Cardiology Case Report: Missed Hemodialysis

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This cardiology case report from Brady Pregerson, MD, features a man in his mid-30s brought by ambulance after 3-4 days of peripheral edema and generalized weakness after a missed dialysis appointment. Can you determine the correct diagnosis?

History:

A patient in their mid-30’s with a history of hypertension, renal failure and CHF is brought to the hospital by rescue ambulance from home for peripheral edema and generalized weakness that has come on gradually over the past 3-4 days. He has missed dialysis at least twice and possibly more.

Exam:

Vital signs are normal. Physical exam is notable for anasarca but the lungs are clear.

An ECG is done:

Computer print out of a patient's ECG. | Credit: Brady Pregerson, MD

Computer Read: NSR at 63, IVCD, minimal ST depression, prolonged QT

What is the most likely cause of the ECG findings in this patient?


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