Blood provides the oxygen and nutrients cells need in order to survive. The heart is crucial for pumping blood to the lungs to bind oxygen and taking it out into the body. Heart disease has many causes, manifestations, and degrees of severity. Ultimately it is dangerous because it greatly limits the supply of blood and oxygen. The heart beats from electrical signaling that it generates from charged minerals known as electrolytes, such as potassium. As such, imbalances in potassium can lead to further problems with the heart.
Causes
In general, heart disease can be caused by infections, genetic problems, toxins, heart attacks, high blood pressure and other factors. As noted by "Harrison's Principles of Internal Medicine" by Anthony S. Fauci, high potassium can be caused by medications including some used for heart disease, hormone imbalances, kidney damage and the release of potassium from cells.
The two do not always occur independently. A possible scenario could be plaque blocking an artery in the heart, depriving part of the heart of blood and leading to the death of this area of heart muscle. The heart will not pump enough blood to the kidneys, which become damaged as a result and no longer adequately filter potassium from the blood. The levels rise and interfere with electrical conduction in the heart. (See Reference 1 and 2
Diagnosis
The diagnosis of heart problems and high potassium is made by a detailed medical history, physical exam, laboratory tests and subsequent specialized tests such as imaging. The history is divided a history of the present illness, and elucidates such symptoms as shortness of breath or difficulty with exertion. The past medical history includes other known diagnosis. Other elements include the past surgical history, medications, family history, social history which includes occupation and habits such as tobacco use, and a detailed review of symptoms.
Physical exam is focused on the heart and lungs but can include other areas of the body as well. A health care professional will look at the pattern and rate of breathing, take the heart rate and blood pressure, and listen to the heart and lungs.
Lab tests will likely entail blood and possibly urine tests.
Depending on these findings, at any point, specialized tests such as ECGs or X-rays may be performed.
Complications
The most feared complication of heart disease with high potassium is a rhythm disturbance of the heart. For example, the heart may pump much too quickly and in an uncoordinated fashion. If the heart is pumping too quickly, it does not have time to fill with blood and therefore does not provide enough blood to the organs. This can rapidly lead to a downward spiral, as the pressure the heart generates also provides blood to itself. Without enough blood provided to the organs, if mild a person may experience difficulty with exertion, if severe, unconsciousness within seconds and death within minutes.
Treatment
The treatment of heart disease depends on the cause. For example, invasive interventions may include using a small device on a wire that is threaded up to the heart through a small incision in the leg to remove a clot. Surgery may be undertaken to provide new blood vessels to the heart or repair a valve. Various medications are also available.
Immediate treatment for high blood potassium involves giving medications to oppose its negative effects on the heart and temporarily lower the level in the blood. Longer term medications can then be given if needed to keep the level of potassium low.
References
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci et al; 17th Ed 2008
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
