EFFECT OF CHANGES IN ELECTROLYTE CONCENTRATION ON HEART.pptx

EFFECT OF CHANGES IN ELECTROLYTE
CONCENTRATION ON HEART
Muralinath. E, Kalyan.C, Karthik Jayanth. Y,
Balaji. T.P, Sravani Pragna. K, Manjari.P,
Renuka. U, ShirishaD, Kranthi Kumar. M and
Gnaneshwar. R.S

• INTRODUCTION
• Distribution of electrolytes in extracellular fluid and intracellular fluid plays an
important role regarding the electrical activity of the tissues along with
myocardium. Thus, any change in the concentration of any electrolyte will alter
the electrical activity of cardiac muscle in a definite manner
• EFFECT OF CHANGES IN SODIUM ION CONCENTRATION
• Normal sodium ion concentration in blood is 135 to 145 mEq/L. Change in
concentration of sodium ion does not alter the electrical activity of heart in a
severe manner. Only the low level of sodium ion in body fluids decreases the
electrical activity of cardiac muscle and electrocardiogram (ECG) demonstrates
low-voltage waves.
• Changes in the concentration of potassium and calcium ions exhibit significant
effects on heart.

• EFFECT OF CHANGES IN POTASSIUM ION CONCENTRATION
• Normal potassium ion concentration in blood is approximately 3.5 to 5 mEq/L.
Changes in ECG occur if the potassium level enhances to 6 mEq/L
(hyperkalemia) or If it reduces to 2 mEq/L (hypokalemia)
• EFFECT OF HYPERKALEMIA
• Hyperkalemia reduces:
• 1. Resting membrane potential, resulting in hyperpolarization
• 2. Excitability of the muscle.
• Effects of hyperkalemia on the excitability of cardiac muscle, depend upon the
severity of hyperkalemia.

• Changes in ECG if Potassium Level enhances to 6 or 7 mEq/L
• T wave is tall and tented. P-R interval and QRS complex are normal.
• Changes in ECG if Potassium Level enhances to 8 mEq/L
• P-R interval and the duration of QRS complex are prolonged because,
hyperkalemia reduces the rate
• of conduction. P wave may be small.
• Changes in ECG When Potassium Level enhances beyond 9 mEq/L
• Severe hyperkalemia makes the atrial muscle unexcitable. So, P wave is absent in
ECG. QRS complex
• merges with T wave. This condition is fatal because, it results in ventricular
fibrillation or stoppage of heart in diastole, because of the lack of excitability.

• EFFECT OF HYPOKALEMIA
• Hypokalemia reduces the sensitivity of heart muscle.
• Changes in ECG if Potassium Level falls to 2 mEq/L
• 1. Depression of S-T segment.
• 2. T wave is small, flat or inverted
• 3. U wave appears. Sometimes, the U wave combines with T wave. Due to this, the Q-T
interval is
• mistaken for being prolonged.
• Changes in ECG if Potassium Level falls below 2 mEq/L
• 1. Depression of S-T segment below the isoelectric baseline
• 2. Inversion of T wave
• 3. Appearance of prominent U wave
• 4. Prolongation of P-R interval.

• EFFECT OF CHANGES IN CALCIUM ION CONCENTRATION
• Normal concentration of calcium ion in blood is approximately 9 to 11 mg/dL
(4.5 to 5.5 mEq/L). Mostly, hypocalcemia influences
• the heart, rather than hypercalcemia.
• EFFECT OF HYPERCALCEMIA
„
• Hypercalcemia is the elevation in blood calcium level. It enhances the
excitability and contractility of
• the heart muscle. In clinical conditions, the effect of hypercalcemia is very rare.

• Changes in ECG
• 1. Shortening of duration of S-T segment
• 2. Shortening of QT interval
• 3. Appearance of U wave.
• Calcium Rigor
• Stoppage of the heart in systole, because of hypercalcemia is termed as the
calcium rigor. It can be shownd in experimental animals by infusing large
quantity of calcium. Calcium rigor is a reversible phenomenon and the heart
begins functioning in a normal manner, if the calcium
• ions are washed.

• EFFECT OF HYPOCALCEMIA
• Hypocalcemia is the reduction in blood calcium level. It decreases the
excitability of the cardiac muscle.
• Changes in ECG
• 1. Prolongation of S-T segment
• 2. Prolongation of Q-T interval
• 3. Appearance of a prominent U wave.
• EXPERIMENTAL EVIDENCES
„
• Effects of ions on heart are demonstrated in an experimental manner by
perfusion of heart from animals such as frog as well as rabbit.

Fig. 1. Hypocalcemia - Pathology, causes, Symptoms and Treatment

Fig. 2. The effects of Hypocalcemia on Spatial Alterans

Fig. 3. Hypocalcemia - Induced slowing of Human
Sinus node Pacemaker

Fig. 4. Hypo calcemia - Illustrations

Fig. 5. Hypocalcemia and
Hypercalcemia

Fig. 6. An overview of Calcium and
Phosphorus metabolism

Fig. 8. Abnormal Ventricular Action
potential because of Hypocalcemia

Fig. 10. Hypokalemia - Causes
and Symptoms

Fig. 11. Hypokalemia - Induced Arrhythmias

Fig. 12. Hyperkalemia - Causes and
effects on heart

Fig. 13. Hypokalenia - Induced
Arrhythmias

Fig. 14. hypokalemia promotes
Arrhythmias

Fig. 15. Understanding Potassium
Deficiency

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the Patient With Cancer. Adv Chronic Kidney Dis. 2022 Mar;29(2):171-179.e1. [PubMed]
• 3.
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Physician. 2015 Sep 15;92(6):487-95. [PubMed]
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