Causes and Clinical Features of Metabolic Alkalosis

Introduction

Metabolic alkalosis is a condition characterized by a higher-than-normal pH in the blood due to excess bicarbonate. It can have serious physiological effects, impacting various bodily systems.

Primary Causes: Excess Bicarbonate

Metabolic alkalosis occurs due to an increase in bicarbonate concentration, which can result from:

• Loss of hydrogen ions (H+) through vomiting or diuretic use
• Excessive ingestion or administration of bicarbonate compounds
• Renal dysfunction leading to impaired bicarbonate excretion

Clinical Features

Patients with metabolic alkalosis may exhibit the following symptoms:

• Muscle twitching and spasms
• Nausea and vomiting
• Confusion or altered mental status
• Hypoventilation due to respiratory compensation
• Arrhythmias resulting from electrolyte imbalances

Diagnosis and Treatment

Diagnosis typically involves blood tests measuring bicarbonate levels and arterial pH. Treatment approaches depend on the underlying cause and may include:

• Correction of electrolyte imbalances (potassium, chloride)
• Administration of acidifying agents if necessary
• Addressing root causes, such as stopping diuretics or treating renal impairment