Differential diagnosis, investigations and treatment
In relation to the differential diagnosis of electrocardiographic
alterations caused by severe hypokalemia, certain pathologies with
similar electrocardiographic findings have been described5. These include:
- Myocardial ischemia: T-wave inversion and ST-segment depression, which
are characteristic of hypokalemia, may also be indicative of
myocardial ischemia.
- Hypocalcemia: QT interval
prolongation, which may occur in hypokalemia, may also be a sign of
hypocalcemia.
- Hypomagnesemia: Like hypokalemia, hypomagnesemia can cause arrhythmias
and QT interval prolongation.
- Use of certain medications: Some medications, such as antiarrhythmics,
tricyclic antidepressants, and antipsychotics, can cause
electrocardiographic alterations similar to those of hypokalemia.
After performing an exhaustive interrogatory and a complete laboratory
test, these conditions were ruled out in our case. Consequently, it is
crucial to keep in mind that, in addition to the ECG, the differential
diagnosis should always be supported by a thorough clinical evaluation
that includes the patient’s medical history, physical examination, and
laboratory results.