Which treatment is effective for cardiac abnormalities due to hyperkalemia?

Calcium gluconate is an effective treatment for cardiac abnormalities associated with hyperkalemia because it stabilizes the myocardial cell membrane, reducing the risk of cardiac arrhythmias. Hyperkalemia increases the extracellular potassium concentration, which can lead to dangerous effects on the heart, including changes in resting membrane potential and increased excitability. Calcium acts to antagonize these effects by counteracting the influence of potassium on the heart.

When calcium gluconate is administered, it helps to protect the heart muscle cells by restoring more normal electrical activity and minimizing the risk of life-threatening rhythms, such as ventricular fibrillation. It does not lower serum potassium levels but is crucial in the acute management of cardiac complications while other treatments are initiated to actually reduce the overall potassium levels in the patient.

Other treatments listed, such as bicarbonate, may help shift potassium into cells but are primarily used in specific contexts like severe acidosis. Kayexalate (sodium polystyrene sulfonate) can help lower potassium in the long term but works more slowly. Dialysis is effective for rapidly removing potassium when there is severe hyperkalemia or when other treatments fail, but it is not immediately useful in stabilizing the heart during acute emergencies.