K+ and Mg2+ Dyshomeostasis in Acute Hyperadrenergic Stressor States

Abstract Acute stressor states are linked to neurohormonal activation which includes the adrenergic nervous system. Elevations in circulating epinephrine and norepinephrine unmask an interdependency that exists between K+ and Mg2+ based on their regulation of a large number of Mg2+ -dependent Na/K A...

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Bibliographic Details
Published in:The American journal of the medical sciences 2017-05, Vol.353 (5), p.422-424
Main Authors: Nayyar, Mannu, MD, Yusuf, Jawwad, MD, Khan, M. Usman, MD, Weber, Karl T., MD
Format: Article
Language:English
Subjects:
Arrhythmias
Catecholamines
Internal Medicine
Magnesium
Potassium
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Summary:Abstract Acute stressor states are linked to neurohormonal activation which includes the adrenergic nervous system. Elevations in circulating epinephrine and norepinephrine unmask an interdependency that exists between K+ and Mg2+ based on their regulation of a large number of Mg2+ -dependent Na/K ATPase pumps present in skeletal muscle. The hyperadrenergic state accounts for a sudden translocation of cations into muscle with the rapid appearance of hypokalemia and hypomagnesemia. The resultant hypokalemia and hypomagnesemia will cause a delay in myocardial repolarization and electrocardiographic QTc prolongation raising the propensity for supra- and ventricular arrhythmias. In this review, we focus on the interdependency between K+ and Mg2+ which is clinically relevant to acute hyperadrenergic stressor states found in patients admitted to intensive care units.
ISSN:0002-9629
1538-2990
DOI:10.1016/j.amjms.2017.01.001