Hi Toni. I reckon @VirginiaEdie Edith is the goal kicker for you. I’m so glad she joined us.
I’ll take this in sections as I am working on a project that needs to be done by tomorrow night.
The potassium dose and worsening heart palpitations is the part I’d like to tackle.
1000mg of potassium. I’ll go and search the standard dose… 1000mEq is the maximum dose and that is about 3900mg. So it doesn’t look like an overdose. But that is an average person dose. Most of these averages have been worked out on testing males. If you are replete in potassium from dietary sources adding an additional dose may have some effect. Sometimes it is laxative. Other times it is on the heart.
I know, from clinical practice, a patient’s heart can stop if a potassium dose is not well mixed into intravenous fluids and a higher concentration bolus runs in. Potassium is something to be very careful with, in my non-medical opinion. (I am not a doctor. I’m just interested in health).
https://www.mayoclinic.org/drugs-supplements/potassium-supplement-oral-route-parenteral-route/proper-use/drg-20070753
The other bit of information you provided is a resting heart rate in the 40s. That is very fit or possibly a bit slow? It’s likely fitness
But it’s at the low end of normal.
So, here is how I see the potassium episode played out. You have a low heart rate as a baseline. That varies with the palpitations. So you started supplementing extra electrolytes. That may have slowed the rate again (improvement noted).
However, if the heart rate is slow, to you it’s normal, and you have a normal beat (normal pQRST complex on ECG - electrocardiogram), then to achieve that slow rate there is usually an extended delay between the T wave and the next p wave for the next beat (the blips on the heart monitor screen).
It is in that extended period between beats where extra beats (ectopic beats) are likely to occur. Depending on which area of the heart contracts they, the extra ectopic beats, have different names e.g. PVC - premature ventricular contraction. We experience that phase of arrhythmia as palpitations as the beats vary in strength and frequency. Eventually those extra beats may flip the heart into fibrillation, usually atrial fibrillation (AF), where the contractions of the heart chambers lose rhythm and start pumping really fast.
So, if your baseline heart rate is ‘normal’ in the 40’s you will likely have to pay close attention to your electrolytes. And potassium’s effect of slowing the heart rate even further may make things worse, as you experienced.
From what you report the cardiologist says your heart structure and function is fine, so you have had the work up there. Did they comment on your observation of your normal expected heart rate? Not sure what tests you went through but you wore the monitor. Did they do any imaging?
Summary: Potassium dosing slows the heart. With an already slow heart rate the heart may respond with palpitations and extra beats, if the heart is slowed too much with a potassium dose. That may have been what you experienced on the day 2 doses of 500mg potassium was supplemented.
Thanks for the brain exercise. remember this is just a forum of ordinary people with a special interest. My suppositions may not reflect the truth of the matter. They are thought explorations. There is more to say and explore but I have to finish that work project.
I’m glad the few added carbs helped directly. Carbohydrate levels and women is another can of worms. By adding a few more carbs it probably helped your kidneys regulate the electrolytes by a slight increase in circulating insulin. But then there is some interesting notes by @anon81060937 about IGF1 - Insulin-like Growth Factor. Methinks insulin is very insulin like. Gah, I’ve got to stop now 