Question

A patient who is a known case of hypertension on multiple anti-hypertensive medications came to OPD. His ECG finding is given below. Which of the following drugs is responsible for the ECG finding?

• A. Prazosin
• B. Metoprolol
• C. Hydrochlorothiazide
• D. Spironolactone

Answer 1

The Correct Option is D

To determine the drug responsible for the ECG finding, we need to understand how each anti-hypertensive medication can affect ECG readings. Spironolactone, the correct answer, is a potassium-sparing diuretic. Its primary function is to retain potassium in the body while promoting salt and water excretion. Elevated potassium levels, or hyperkalemia, can significantly alter ECG findings.
Here's how each drug affects ECGs:

1. Prazosin: It is an alpha-blocker and does not typically lead to significant ECG changes.
2. Metoprolol: This beta-blocker can cause bradycardia but does not usually affect ECG in a way that is unique for this context.
3. Hydrochlorothiazide: This diuretic can lead to hypokalemia, potentially causing ECG changes like U waves and prolonged QT intervals, which are not seen here.
4. Spironolactone: It can cause hyperkalemia (elevated potassium levels), leading to characteristic ECG changes such as peaked T waves.

Given these potential effects, the presence of ECG changes consistent with hyperkalemia, such as peaked T waves, suggests that Spironolactone is the drug responsible. Elevated potassium levels are a notable side effect of this medication and are well-documented to cause such ECG alterations.
Therefore, based on the provided options and the understanding of medication effects on ECG readings, Spironolactone is the most likely culprit. Always consider patients' history and medications when interpreting ECGs for potential drug-related causes.