Patient’s Problem

Mr. Dev (name changed to protect identity), 45 years old, developed four days of worsening weakness and night leg cramps, which soon made climbing stairs difficult. He also had fatigue, palpitations, constipation, and dizziness. He had doubled his hydrochlorothiazide dose on his own. With symptoms progressing, he was advised to consult a general physician in Vadodara.

Diagnosis

Based on his symptoms, physical examination, and lab findings, the doctor diagnosed moderate hypokalemia caused by excessive diuretic use.

Key findings included:

Physical Exam:
He appeared tired and mildly dehydrated, with a heart rate of 102 bpm. His leg strength was reduced, and his deep tendon reflexes were diminished.

Lab Tests:
His serum potassium was very low at 2.7 mEq/L (normal 3.5–5.0). Magnesium was also low, which can worsen potassium loss. Mild metabolic alkalosis was present, which often happens with diuretic overuse.

ECG:
Flattened T waves and prominent U waves were seen, classic signs of clinically significant hypokalemia.

These findings confirmed the diagnosis and guided the treatment plan.

Treatment

Mr. Dev was admitted for monitored correction of his electrolytes.

Potassium Replacement:
He was given oral potassium chloride in divided doses. The team planned for IV potassium if his symptoms or ECG changes worsened.

Magnesium Repletion:
Magnesium supplements were started, as potassium cannot be stabilized without correcting magnesium levels.

Medication Adjustment:
Hydrochlorothiazide was stopped immediately. A safer blood pressure plan will be considered after review by a general physician in Vadodara or one of the lady doctors in Vadodara at Shivaay Hospicare.

Supportive Care and Monitoring:
His electrolytes were checked every few hours, and ECG monitoring was continued to track any arrhythmias. He was also educated about the risks of changing medication doses without medical advice.

Women general surgeons and experienced physicians at the hospital ensured his condition was stabilized with timely care.

Result

Recovery is expected within 24–48 hours once potassium and magnesium levels are corrected. If ignored, hypokalemia can lead to serious issues like arrhythmias, severe muscle weakness, or even paralysis, making early treatment crucial.

Note: This case study is for illustrative purposes only and should not replace professional medical advice. If you have concerns about your health, please consult with a qualified healthcare provider.