![]() On the left upper corner of the above ECG, the heart rate is printed as 109/min. Resulting in false reporting of the heart rate. Sometimes pointed tall T waves may be sensed by the ECG software as another QRS complex (as in the above ECG), This ECG was recorded at a standard calibration of 10 mm/mV. Nodal rhythm with no preceding P waves and right bundle branch block are seen. Sharp, pointed T waves with narrow bases and relatively short QT interval should raise the suspicion of hyperkalemia. Her serum potassium level was measured as 8.0 mmol/L while her serum creatinine level was 2.1 mg/dL. (probably due to acute pulmonary embolism). The ECG above belongs to an 65 years-old woman with lung cancer, acute renal failure and right heart failure Some atrial extrasystoles with P waves are also seen.ĮCG 8a. Junctional beats do not have preceding P waves. It was recorded 30 seconds after the ECG 7a, but at a calibration of 20 mm/mV. This ECG is recorded at a standard calibration of 10 mm/mV. The ECG above belongs to an 84 years-old woman with chronic renal failure, hyperkalemia (6.9 mmol/L)Īnd coronary artery disease. The actual heart rate in this patient is 31/minute.ĮCG 7a. Which results in inadvertently doubling the heart rate as 62/minute. In the above ECG, many leads show QRS complexes and T waves with similar amplitudes.īecause of this, the ECG software counts QRS complexes and T waves as seperate QRS complexes, Hyperkalemia may result in tall, pointed T waves. This ECG was recorded at a standart calibration of 25 mm/second. QRS complexes are widened and the T waves in right precordial leads are relatively prominent. When the above ECG was recorded, her serum potassium level was measured as 8.6 mmol/L (hyperkalemia). Above is an ECG from a 75 years-old woman with hypertension, COPD, and chronic renal failure. Now the P wave amplitude in lead II is higher and the width of the QRS complex in anterior leads are lesser.ĮCG 6. The next day, her serum potassium level was decreased to 5.7 mmol/L and the above ECG was recorded. There is right bundle branch block, The amplitude of the P wave in lead II is diminished.ĮCG 5b. The ECG above belongs to an 85 years-old woman with mild aortic stenosis and a serum potassium level of 7 mmol/L. Precordial leads of the same patient is seen above.ĮCG 5a. The ECG is recorded at a paper speed of 50 mm/second, which has contributed to the wide appearance of the QRS complexes. ST segment is absent while the T waves are peaked. P waves are not seen, QRS complex is widened, The ECG above belongs to a patient with a serum potassium level of 8.9 mmol/L. Postdialysis serum levels of potassium is 4.6 mEq/L while calcium is 10.5 mg/dL.ĮCG 4a. The same patient's ECG after hemodialysis is seen above. Muazzez Isik has donated the above ECG to our website.ĮCG 3b. Serum potassium level was 9 mEq/L while serum calcium level was 7.8 mg/dL.ĮCG signs of both hyperkalemia and hypocalcemia are seen.ĭr. The ECG above belongs to a patient who refused to undergo hemodialysis for 10 days. The serum potassium level is 3.6 mEq/L.ĮCG 3a. The ECG of the same patient after hemodialysis. The pre-dialysis ECG of another patient with serum potassium level of 6.6 mEq/L.ĮCG 2b. Serum potassium level is 4.0 mEq/L.ĮCG 2a. ECG of the same patient immediately after hemodialysis. Serum potassium level is 7.1 mEq/L.ĮCG 1b. ECG of a chronic renal failure patient immediately before hemodialysis. Ĭhou's Electrocardiography in Clinical Practice. Hyperkalemia must be remembered in the differential diagnosis of wide-QRS tachycardia. Sinus tachycardia in a chronic renal failure patient with hyperkalemia may be erroneously diagnosed as ventricular tachycardia. Giant negative T waves (after treatment of hyperkalemia). Spontaneous conversion of atrial fibrillation įailure to observe these findings do not exclude the presence of hyperkalemia.īrugada-like electrocardiographic patterns The ECG findings of hyperkalemia have low sensitivity and low spesificity. Sharp, pointed T wave with a narrow base. P wave disappears or decreases in amplitude.
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