摘要Hyperkalemia is a life-threatening electrolyte disorder that often occurs in patients with chronic kidney disease (CKD) and in those using potassium-sparing diuretics.Hyperkalemia can destabilize myocardial conduction by reducing the resting membrane potential, leading to increased cardiac depolarization, myocardial excitability, and arrhythmias, which can promote progress to ventricular fibrillation and asystole.[1] These patients often present with non-specific symptoms, such as fatigue and inappetence, or even sudden death.Determining the need for emergency therapy or less aggressive treatment is largely based on the patient's electrophysiological presentation.In clinical settings, we need to differentiate hyperkalemia from hyperacute myocardial infarction, early repolarization, and pericarditis because of similarities in T-wave and ST-segment changes in the electrocardiogram (ECG).Here we present a case of hyperkalemia caused by amiloride, and discuss the ECG changes associated with an altered level of serum potassium.This case may help clinicians learn to recognize and manage patients with hyperkalemia.