Afectación de nódulo sinusal secundario a hiperkalemia manejo en emergencia: Reporte de Caso
Reporte de caso
DOI:
https://doi.org/10.69825/cienec.v7i32.340Abstract
La disfunción del nódulo sinusal (ENS) es una causa importante de bradicardia sintomática en pacientes de edad avanzada. La hiperpotasemia grave, al alterar el potencial de membrana del marcapasos cardíaco, puede desencadenar bloqueo sinoauricular agudo. Presentamos el caso de una mujer de 81 años con ENS secundaria a hiperkalemia, cuyo manejo urgente logró revertir la bradicardia y permitió planificar un tratamiento definitivo. grave y la eficacia de un protocolo hipokalemiante en urgencias. Asimismo, resalta la importancia de un enfoque multidisciplinario y de planificar la colocación de marcapasos en ENS crónica para prevenir recurrencias y mejorar la calidad de vida en pacientes geriátricos. La rápida identificación de la hiperkalemia como factor reversible de disfunción sinusal y la aplicación puntual de un protocolo hipokalemiante (gluconato de calcio, insulina–dextrosa y salbutamol) permitieron la normalización del ritmo cardíaco y la corrección del potasio sérico en pocas horas. No obstante, dada la ENS crónica y la edad avanzada de la paciente, la derivación para implante de marcapasos definitivo se establece como medida esencial para prevenir recurrencias y mejorar su pronóstico a largo plazo.
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