1Post Graduate, Department of General Medicine, Sree Balaji Medical College, Chennai, India
2Associate Professor, Department of General Medicine, Sree Balaji Medical College, Chennai, India
3Assistant Professor, Department of General Medicine, Sree Balaji Medical College, Chennai, India
Background: Thiazide diuretics are widely prescribed antihypertensive agents but frequently cause electrolyte disturbances, particularly hypokalemia. Even mild potassium depletion may predispose patients to ventricular arrhythmias.
Objective: To describe three cases of ventricular arrhythmias associated with masked hypokalemia in patients receiving thiazide therapy and review diagnostic challenges.
Methods: Three patients with ventricular arrhythmias while on thiazide diuretics were analyzed. A PRISMA-based systematic literature review of studies published between 2023 and 2025 was also conducted.
Results: All patients presented with ventricular arrhythmias with potassium levels between 3.4–3.7 mEq/L. Electrolyte correction and discontinuation of thiazide therapy resolved arrhythmias.
Conclusion: Masked hypokalemia is an underrecognized cause of ventricular arrhythmias and requires careful electrolyte monitoring.
Keywords: Hypokalemia; Thiazide diuretics; Ventricular arrhythmia; Electrolyte disorders; Case series
How to cite this article: Amitesh S, Umashankar, Lakshmi A. Masked Hypokalemia–Induced Ventricular Arrhythmias in Patients Receiving Thiazide Diuretics: A Three Case Series and Systematic Review of Diagnostic Pitfalls. Int J Drug Deliv Technol. 2026;16(8s): 918-919; DOI: 10.25258/ijddt.16.8s.101
Source of support: Nil.
Conflict of interest: None