What are the symptoms of water and electrolyte imbalance

Water and electrolyte disorders often manifest as hypernatremia, hyponatremia, and hyperkalemia. These diseases and problems can easily have adverse effects on human health, leading to symptoms such as headaches, dizziness, nausea, vomiting, and chest tightness.

1. Hypernatremia

The clinical manifestations are atypical and fatigue may occur. Dry lips and tongue, loss of skin elasticity, irritability, and even mania, hallucinations, delirium and coma. Brain atrophy caused by hypernatremia may be followed by cerebral hemorrhage, subarachnoid hemorrhage, and even death.

2. Hyponatremia

Mild hyponatremia (serum sodium concentration 120-135mmol/L) may cause loss of taste and muscle aches; moderate hyponatremia (serum sodium concentration 115-120mmol/L) may cause headache, personality changes, nausea, vomiting, etc.; severe hyponatremia (serum sodium concentration <115mmol/L) may cause coma and loss of reflexes.

3. Hyperkalemia

It manifests in three aspects: ① Severe physical symptoms such as bradycardia, atrioventricular block and even sinus arrest. The electrocardiogram shows tall and sharp T waves. In severe cases, the PR interval is prolonged, the P wave disappears, the QRS wave widens, and eventually the heart stops beating. In the early stage, the blood pressure increases slightly, and in the later stage, the blood pressure decreases, and there are irregular breathing and arrhythmias. ② Neuromuscular symptoms manifest in the early stages as muscle pain and weakness, and when the symptoms are most severe in the extremities, respiratory muscle paralysis may occur. ③ Early manifestations of mental symptoms include apathy, slow response to the outside world, excitement, emotional instability, restlessness, etc. In severe cases, there will be impaired consciousness, drowsiness, coma, etc.

4. Hypokalemia

It is not only related to the concentration of serum potassium, but also closely related to the speed of hypokalemia. Therefore, in patients with slow onset, although hypokalemia is severe, the clinical symptoms may not be obvious. On the contrary, in patients with acute onset, although hypokalemia is not severe, the clinical symptoms may be very significant: ① Physical symptoms include lack of appetite, abdominal distension, thirst, nausea, vomiting, chest tightness, palpitations, and severe myocardial involvement, which can lead to heart failure. The initial electrocardiogram shows flat or absent T waves and the appearance of U waves. In severe cases, ventricular tachycardia, ventricular fibrillation or sudden death may occur. ② Neuromuscular symptoms are the most prominent symptoms of hypokalemia, and the important manifestations are decreased muscle strength and weakness in the limbs, flaccid paralysis and periodic paralysis. ③ Early manifestations of mental symptoms include fatigue, emotional indifference, memory loss, depression, and stupor. In severe cases, there may be impaired consciousness, drowsiness, delirium and even coma.

5. Hypercalcemia

Slow reaction, indifference to the outside world, emotional indifference and memory impairment; there may also be symptoms such as hallucinations, delusions, depression, etc.; in severe cases, there may be consciousness disorders such as drowsiness and coma.