Hyperaldosteronism and sudden cardiac death

Patients who present with significant hypokalemia (e.g., hypokalemia of <3.6 mEq/l with concomitant hypertension, or <3.0 mEq/L in a patient using diuretics) and malignant arrhythmias should be considered for correctable causes of chronic hypokalemia. Suspicion should be aroused when hypokalemia is documented despite usage of angiotensin converting enzyme inhibitors or potassium sparing diuretics. The 1.5% prevalence from a tertiary center ICD registry suggests that this pathology may be more frequent than expected.