Compartment Syndrome and Rhabdomyolysis Presenting with the Rare Pseudo-Infarction Pattern of Hyperkalemia

Richard Pescatore^1, , Mark Robidoux¹, Robert Cole², Brett Waldman³ and Catherine Ginty¹

¹Department of Emergency Medicine, Cooper University Hospital, Camden, NJ USA

²Department of Critical Care Medicine, Cooper University Hospital, Camden, NJ USA

³Department of Cardiology, Cooper University Hospital, Camden, NJ USA

Cite this paper:
Richard Pescatore, Mark Robidoux, Robert Cole, Brett Waldman and Catherine Ginty. Compartment Syndrome and Rhabdomyolysis Presenting with the Rare Pseudo-Infarction Pattern of Hyperkalemia. American Journal of Medical Case Reports. 2014; 2(12):262-265. doi: 10.12691/ajmcr-2-12-1

Abstract

The rapid identification and treatment of patients with ST-segment elevation myocardial infarction (STEMI) is a priority for emergency department providers. Occasionally conditions other than acute coronary syndrome (ACS) can mimic the presence of ST-elevation on electrocardiogram (ECG), making the accurate identification of these patients challenging. We present a case in which severe metabolic derangements resulted in a rare pseudo-STEMI pattern on ECG. A 26 year old male was found at home by family after a reported fall. A pre-hospital ECG conducted by EMS personnel indicated STEMI and the cardiac catheterization team was activated prior to patient arrival. Before undergoing PCI, laboratory values revealed severe hyperkalemia and rhabdomyolysis. Treatment of the patient’s hyperkalemia resulted in resolution of ECG abnormalities. The patient later developed acute compartment syndrome and underwent emergent fasciotomy. This case demonstrates the rare pseudo-infarction pattern of hyperkalemia and underscores the importance of clinical context in the initial evaluation of the emergency patient.

Keywords:
hyperkalemia Psuedo-Infarction Emergency Medicine compartment syndrome rhabdomyolysis myocardial infarction

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