Abstract

Hyperkalemia is a commonly encountered electrolyte abnormality that can significantly alter normal cardiac conduction. Potentially lethal dysrhythmias associated with hyperkalemia include complete heart block and Mobitz type II second-degree atrioventricular (AV) block. We report a case of trifascicular block, due to hyperkalemia. The patient's symptoms and electrocardiogram (ECG) evidence of trifascicular block resolved with lowering of serum potassium levels, with subsequent ECG showing left anterior hemiblock. This paper highlights an infrequently reported dysrhythmia associated with hyperkalemia that emergency physicians should be familiar with.  

Key words:  Hyperkalemia, trifascicular block, right bundle branch block, left anterior fascicular block, first degree AV block, isoprenaline, hemodialysis, emergency.

Abbreviation

Abbreviations: AV, Atrioventricular; ECG, electrocardiogram; MLB, maharani laxmi bai; RBBB, right bundle branch block; LAFB, left anterior fascicular block; ABG,arterial blood gas; TLC, total leucocyte count; DLC, differential leucocyte count;CPK- MB, creatine phosphokinase.