Electrocardiographic Alterations Produced by a Decrease in Plasma pH, Bicarbonate and Sodium as Compared with those Produced by an Increase in Potassium

Abstract

The effects of a decrease in plasma pH, bicarbonate and sodium on the electrocardiographic pattern are compared with those produced by elevation of scrum potassium and lithium in the dog. The electrocardiographic alterations were found to be similar in form and progression. The alterations can be correlated with those found in isolated nerve and muscle preparations.

Electrocardiogram in Asiatic cholera. Separated studies of effects of hypovolaemia, acidosis, and potassium loss.

“…This conclusion is in agreement with that of recent studies during artifically-induced acidosis and alkalosis in human subjects (Reid et al, 1965). In previous studies interpreted as showing a pronounced effect of acid-base changes on T wave amplitude, it appears likely that the T wave changes were, in fact, due to concomitant alterations in plasma K (Abrams, Lewis, and Bellet, 1951;Magida and Roberts, 1953;Roberts and Magida, 1953). In the present study, in which cardiograms were recorded immediately after rapid infusion of alkali and before alterations in plasma K occurred, no changes resulted from marked increase in arterial pH.…”

Diabetic Keto Acidosis

“…[6][7][8][9] The following case of diabetic keto acidosis illustrates how therapy guided by electrocardiographic changes alone could have been dangerous since plasma hypokalemia was associated with electrocardiographic changes suggestive of potassium toxicity.…”

Lithium causing a serious sinus‐node dysfunction at therapeutic doses

“…On the other hand, lithium stops the action of the polypeptidic hormones (catecholamine, glucagon) (Ricciutti et al, 1971;Schou, 1957) by inhibiting the adenyl cyclase or by interfering with the CAMP action (Singer and Rotenberg, 1973). The cationic interferences (Carmeliet, 1964) of lithium occur not only with K' (Kusick, 1954;Roberts and Magida, 1953;Singer and Rotenberg, 1973) but also with Na' (Beauge, 1975;Stein et al, 1955) andCa2' (De Meis, 1971). The ionic and hormonal effects appear thus to be synergic in order to diminish the automatism and intracardiac conduction (Ricciutti et al, 197 1 ;Trautwein, 1963).…”