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Life-threatening arrhythmia caused by primary aldosteronism

Tomas Zelinka, Robert Holaj, Ondrej Petrak, Branislav Strauch, Mojmir Kasalicky, Tomas Hanus, Vojtech Melenovsky, Vlastimil Vancura, Marcela Burgelov√°, Jiri Widimsky jr.

Med Sci Monit 2009; 15(12): CS174-177

ID: 878266

Available online: 2009-12-01

Published: 2009-12-01

Background: Arrhythmias are one of the typical complications of primary aldosteronism (PA), is commonly characterized by hypertension and hypokalemia.
Material and Method: In this report, we present 3 cases of subjects in whom primary aldosteronism manifested with life-threatening arrhythmias. In 2 subjects, after excluding organic heart disease, an implantable cardioverter defibrillator was inserted and, only after the second episode of polymorphic ventricular tachycardia accompanied with low plasma potassium levels, the diagnosis of primary aldosteronism was made.
Conclusions: It is important to include diagnosis of primary aldosteronism in the diagnostic work-up of hypertensive subjects without any structural cardiovascular impairment who present with malignant arrhythmia and hypokalemia. Appropriate treatment of primary aldosteronism may avoid insertion of an implantable cardioverter defibrillator.

Keywords: Tachycardia, Ventricular - therapy, Hypokalemia - etiology, Hypertension - etiology, Hyperaldosteronism - diagnosis, Defibrillators, Implantable, Arrhythmias, Cardiac - therapy, Adult, Torsades de Pointes - therapy