery dominance + hypokalemia

pg 66-68

the artery that supplies the _________________ determine the coronary dominance

posterior descending artery

in 85% of the population, the ____________ gives off the PDA (_________ dominant)

right coronary artery… right

in 15% of the population, the ____________ gives off the PDA (_________ dominant)

left circumflex artery… left

__________&_________ + _________ on ecg → hypOkalemia

muscle weakness…cramps… U wave

important reason for hypokalemia

thiazide like diuretics (bendroflumethiazide)

loop diuretics (furosemide)

__________,___________,__________ → hyperkalemia

__________,___________→ hypokalemia

spionolactone, ARB(losartan), ACEi

loop diuretics, thiazide like diuretics

U wave (hypokalemia) - an additional wave after T wave

management of hypokalemia

• oral/IV K chloride (<2.5 then IV)

• stop the cause (furosemide or thiazide like diuretics)

causes of hypokalemia

• thiazide like diuretic

• loop diuretic

• vomit/diarrhoea

• villous adenoma

• renal tubular failure

• cushing syndrome

• conns disease (1ry hyperaldosteronism)

causes of hyperkalemia

• ARB

• ACEi

• K sparing diuretics (spironolactone, eplerenone)

• addison’s (primary adrenal insufficiency)

• CKD/acute renal failure

• congenital adrenal hyperplasia

____________ wave → hyperkalemia

____________ wave → hypokalemia

tall tented T

U wave

treatment of hyperkalemia

-IV calcium gluconate/ CaCl (protect cardiac membrane)

-insulin with dextrose/salbutamol inhalation (reduce K serum)