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Hyperkalemia

Hyperkalemia

Fri, 12/16/2016 - 18:57 -- Dawn

This ECG is from a 57-year-old woman with extreme weakness.  We do not know her medical history or complete lab results, except that her serum potassium level was 8.8 mEq/liter at the time of this ECG.  

ECG Basics: Sinus Tachycardia, Peaked T Waves, and Baseline Artifact

Sun, 03/13/2016 - 21:45 -- Dawn

This strip offers several good teaching opportunities.  If it were a 12-lead ECG, no doubt it would be a bonanza!  First, there is sinus tachycardia at a rate of about 138 per minute.  The P waves are all alike and regular.  The T waves are tall and narrow, with a sharp peak.  This is often a transient sign of hyperkalemia, and should be investigated with serum electrolyte tests and with a 12-lead ECG.  In addition, the baseline shows a wandering type of artifact.

Hyperkalemia

Sun, 08/23/2015 - 14:06 -- Dawn

This ECG was obtained from a patient who had a serum potassium level of 7.4 mEq/L.  It shows some of the earliest ECG signs of hyperkalemia.  There are tall, sharply-peaked T waves in many leads.  The P waves have not yet widened and lost amplitude, but they will soon flatten out and disappear.

Hyperkalemia

Sat, 07/26/2014 - 22:29 -- Dawn

This ECG was obtained from a patient who was suffering from renal failure and had a serum potassium level of 6.8 mEq/L.  It shows some of the earliest ECG signs of hyperkalemia.  There are tall, sharply-peaked T waves in many leads.  There is an irregular, bradycardic rhythm.  We can just barely see P waves, but they will soon flatten out and disappear.  At this level of hyperkalemia, we can expect to see conduction disturbances and bradycardia.  Caution:  hyperkalemia can progress and become life-threatening very quickly.

Hyperkalemia in a DKA Patient

Sun, 05/04/2014 - 14:14 -- Dawn

For your collection, we present another interesting set of ECGs from Paramedic Erik Testerman.  They are from a 48 year old man who presented responsive only to painful stimuli, with deep, rapid (Kussmaul's) respirations.  His blood glucose in the field read as "HIGH" - too high for the glucometer to register a number.  He was treated with 3 large-bore IVs, 2 liters of NSS IV, O2.  At the hospital, his blood glucose again registered as "HIGH" on the glucometer, arterial O2 was 90%, CO2 15 (low), pH 6.8 (acidotic), HCO3 -2 (depleted).

ECG Challenge From Dr. Ahmed - Patient With Hyperkalemia

Fri, 07/26/2013 - 16:03 -- Dawn

This ECG was kindly donated to the ECG Guru website by Dr. Ahmed for open discussion among our members.  The patient was a 70+ year-old man who presented with a complaint of dizziness.  His serum potassium level was found to be 6.5 (normal is 3.5 - 5.0).  Upon correction of his K levels, his rhythm was atrial fibrillation at 130 / min.

WHAT DO YOU THINK ABOUT THIS INITIAL ECG?  What is causing the slow rate? Is there atrial activity?  Do you see QRS morphology changes?  What about the anterior ST and T wave changes? 

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